American Physical
Therapy Association

Section on Women's Health
American Physical
Therapy Association


Commonly Treated Conditions- Incontinence

Millions of women and men suffer with incontinence. Weakened pelvic floor muscles, which support the internal organs of the pelvis and prevent leakage, are a major cause of incontinence. Pelvic floor muscles in spasm can contribute to incontinence and can cause pain in the rectal and pelvic region. Physical Therapy offers muscle re-education and bladder retraining, so that each individual can learn how to effectively use these muscles to reduce their symptoms.

Treatable forms include: stress urinary incontinence, urge urinary incontinence, and mixed urinary incontinence which is a combination of the first two types. Individuals can have bladder urgency and frequency without leakage.

Also treatable, is fecal incontinence. A weakened external anal sphincter and pelvic floor muscles often cause this problem, especially in women during the postpartum period or in men and women later in life.

BLADDER FUNCTION: So what is normal, anyway?

It is a very distressing situation for an adult to lose bladder function. Knowing what is normal is the first step towards making a decision to ask for help. Answer these 4 questions to help you decide whether you should see your doctor or another health professional.

  1. Do you urinate more than 8 times during an average day?
  2. Do you wake up to urinate more than once after going to sleep?
  3. Do you rush to get to the bathroom for fear of losing urine?
  4. Do you worry about finding a bathroom quickly when you are away from home?

If you answered yes to any of the above, it may indicate a bladder condition that can be addressed by your doctor or a physical therapist trained in this area.

Normal bladder function is something you take for granted after you go through “potty training”. You trust that the bladder will hold urine until you are ready to empty, usually at a capacity of about 2 cups of urine. Depending on the type and amount of fluids you drink, you should empty 6 to 8 times in 24 hours.

The bladder is in a relaxed state as it stores urine. As urine begins to collect, you get gradually stronger “messages” as the bladder wall stretches. The urge to urinate eventually leads you to find a toilet; at this time, the bladder works like a pump to empty the urine. You should not need to strain or force voiding.

The ideal time to wait between voids is from 2 to 4 hours; going infrequently can also be a sign of a problem. Bladder retraining and avoiding caffeine, citrus or acidic foods are simple changes that can reduce bladder problems. Adequate water and fiber intake also play an important role in keeping the bladder healthy. With education and proper treatment, you can stay in control of your bladder instead of your

From the Women's Health Section of the APTA Written by : Barb Settles Huge

Many of the foods we eat on a daily basis may irritate our bladder and cause leakage or frequency. You may try eliminating the irritant from your diet for a few weeks and see if there is an improvement. There are substitutes for many of the irritants including: warm broth (watch the salt content of packaged varieties), herbal tea, cereal beverages instead of coffee; and white chocolate instead of regular chocolate.


    liquor, wine, beer, wine coolers

    coffee, tea, dark sodas, some darker herb teas (including decaffeinated versions of all of these), chocolate, many cough medications and over-the-counter medications, e.g. some aspirin and antihistamine preparations (check the labels).

    orange, grapefruit, pineapple, lemon, lime

    tomato juice, red spaghetti sauce, pizza, barbecue sauce, chili

    Mexican, Thai, Indian, Cajun, Southwestern style

    Nutrasweet, saccharin, sugar, corn sweeteners, honey, fructose, sucrose, lactose
    These ingredients are added to many packaged foods including soft drinks, sweetened tea, and processed foods.

From the Women's Health Section of the APTA Written By: Elaine Meadows

Personal Physical Therapy Services Phone 540-450-0680 • Fax: 540-450-0681 • Email: