Incontinence and Training The Pelvic Floor


Incontinence is a term that describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faecal or bowel incontinence).

Incontinence is a widespread condition that ranges in severity from ‘just a small leak’ to complete loss of bladder or bowel control.

In fact, over 3.8 million Australians have bladder or bowel control problems for a variety of reasons.

Incontinence can be treated and managed. In many cases it can also be cured.

Types of incontinence

Urge incontinence – Urge incontinence is a sudden and strong need to urinate.

Stress incontinence – Stress incontinence is the leaking of small amounts of urine during activities that increase pressure inside the abdomen and push down on the bladder. This occurs mainly in women and sometimes in men (most often as a result of prostate surgery).

Stress incontinence in women is often caused by pregnancy, childbirth and menopause. Pregnancy and childbirth can stretch and weaken the pelvic floor muscles that support the urethra causing stress incontinence during activities that push down on the bladder.

During menopause, oestrogen (a female hormone) is produced in lower quantities. Oestrogen helps to maintain the thickness of the urethra lining to keep the urethra sealed after passing urine (much like a washer seals water from leaking in a tap). As a result of this loss of oestrogen, some women experience stress incontinence during menopause.

Overflow incontinence – Overflow incontinence is when the bladder is unable to empty properly and frequent leakage of small amounts of urine occurs as a result.

Do you have a problem?

Most women consider their toilet habits “normal”. But are they?

  • Do you go to the toilet four to six times each day?
  • Do you sleep through or get up only once through the night?
  • Do you have dry pants at all times?
  • Do you pass 300-400 mls each time? – one coffee mug holds 250mls.
  • Do you pass water easily, without straining or stopping and starting?
  • Do you find urinating is painless and quite a comfortable thing to do?

If you answer “yes” to all these questions, you have NO problem and your urinary pattern is normal.

If you answered “no” to any of these questions then something in your waterworks is not quite right and you should take steps right now to help overcome these problems before they become worse.

Physiotherapy can help

Physiotherapists can help in a variety of ways to help you improve your bladder and bowel control.

If you are interested in improving your pelvic floor control, our physiotherapists can help in providing advice and strategies to improve your control in these muscles.

Tips that will help prevent and man- age poor bladder and bowel control

Increase your fibre intake

Increase your water intake

Your urine should be pale yellow to green in colour

Roughly 2 L of water a day

Activating and strengthening your pelvic floor

  1. as you breathe out, gently draw your pubic bone back towards your tail bone
  2. imagine a tail is attached to your coccyx. As you breathe out, slowly draw this ‘tail’ forwards and gently lift it up between your legs
  3. imagine you are stopping the flow of urine

Improve your posture—

Slumping shuts down your pelvic floor and core muscles. Regain control over your spine by retrain- ing yourself to sit and stand upright.

Try a new toilet position—

If your habit is to slump and strain, you are at risk of aggravating bladder incontinence.

  • Place your feet on a stool, resting forearms on thighs
  • Straighten your lower back
  • Open your knees and lean forward from your hips (keeping your chest up)
  • Breathe deeply and totally relax your abdomen forwards