Bladder problems are extremely common, with urinary incontinence (involuntary leakage of urine) being the most common of bladder conditions affecting women. In fact, as many as one in every three women suffers from incontinence and 90% of these women can get better with physiotherapy.

Although incontinence is common, particularly for women who have had children, it should never be accepted as "the norm". Symptoms may be infrequent at first, but left untreated, incontinence can be a problem that rules your life, affecting your confidence and emotional well-being.

What is ‘normal’ bladder function?

As urine is produced, it fills the bladder. Similar to a balloon, the bladder walls stretch to accommodate the increasing amount of fluid. Normally, as the bladder fills with urine, you will start to be aware of the sensation that you need to go to the toilet, but because the walls are stretching, you are able to hold on or defer emptying until an appropriate time and place. The muscles of the pelvic floor also play a role in assisting you to hold until you choose to empty your bladder.

It is often hard to know what is "normal" or "abnormal" when it comes to bladder habits. These questions may help.

  • Do you go to the toilet more than 4 to 6 times per day?
  • Do you need urinate more than 2 times per night?
  • Do you leak urine when you cough, sneeze, lift, laugh or with exercise?
  • When you pass urine, in there excessive stopping and starting of the urine flow?
  •  Do you feel an urgent need to empty your bladder?

 Answering "yes" to any of these questions may indicate that you may be suffering from a bladder problem. Even if your symptoms are mild, being pro-active to seek treatment now can help prevent your bladder control from becoming worse.

What causes incontinence?

There are a number of conditions that result in bladder leakage. These include:

Stress urinary incontinence (SUI): If you have stress incontinence, your bladder may leak when you cough, sneeze, laugh, lift, run or jump. A common cause is pelvic floor muscle weakness, particularly for women who have had children, or after menopause.

Over active bladder: If you have an overactive bladder, you may find you need to empty your bladder urgently and often, even when your bladder isn’t full. This can make leaving the house tricky, and you will likely know where all of the toilets are in your local shopping centre in case of a toileting emergency. An overactive bladder may also interfere with your sleep, causing you to wake frequently through the night.

Overflow Incontinence: This condition results in bladder leakage because the bladder fails to empty properly and overfills. Failure to empty may be because of an obstruction (e.g. scar tissue, constipation), or because the bladder muscle can’t work effectively enough to squeeze the urine out. There may be difficulty starting the flow, a weak stream, straining to empty, or a constant dribble.

Functional Incontinence: If you have functional incontinence, you may experience bladder leakage because of physical factors which prevent you from reaching the toilet in time.

What can I expect from a physiotherapy treatment program?

At Winmalee Women’s Health Physiotherapy, we have clinical expertise in the assessment and treatment of all types of urinary incontinence. Our treatment programs are individually tailored to your condition and are based on current research.

Physiotherapy is always carried out in a private treatment room; always with the same physiotherapist, providing sensitive, professional treatment. Your initial appointment will involve a thorough assessment, including questioning about your pelvic floor function and habits. This may be followed by an internal vaginal examination which enables assessment of any weakness, spasm or change to your pelvic floor muscles.

The goal of Physiotherapy is to teach you to regain control of your bladder. Treatment will always involve education, helping you to understand your condition and address lifestyle factors which can improve your bladder control.

Treatment is often focused around the pelvic floor muscles. You will be taught how to identify, tighten and use your pelvic floor muscles to prevent incontinence.

Other treatment modalities for bladder problems may include biofeedback to teach pelvic floor muscle control, bladder-retraining programs and urge suppression techniques. Nerve stimulation may also be used to help change the messages being sent to the brain via the urinary system.

Throughout treatment you are given support and encouragement as you begin to learn and use new techniques to gain control of your bladder.

A home exercise program will always be an important part of your treatment.