Tips & Techniques

Peeing Your Pants??

Ashley Dougvillo 
 • 
December 2, 2019

Incontinence (peeing your pants) is a well known but often under discussed topic. I am here to tell you that this is not something that should be your new "normal."

Let’s start with some fun facts:
● Incontinence affects around 25 million adults!

● A research study was done where 47 women were tested for pelvic floor effort with 60% showing effective effort and 40% showed ineffective effort.  Of that group, 25% of them displayed a technique that encouraged urinary incontinence. What this shows us is that exercise programs need to be monitored and catered to the woman’s individual needs, or else it can make the problem worse.

● There are different types of incontinence with the most common being:

  1. Stress
  2. Urge
  3. Mixed

The first step is to identify what could be causing the dysfunction and to implement an appropriate plan. Incontinence could be due to weakness, but it also can be due to the opposite, an overactive pelvic floor. Implementing a kegel program in that case, would actually contribute to more dysfunction. However, in the case that kegels are appropriate….what exactly are they?

A kegel is purposeful tightening of the pelvic floor. You can visualize it as squeezing your muscles in order to stop the flow of urine. Kegels should be specialized for each patient pathology. For example, if you have difficulty with endurance of the pelvic floor, the prescription for kegels at home would be different than somebody else that may have an issue with the strength of contraction. This is another reason why your pelvic floor should first be assessed by a professional.

In addition to proper exercise prescription, a well rounded nutrition and hydration plan are also important. Fluid intake should be half your body weight in fluids per day (with 60% of the ounces being water). For example, if a person weighs 200 pounds, they should be consuming 100 ounces of liquid per day with 60 of those ounces being pure water. We will also want to look to see whether the individual is consuming any bladder irritants. Unfortunately bladder irritants include some delicious treats: wine, tea, dark chocolate, etc. (Incontinence would not be purely caused by the consumption of these foods/drinks, however, they could be contributing to the incontinence indirectly.)

A good way for us to monitor this is for patients to keep a bladder diary for 2-3 days. With the bladder diary the individual would track their food/fluid intake, the number of voids/amount of voids, and any leakage/amount of leakage. This would help to paint a picture of what could be contributing factors to the incontinence.

Ultimately, incontinence is a complex and often frustrating occurrence that many females have to deal with daily. Treatment interventions should be catered to each individual woman, but ultimately there are options for recovery!

 

Meet the Author
Ashley Dougvillo joined Smith Physical Therapy and Running Academy in 2019. She graduated from Marquette University in Milwaukee, WI in 2008, receiving her Bachelor of Science degree with a concentration in Biomedical Sciences. She then went on to attend Northwestern University in Chicago, IL to complete her Doctorate of Physical Therapy in 2010. She is a Certified Manual Therapist and has additionally obtained specialty certifications in the Pose Method of running, kinesiotaping, FMS/SFMA, ASTYM, and Women's Health.
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