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obesity increases urinary incontinence

Learn How Obesity Increases Urinary Incontinence and How Pelvic Floor Therapy Can Help

Urinary Incontinence is common, why suffer?

Urinary incontinence is the loss of bladder control. Urinary incontinence affects up to 1 in 3 women. The two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence (also called overactive bladder, or OAB). Incontinence affects twice as many women as men. This may be because pregnancy, childbirth, and menopause are contributing factors to urinary incontinence. Urinary incontinence should not be considered a normal part of aging, and it can be treated.

A new article published in September, 2018 by Lamerton, Torquati, & Brown found that being overweight (BMI 25-30) increased risk of urinary incontinence for young and middle aged by 35% and obesity (BMI ≥30) almost doubles the risk at 95%.

The findings of this study are important because those with urinary incontinence when young and middle aged adults are more likely to have worse symptoms when they are older. Another reason why the study is important is that weight, relative to factors like genetics, is a risk factor that can be controlled with diet and exercise.

What is urinary incontinence?

Urinary incontinence refers to the loss of urine, out of your control. There is actually more than one kind of urinary incontinence:

  • Stress Incontinence: leaking with activities like coughing, sneezing and jumping
  • Urge Incontinence: leakage associated with urgency: waiting for the restroom, putting the key in the door, fumbling with your pants, etc.
  • Mixed UI – a combination of stress and urge symptoms

How does weight affect urinary continence?

The findings of this study suggests that excess abdominal weight places increased pressure on the bladder and pelvic floor muscles. When the pelvic floor muscles have increased demand on them (holding your organs up), they can get weak, which can lead to urinary leakage.

What you can do to Prevent Urinary Incontinence

There are lots of factors besides weight that contribute to urinary incontinence. If you have any concerns regarding your pelvic health, it is always best to get a thorough evaluation from your doctors and a pelvic floor therapist (licensed physical therapist that specializes in pelvic health).

Here is a short list of things that can contribute to urinary incontinence:

  • Ingesting a lot of bladder irritants (alcohol, coffee, soda, citrus, tomatoes, chocolate, carbonated drinks, among others).
  • Drinking too much water, or not enough water. Chugging a quart of water in one sitting may overwhelm your bladder and create a strong sense of urgency. However, not drinking enough water will cause your urine to be too concentrated, which will irritate the bladder and contribute to leakage. Golden rule of thumb is to drink 64 oz of water a day (or more if it is hot or humid out, or your activity demands increase) and drink smaller amounts of water at a time. Try sipping throughout the day from a water bottle, or having a half glass of water every hour.
  • Medications including blood pressure drugs, heart medications, diuretics, muscle relaxants, antihistamines, sedatives and antidepressants can contribute to incontinence. If you are taking these medicines and develop issues with urination, see your doctor.
  • Weight. As we’ve been discussing in this article, excessive body weight can add pressure on your bladder and pelvic floor, resulting in leakage. Maintaining a healthy weight with activities, diet, and exercise may help with leakage.
  • Smoking. The nicotine in tobacco has been shown to irritate the muscle that controls the bladder (Wyman, Burgio, & Newman, 2009). Smokers are also likely to have a chronic cough which can create more pressure on the bladder and pelvic floor.
  • Constipation. As we’ve written about in the past, straining with bowel movements can damage the pelvic floor. Exercising, drinking enough water and eating high-fiber foods, such as lentils, beans, and fresh vegetables and fruit, might help improve constipation.
  • Weak pelvic floor muscles. Weakness in the pelvic floor can be due to the muscles being too tight or too weak and underactive. A pelvic floor therapist can help determine what is going on with your pelvic floor.

How Pelvic Floor Therapy Can Help

If you have urinary leakage, make an appointment with a pelvic floor therapist. Pelvic floor therapy can help figure out what overlapping issues are contributing to your urinary incontinence.

What does pelvic floor therapy look like?

The treatment modalities you will receive in pelvic floor therapy depend on your body and the issues present.
Some of the modalities used at Femina Physical Therapy for the treatment of urinary incontinence can include (but are not limited to):

  • Bladder and bowel habits including lifestyle modifications like optimal fluid intake and constipation management
  • Therapeutic exercise to strengthen the pelvic floor
  • Biofeedback training with intravaginal sensors
  • Electrical stimulation using the InTone device
  • Manual therapy to treat connective tissue dysfunction and myofascial trigger points
  • Visceral mobilization (gentle massage techniques that loosen internal adhesions and restore movement to the organs including the intestine, bladder, uterus, and ovaries) to reduce intra-abdominal pressure, improve motility, and organ function
  • Internal pelvic manual therapy to treat sensitive tissues, muscle spasms, trigger points, and muscle guarding that can contribute to urgency, frequency, and leakage
  • Training in self treatment techniques including correct form for pelvic floor strengthening and abdominal lymphatic massage
  • Neuromuscular re-education and autogenic relaxation to reduce chronic muscle over-activity and improve parasympathetic nervous system function, including reducing bladder spasms

Contact one of our Los Angeles area offices for more information. November is Bladder Health Awareness month and we will be posting articles all month on this important topic, so check back often or better yet join our mailing list so you don't miss out!

 

Resources

Lamerton, T. J., Torquati, L., & Brown, W. J. (2018). Overweight and obesity as major, modifiable risk factors for urinary incontinence in young to mid-aged women: a systematic review and meta-analysis. Obesity Reviews. doi:10.1111/obr.12756

Mayo Clinic. Bladder control: Lifestyle strategies ease problems. . Accessed 10/15/18 at https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/in-depth/bladder-control-problem/art-20046597

Wyman, J. F., Burgio, K. L., & Newman, D. K. (2009). Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence. International Journal of Clinical Practice, 63(8), 1177–1191. doi:10.1111/j.1742-1241.2009.02078.x 

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I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

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Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

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Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by Y.L. (mom of 2)

After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

Y.L. (mom of 2)

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

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Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

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