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Physical Therapy for Urinary Incontinence

You don’t have to suffer from urinary incontinence.

Over 20 million people suffer with urinary incontinence. The majority of these are women and most of these women don’t even mention it to a health care provider for seven years. A recent study in the Annuals of Internal Medicine (May 2006) stated that a three question test could help clinicians diagnose two most common types of urinary incontinence. 


  1. Have you leaked urine in the last 3 months,
  2. When do you leak urine, and
  3. When do you leak urine to most?

Having a simple process that has proven to be highly sensitive to the correct diagnosis should enable women to be connected to the resources that are in the community to assist with the treatment of urinary incontinence.


Since treatment options are available, why do women take seven or more years to seek treatment? Many women think that urinary incontinence is an inevitable consequence of having children, but this assumption has been challenged by 2005 research findings in Obstetrics and Gynecology that show the correlation between urinary incontinence and vaginal birth is not a clear link. This study looked at the prevalence of urinary incontinence in post-menopausal sisters, one who had children and one who did not. The study found no significant difference in severity or type of urinary incontinence between the sisters. It did show a familial predisposition or genetic correlation. 


One thing is clear, if you leak urine, something is not working the way it’s supposed to. If you want to control your urinary incontinence, you first need to look at what’s causing the problem, and then take appropriate action. That’s why it’s important for women to understand how their bodies work so they can be active participants in decisions about their treatment. 


What are the types of urinary incontinence?

There are several types of urinary incontinence:

  • The type that has you racing to the bathroom to “beat your bladder” is known as urge incontinence. Another common name for this type of urinary incontinence is “overactive bladder.”
  • If you leak urine when you cough, sneeze or exercise, you’re suffering from stress incontinence.
  • If you suffer from both then you have what is called mixed incontinence. 
  • Functional incontinence is when you’re unable to get to the bathroom in time because of weakness or pain that impairs your ability to move.


Your bladder is a muscular organ that holds urine. During urination, muscles in the bladder contract or tighten to force urine out of the bladder, into a tube called the urethra, and then out of the body. When the bladder contracts, the muscles around the urethra relax and allow the urine pass through. Spinal nerves control how these muscles move and how your bladder contracts, and the muscles under voluntary control are known as pelvic floor muscles. These muscles are controlled by nerves coming from the sacral segments of your spinal cord. Your bladder, on the other hand, is controlled by nerves in the thoracic and lumbar region of your spine.


When everything is working properly, your body senses when the bladder is full, and you decide if it’s a convenient time to empty your bladder. If you’re hydrating properly, you should need to empty your bladder at regular intervals, but you should be able to wait for about three hours between voids. Your degree of urgency, or the message that you need to void, should match the volume in the bladder. In other words, if it’s a mild urge, then you should not have an overly full bladder. If your urge is very strong, you should not just have a small amount of urine. In addition, you should feel like your bladder is empty after urination, and you should not have to push or wait for your urine to start to flow once you sit on the toilet.


What causes urinary incontinence?

Urinary incontinence can be caused by a variety of issues:

  • Infection
  • Certain types of medical conditions or diseases, such as spinal stenosis, multiple sclerosis or diabetes
  • Hormonal changes (atrophic vaginitis)
  • Organ prolapse
  • Lack of strength and coordination of the pelvic floor muscles


Leakage associated with exercises or when you cough or sneeze occurs when the pressure exerted on the bladder overcomes the sphincter’s ability to prevent urine escaping, which could be related to a weakness or miscoordination of the sphincter muscles. Inappropriate urge, or urge incontinence, can be due, in part, to bad habits, but another possibility is due to nerves controlling the action of the bladder or sphincter muscles are not working properly.


Today, there are more treatment options available for urinary incontinence. Surgeries have been performed for many years, including a new approach that implants your own adult stem cells into the urethra. While effective in experiments, it is a costly procedure that is not available in the United States. Generally, the simplest and safest treatments should be tried first.


At Palmer Physical Therapy for Women, a female physical therapist will approach treatment of urinary incontinence by evaluating and identifying the nerve and muscle issues associated with urinary incontinence. If the nerves in your back are impaired due to chronic inflammation, it stands to reason that the muscles and organs they supply would not function normally either. By treating the source of the inflammation, such as limited spinal and hip motion, poor body mechanics and postural problems, you can set the stage for retraining and strengthening muscles.

Muscles in your pelvic floor are not the only weak muscles contributing to urinary incontinence. Abdominal muscles are a key player, too, and most people do not engage the deepest layer of abdominal muscles, the transverse abdominus, effectively. In addition to proper spine mobility, strong and coordinated core muscles, proper voiding habits also play a role in a healthy urinary system. By addressing all problems simultaneously, you are more likely to get the lasting results you want.


Taking care of your body requires information and assistance from those trained to help you identify and rectify the contributors to the problem, and, at Palmer Physical Therapy for Women, we can put together a simple and effective treatment for your urinary incontinence. 


Palmer Physical Therapy for Women

Physical Therapy for Exercise and Eating Disorders

12 February 2024
Are you or someone you know an “exercise junkie?” Do you worry about your weight, restrict your food and fluid intake, diet constantly or exercise excessively to avoid gaining weight? Has your menstrual cycle been disrupted, is it erratic or has it stopped altogether? Do you feel stressed or depressed? Have you resorted to taking diet pills and laxatives? Do you ever force yourself to vomit after eating? These are a few of the questions health professionals may ask if they suspect someone may be a victim of the female athlete triad, which includes disordered eating, amenorrhea and osteoporosis. Women and girls with this condition exhibit signs of pathogenic weight control and are at high risk for many medical problems. Eating Disorders Eating disorders span the spectrum from restrictive eating or avoiding certain foods to anorexia or bulimia. Disordered eating results in a negative energy balance, where more calories are being used than consumed. An electrolyte imbalance can occur, which can lead to dehydration, decreased thermal regulation, cardiovascular problems, poor healing and even sudden death. Most people have heard of anorexia nervosa, which is an eating disorder characterized by an intense fear of fatness, an abnormal body image, absent or disrupted periods and weight loss to less than 85 percent of normal. There may also be associated signs like low blood pressure, slow heart rate, dry skin and nails, hair loss or thinning and excessive fine hair on the sides of the face and arms. Bulimia nervosa is a related eating disorder characterized by recurrent bingeing and purging, two times a week or more. Associated signs may include enlarged salivary glands, periodontal disease, conjunctival bleeding and scars on the back of the hand from repetitive, forced vomiting. Statistics show that about one in every 100 women binges and purges to lose weight. Amenorrhea Menstrual dysfunction occurs in women and girls with disordered eating. Primary amenorrhea is a condition in which girls do not start their periods by age 16 when the usual sex characteristics are present or by age 14, if no other sex characteristics are present. Secondary amenorrhea is a condition in which the period is absent or irregular and is diagnosed in previously menstruating women when there is an absence of three consecutive periods, or less than two cycles per year. Athletic amenorrhea is a condition that falls under this secondary category and occurs when there is a combination of caloric restriction, excessive exercise, emotional stress and low body fat. Health Consequences Health consequences that may result from eating disorders and amenorrhea include osteoporosis, stress fractures, scoliosis, infertility and cardiovascular disease. Osteoporosis, in this instance, is a premature loss of bone in premenopausal women, an inadequate formation of bone or a combination of both. People at high risk of osteoporosis are likely to include women of slender build, those with low calcium intake, those with a family history and those of caucasian and Asian heritage. Female Athlete Triad When the eating disorders, amenorrhea and osteoporosis exist together, it may be diagnosed as the female athlete triad, which occurs most frequently in athletic women but can also affect non-athletic women and girls. The true prevalence is not known because it is often unreported or underdiagnosed. Prevention and treatment should include a multidisciplinary approach by physicians, dietitians, psychologists, physical therapists, nurses, coaches, athletic trainers, dentists and family. Appropriate history and education are the keys to recognition of the problem and prevention. Counseling and family support may help in determining the underlying cause, promoting a healthy body image, promoting healthy eating habits and addressing issues, such as stress, anxiety and depression. Proper exercise should be in an appropriate balance with the fuel consumed to achieve and maintain a healthy body and lifestyle. For more information regarding diet, nutrition, and exercise, please consult your physician, a nutritionist and a women’s health physical therapist. Ann Sundgren, PT Palmer Physical Therapy for Women

"Let's Get Physical" to address side effects of cancer treatment

12 February 2024
"After cancer diagnosis, many patients anticipate a treatment regimen that might include surgery, chemotherapy, targeted therapy, immunotherapy or radiation. But there's another type of treatment that can benefit people with cancer, and it's one that they don't always get - physical therapy. Physical therapy can help address side effects of cancer or its treatments, including pain, weakness, body changes and fatigue." "Many people being treated for cancer experience severe fatigue, which often tops lists of common side effects of both chemotherapy and radiation. Although it might seem counterintuitive, physical therapy can play a vital role in fighting fatigue." "You don't have to rehabilitate what you don't lose. Waiting for patients to lose function, and then give it back to them is not best practice. Our job is to keep you happy, healthy, and moving." "Patients often worry that they are not well enough for physical therapy, but people who try physical therapy don't get as sick, don't have as much pain, and tolerate chemotherapy and radiation better." From the winter 2018 edition of Cure magazine. Please follow the link for more information about the benefits of physical therapy during cancer treatment. https://www.curetoday.com/publications/cure/2018/winter-2018/lets-get-physical Research shows that physical activity during and/or after cancer treatment can help you minimize and overcome the effects of cancer treatment. At Palmer Physical Therapy for Women, our therapists are trained in oncology rehabilitation and will evaluate your pain, neuropathy, range of motion, tissue restriction, strength, endurance and balance. An individualized plan of care and exercise program will help you address any deficits and achieve your specific needs and goals. We are ready to help you get your quality of life back! Susan Palmer, PT

Nordic Walking

12 February 2024
Nordic Walking—What Is This New Craze? Popular in Europe for many years, Nordic Walking, also known as Urban Poling, is recently becoming an exciting exercise option here in the United States. To understand Nordic Walking better, envision cross-country skiing without the skis. There are many great benefits from Nordic Walking. Namely, there is 80% more muscle activation than traditional walking, with up to a 40% increase in calorie burning. Nordic Walking improves posture, gait pattern, and balance, while increasing core and upper body strength. Using the poles with walking significantly decreases stress on the back, hips, knees, ankles and feet, enabling those with painful or chronic conditions to tolerate and enjoy more physical activity. Working out with the Nordic poles helps to increase overall strength and endurance, which can carry over to other daily activities and enhance the quality of life. Weightbearing and resistance activity with the upper body helps prevent bone loss due to osteopenia or osteoporosis as well. At Palmer Physical Therapy for Women, we are utilizing the poles as part of our individualized rehab programs for those with balance or falling issues, for those with spine or lower extremity pain or dysfunction, or for those with postural problems. There are many great exercises that utilize the poles to assist with stretching, strengthening or balance. We have also been promoting Nordic Walking to our clients and to other community groups as a new, unique form of fitness activity. Especially during the recent COVID-19 pandemic, Nordic Walking can easily be done outdoors for social distancing, nearly anytime, anywhere. It requires little equipment, with minimal expense. Once the proper gait pattern is achieved on level surfaces, Nordic Walkers can challenge themselves on uneven ground, hills, or inclines. Palmer Physical Therapy for Women is now offering classes for an introduction to Nordic Walking. Participants learn a comprehensive home exercise program using the poles to help with stretching, strengthening and balance. Physical therapists adjust and fit the poles properly to the individual, and educate them about proper gait pattern, posture correction and control. Some of the comments from our recent classes: “I started walking with Nordic poles July 18, so have been walking with them for a month. Previously, my walking was a chore and just something I felt I had to do for health reasons, not so much because I enjoyed it. Now, every morning, I am eager to exercise with the poles. I also started doing the recommended stretches, balance and strengthening exercises using the poles. I feel like I have settled into an exercise program that I totally enjoy! Even after only one month, I sense that I am more aware of having correct posture. I can tell from my Apple Watch app that I am burning more calories with the poles. I initially thought I would be embarrassed walking in my neighborhood, but I mostly get smiles, thumbs up, and inquiries about this form of exercise. Now I like being the unique exerciser! I would highly recommend walking with Nordic poles!” Jan Dav is Future ongoing fitness classes will be offered for those interested in advancing with more comprehensive exercise and conditioning. For further information about class times, please call Palmer Physical Therapy for Women, 316-630-9944. Our office is located at 10333 E 21 st ST N. #406, Wichita, KS 67206. We look forward to working with you!
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