What Does a PT Do for Urinary Incontinence

As many of you may know that a physical therapists can help people to exercises with weights to help with strengthening or they can teach someone how to use crutches after surgery to help them walk. But how can physical therapists help with bladder or bowel problems like incontinence?

The pelvic floor muscle is a skeletal muscle just like other muscles in our body and they respond to

the same training techniques. Some physical therapists have developed special skills in

training the pelvic floor muscles. These therapists are called pelvic floor therapists.

If someone wants to strengthen their biceps arm muscle they have to learn the correct

exercises. Then they perform the exercises with the correct difficulty (not too hard, not too

easy) for the correct duration of time (it takes 4 to 6 months to increase the size of a

muscle). Pelvic floor muscle training is the same. First you have to learn the correct

exercise. This is challenging as it is an inside muscle and sometimes hard to find. In

fact, 40% of people are doing the exercise wrong. The best way to tell if you are doing

the exercise correctly is by palpating inside the vagina or rectum. A trained physical

therapist can measure the muscle by palpating just inside the vagina or rectum and asking

you to squeeze. This usually not painful but gives a lot of information about the muscle

How big is the muscle?

 Can you feel the muscle?

 Is the muscle painful and tense? – it is very important to relax and this may be the primary reason exercises do not work.

 Can the muscle elevate and support the organs – especially important when the organs are sagging?

 Can the muscle squeeze tight – to stop urine leakage?

 Can you hold the contract – long enough to get to the bathroom?

 Does the belly muscle work with (or against) the pelvic muscle?

 Does the breathing work with the pelvic floor muscle?


All these things are helpful in developing the correct exercise program. In many cases

the exercises are difficult to learn and additional information is needed. EMG

biofeedback can help. This device allows you to see the muscle contraction just like the

EKG allows you to see the heart contraction. To monitor the pelvic floor muscle a sensor

is placed inside the rectum / vagina or stuck to the outside of the rectum. If the

contraction is strong the line goes up (and stays up). If the contraction is weak the line

does not go up very high and fall quickly. Seeing this can help you to activate the correct
muscles and keep them activated increasing the effect of the exercises.

A proper exercise program includes the answers these questions:

 How long to hold the contraction?

 How long to rest between? – rest is as important as hold

 How many to do at a time and how many times to do them in a day? – studies tell us that you must do more than 45 per day to get results

 What position should the exercises be done in?

 How do you breathe during the exercises?


If you want more information about this or any of our services please call us at 864-534-1780.