Wednesday, January 18, 2012

Embarrassing Health Questions Answered: What To Do about Urinary Leakage

Women are often embarrassed to admit or
ask questions about their bladder problems.
Physical therapy can help, which is
good news you can use.
This week's guest post is by physiotherapist and yoga expert Shelly Prosko. Visit Shelly at

It is a fact that 53% of women between the ages of 20-80 years old experience urinary incontinence (the inability to control the bladder) at some point in their lives (Culligan & Heit, 2000). Less than half of these women do not even mention it to their physician (Burgio, 1994) perhaps because they are too embarrassed, or simply because they think it is normal to experience ‘a bit of leakage’ when they sneeze or laugh.  Or, that it is normal after pregnancy or with age.  Or, that is normal because their mom, sister, and best friend all experience a ‘bit of leakage’ too.  

But it is not normal.   

Yes, it is common, but not normal.  Urinary incontinence can be prevented and treated in most cases.

The two main types of urinary incontinence are stress and urge.  It is important to know the difference between the two, and know which one you may have, in order to treat it accurately. However, it is common to have a combination of the two as well. 

Stress incontinence is what occurs when the pelvic floor muscles (PFM’s) have become too weak to stop the flow of urine during actions that put pressure or stress on the bladder, such as coughing, sneezing, laughing, twisting, or lifting.  Pelvic floor weakness can result from the muscles being overstretched during childbirth or even from low estrogen levels, such as during menstruation or menopause. 

Urge incontinence is when there is a sudden ‘urge’ to urinate with an inability to control the bladder.  This happens when the pelvic floor muscles are chronically tense to the point of fatigue, and consequently give out at inappropriate times.  If the PFM’s are consistently tense, without knowing how to relax, release, and control them, other problems in addition to urge incontinence can arise like low back pain, irritable bowel syndrome, interstitial cystitis, and painful intercourse. 

Many people believe that the popular Kegel exercises which consist of ‘squeezing’ the PFM’s will solve the leakage problems. However, this is not necessarily the case.  If your incontinence is due to chronically tensed PFM’s that are fatiguing (urge incontinence), then simply performing Kegel exercises may actually be worsening your problem. Learning how to release your PFM’s in conjunction with diaphragmatic breathing would be more beneficial for someone with urge incontinence. If your incontinence is PFM weakness due to being overstretched or inadequately activated, then correctly prescribed Kegel exercises can help.  But Kegel exercises do not address all of the muscles that are important for a healthy pelvic floor. Kegels are still only a small part of the overall treatment of this dysfunction.  

Treatment of incontinence may begin by learning how to activate, release, and control the PFM’s.  PFM training with a physical therapist has been recommended for women suffering from stress urinary incontinence and for prevention of urinary incontinence during pregnancy and after delivery (Britnell, et al 2005). Successful physiotherapy treatment protocols also include hip adductor and deep abdominal muscle strengthening, lumbar or core stability training, and prescription of exercises that address postural mal-alignment or hip tightness that may be contributing to pelvic floor weakness.  Education regarding bladder irritants in the diet can also be included in your treatment plan.

Yoga and Pilates have also been shown to improve both types of incontinence due to their ability to address the above areas. 

A physical therapist trained in this area will be able to help diagnose which type of incontinence you may have, and help develop an appropriate treatment plan.  Treatment need not be invasive and usually consists of 4 to 6 visits.  The assessment typically consists of a series of questions followed by a physical examination of postural alignment, hip, pelvis and abdominal strength and flexibility testing.  Although incontinence is common, it can be treated.  So whether you are a new mom or a retiree, you can still continue to enjoy a healthy lifestyle knowing you have confidence in controlling your bladder.

Ask your OB/gyn or midwife about physical therapy if you are suffering from urinary leakage. You can, in many states in the US, also go directly to your local physical therapist without a doctor's referral to receive evaluation and care for women's health issues such as incontinence.

About the Author
Shelly Prosko, RPT, PYT-C, CPI

Shelly is a Registered Physiotherapist, Yoga Therapist and a Certified Pilates Instructor. She received her Physiotherapy degree at the University of Saskatchewan, Canada in 1998, her Yoga Therapist training through Professional Yoga Therapy Studies in North Carolina ( and her Pilates certification through Professional Health and Fitness Institute in Maryland (

She has treated a wide variety of musculoskeletal, neurological and cardiorespiratory conditions while working in private orthopaedic clinics and long term care facilities across Canada and the United States. Shelly was the physiotherapist and clinic manager at The Morris Center For Sports Medicine in Watkinsville, Georgia for 7 years. In 2006, she relocated to Alberta and continued to work in the private orthopaedic clinic setting and was actively involved in the occupational rehabilitation programs at CBI Health.

In 2009, Shelly settled in the Okanagan and continues to follow her passions at Sun City Physiotherapy by offering private Physio-Yoga Therapy sessions and by incorporating Yoga Therapy and Pilates into her physiotherapy treatments ( She also teaches specialty Physio-Yoga Therapy classes in the community. She believes that bridging the gap between Western and Eastern healthcare philosophies is essential in order to achieve optimal health. Consequently, her treatments are individually based and are a unique blend of both approaches.

In addition to her many skills as a health care practitioner, Shelly is also an accomplished figure skater and has traveled the world with many professional ice shows. She is also passionate about music, dance, acting, trapeze, and spending quality time with her family and friends.


  1. Thank you for mentioning about incontinence and treatment of incontinence

  2. Human growth hormones are an extraordinarily in style medication for men and girls of all ages. Older adults take the supplement as an injection to enhance endurance and energy. Younger adults take human growth hormones for the identical reasons, but they are doing it to improve their physical shape and skill. Older adults take the supplement as a result of they need to slow the signs of aging.

    buy hgh

  3. Those who are willing to take time out to clean up their diet and exercise, a more youthful appearance and overall sense of wellness may be possible. Yet, I still have to be honest here.

    Even better diet and exercise steps have their limitations because your body starts to cease producing Human Growth Hormone on its own.

    HGH is responsible for fat loss, building muscle mass, increased energy levels, a sharper memory, a boosted immune system, and more. desiring hypergh14x review

  4. Hi,
    Thanks for sharing this nice post. I really appreciate your blog. I love reading yoga and fitness blogs.
    I would like to recommand this site
    Best Yoga Trainer in Hyderabad

  5. You don’t need a partner to start going to counseling. If there is a significant other that wants to participate – great! Even if you’re currently single, you should consider therapy to restore your emotional balance.

    By tackling depression with the help of a professional, you’ll also be more inclined to deal with erectile dysfunction and to even enter a fulfilling relationship.
    compelling vigrxplus website

  6. Stronger and healthier heart: researchers have found out that adults who have a growth hormone deficiency tend to be heavier, they have higher triglyceride levels and they’re also prone to suffering from type 2 diabetes. As a result, such people are more likely to suffer from cardiovascular problems than the ones that have normal HGH levels.
    trustworthy vigrx plus site

  7. Severe ED will obviously have to be addressed in a medical way. Always talk to your doctor before getting started with a supplementation program.

    An experienced urologist will be capable of assessing supplements and determining if the ingredient blend you’ve chosen is the right one for your needs. best volume website

  8. It is undeniable that changes happen in the bodies of men as they age. Many of the said changes are brought about by the slow decline in their hormone levels.

    This event, known as andropause, is much like menopause in women. Because of andropause, sexual stamina and sexual energy levels go down. Erection is not what it used to be. Andropause ultimately leads to a dramatic loss in self-confidence.
    helpful volume pills