Incontinence in Women

Urinary incontinence is the accidental leakage of urine.

Life's events can weaken the pelvic muscles. Things such as pregnancy, childbirth, and being overweight can do it. One in three women who have ever had a baby wet themselves.

Pelvic floor muscles are just like other muscles. Exercise can make them stronger. Women with bladder control problems can regain control through pelvic muscle exercises, also called Kegel exercises.

Your hip bones are part of the pelvic area. At the bottom of the pelvis, several layers of muscle stretch between your legs. The muscles attach to the front, back, and sides of the pelvis bone.

Two pelvic muscles do most of the work. The biggest one stretches like a hammock. The other is shaped like a triangle. These muscles prevent the leaking of urine and stool. Bladder control exercises strengthen the muscles that hold the bladder and many other organs in place.

Finding the Right Muscles

This is very important!

For bladder control exercises, you should tighten the two major muscles that stretch across your pelvic floor. They are the "hammock" muscle, and the "triangle" muscle. Here are three methods to check for the correct muscles:

• Try to stop the flow of urine when you are sitting on the toilet. If you can do it, you are using the right muscles.
• Imagine that you are trying to stop passing gas. Squeeze the muscles you would use. If you sense a "pulling" feeling, those are the right muscles for pelvic exercises. 
• Lie down and put your finger inside your vagina. Squeeze as if you were trying to stop urine from coming out. If you feel tightness on your finger, you are squeezing the right pelvic muscle.

Pelvic Floor Muscle (Kegel) Exercises are designed to strengthen the muscles of the pelvic floor that support the bladder and close the sphincters. The general approach for practicing incontinence exercises is as follows:

Begin with empty bladder.

Start with gravity assisted positioning-Hips higher than the heart

Supported Bridge

Elbows/knees Position

CONTRACT-RELAX TECHNIQUE: Tighten the pelvic floor muscles as if attempting to stop urine flow or hold back gas. Hold for 3 to 5 seconds and relax for same length of time. Repeat 10 times. Breathe normally.

QUICK CONTRACTIONS:Repeat contractions of pelvic floor muscles while maintaining a normal breathing rate and keeping accessory muscles relaxed. Try 15 to 20 repetitions per set with coughing and sneezing.

ELEVATOR EXERCISES: Imagine riding in an elevator. As the elevator goes up from one floor to next,contracts the pelvic floor muscles a little more. As strength and awareness improves, add more floors to the sequence of the contraction. Relax the muscles as if descending one floor at a time.

Remember!!

• Performing Kegels with a full bladder can cause urinary tract infections & can further weaken the pelvic floor muscles.
• Don't squeeze other muscles at the same time. Be careful not to tighten your stomach, legs, or other muscles. Squeezing the wrong muscles can put more pressure on your bladder control muscles. Just squeeze the pelvic muscle.
• Breathe normally.

You can exercise while lying on the floor, sitting at a desk, or standing in the kitchen. Using all three positions makes the muscles strongest. As working against gravity is like adding more weight.

How to Protect the Pelvic Muscles

You can protect your pelvic muscles from more damage by bracing yourself.

Think ahead, just before sneezing, lifting, or jumping. Sudden pressure from such actions can hurt those pelvic muscles. Squeeze your pelvic muscles tightly and hold on until after you sneeze, lift, or jump.

After you train yourself to tighten the pelvic muscles for these moments, you will most likely have fewer accidents.

Be patient. Don't give up. It's just 5 minutes, three times a day. You may not feel your bladder control improve until after 3 to 6 weeks. Still, most women who do bladder control exercises notice an improvement after a few weeks.

Urinary Incontinence should not cause embarrassment. It is a medical problem, like arthritis and diabetes. There is a solution!


Looking for an Evidence? Here it is:
http://www.ahrq.gov/news/press/pr2012/muscleuipr.htm