Urinary Incontinence: What research shows regarding behavioral therapy as first line of defense

Contrary to popular belief, urinary incontinence (UI) does not have to be a “normal” part of aging or a repercussion of bearing children. I can remember growing up and hearing my mom say “I pee a little when I sneeze/cough, but I’ve had three kids so that’s normal.” As I dive deeper into the profession, and successfully treat more patients with UI, it saddens my heart to hear “well that’s just normal”.

I have been a licensed physical therapist assistant since 2021, but just recently found a passion for pelvic floor physical therapy after having my son in 2022 and experiencing some pelvic floor dysfunction myself. 

Defining Urinary Incontinence

First, what is urinary incontinence? UI is a loss of bladder control. There are several different types of incontinence, but the most common type is stress urinary incontinence (SUI). This is when leakage occurs with activities that cause increased abdominal pressure such as coughing, sneezing, laughing, lifting something heavy, or during exercise. UI is very prevalent in the United States and affects approximately 60% of women. 

How Physical Therapy Helps Treat Urinary Incontinence

You may be thinking, how can physical therapy help the aforementioned issues? Behavioral therapies combined with pelvic floor muscle training (strengthening and/or relaxation) has proven extremely effective. Research shows that individuals that combine behavioral therapy with pelvic floor muscle training will likely spend less money on treatment than those who did not receive education on behavioral therapy. 

There are some fairly common behavior therapies that can be taught  in the initial stages of treatment. Some common educational interventions include, but are not limited to: anatomy & physiology of pelvic floor/micturition, normal void intervals, strategies to delay urgency and assist with bladder training, as well as common bladder irritants that may increase urgency/frequency.

If you are experiencing any type of urinary incontinence, please speak with your healthcare provider for a referral to a pelvic floor specialist in your area. This does not have to be your “normal!”

Brooke attended the physical therapy assistant program at Orangeburg-Calhoun Technical College after studying exercise science at the University of South Carolina, Aiken. She has been practicing as a Physical Therapy Assistant since 2021 and serves patients and clients both in ProActive’s aquatic therapy programs and at the clinic.

References

Pan, L. C., Datar, M., McKinney, J. L., Keyser, L. E., Goss, T. F., & Pulliam, S. J. (2022). Adherence to professional society guidelines among women with stress or mixed urinary incontinence. Neurourology and urodynamics, 41(6), 1489–1497. https://doi.org/10.1002/nau.24986