Your Health

Understanding and treating incontinence

Last month’s column on pelvic health received so much positive feedback that I’m following up with a look at a common, related topic: bladder leakage.

You sneeze, jump, laugh or cough, and suddenly you feel a small amount of urine leak out. Sound familiar? First, there is no need to be embarrassed. Bladder incontinence affects millions of women of all ages, especially pregnant and postpartum ones. A recent study revealed that more than 10 percent of women between the ages of 19 and 30 experience unintentional leaking of the bladder. Prevalence peaks around menopause, and it still remains a common problem among women over 60.

There are two main types of urinary incontinence:

• Urge incontinence: full emptying of the bladder before you can reach the bathroom room (you feel a sudden need to urinate but can’t control it).

• Stress incontinence: smaller emptying of the bladder due to the physical stress of movement.

Approximately 40 percent of people with urinary incontinence have both types.


Many factors influence whether you experience bladder leakage at some point in your life. We frequently see the following problems with female patients.

• Low bladder capacity. Being continent means you can hold your urine until you’re ready to use the toilet. But if your bladder can’t hold a lot of urine, it may release sooner and without your approval, so to speak.

• Weak and dysfunctional pelvic and core muscles. Pelvic floor and core muscles help hold your organs in place and, among other things, allow your urethra to close tightly. If any of your core muscles become weak and dysfunctional (often due to pregnancy, disuse, poor posture, genetics, etc.), then they may not be able to sufficiently keep the urethra closed in the face of abdominal pressure or movement.

• Body weight. Epidemiological evidence shows that obesity is a strong risk factor for urinary incontinence. We’re talking a 20-70 percent increased risk of bladder leakage with every five-unit increase on the body mass index scale. Theories as to why this happens include increased sustained pressure on the bladder and increased stretching of the pelvic floor muscles, which contributes to their dysfunction and weakening.

• Diet. Certain foods and beverages are known to irritate the bladder, including chocolate, carbonated drinks, citrus fruits and caffeine.


I don’t want women to believe that unintentional bladder leakage is a normal part of aging and/or motherhood. While it is common, it’s not something you just have to learn to live with. There are things you can do to resolve and prevent it.

• Seek professional help. Don’t assume that your incontinence will just fix itself over time. If anything, unresolved bladder leakage could get worse and increase your risk of chronic complications such as recurring urinary tract infections and pelvic organ prolapse. Consulting with a pelvic floor physical therapist is among the best investments you can make in your health.

• Learn and consistently do effective pelvic floor exercises. Again, this is something a pelvic floor professional can help you understand. There is so much more to resolving bladder incontinence than just Kegel exercises. An informed physical therapist can teach you a range of progressive exercises to ease symptoms and avoid recurring problems.

• Eliminate known bladder irritants from your diet, improve your posture and revitalize your whole-body (and mental) health. Bladder incontinence is often associated with other issues such as painful sex, back pain and poor body image, and any woman experiencing these problems deserves to be kind to herself and seek help if she wants it.

• Get a pelvic floor assessment. PhysioFit is passionate about empowering women to be advocates for their own health. If you’d like to connect with a pelvic floor physical therapist, call our clinic.

PhysioFit has scheduled a Love Your Pelvic Floor Workshop for women 6 p.m. Monday at our clinic, 1000 Fremont Ave., Los Altos. You will leave the workshop with more body awareness, a better understanding of how to prevent and treat pelvic floor disorders and a great starter workout to help you restore your core. All ages are welcome. To register, call 887-6046.

Kim Gladfelter is owner, physical therapist and Pilates instructor at PhysioFit Physical Therapy and Wellness. For more information, visit

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