The pelvic floor is the structure that closes the pelvis at the bottom, surrounding the vagina, anus and urethra and is composed of muscles, fasciae and ligaments. The fascia and muscles of the pelvic floor support the bladder, uterus and rectum.
The most common urinary incontinence is stress urinary incontinence. There is an involuntary urine loss after a physical effort such as coughing, jumping, running.
Physiotherapy has an important role in the treatment of urinary incontinence. The aim of Physiotherapy is promoting body awareness, strengthening pelvic floor muscles and vesical re-education
The physiotherapist will evaluate the patient and will assemble an individualized treatment program based on body awareness and the degree of muscle strength. Starting with simple exercises and progressing for the most difficult
Firstly, the patient needs to understand which muscles it should contract. And for that the physiotherapist will guide through the verbal instruction or the palpation
The best known exercises are the Kegel exercises, which there is a voluntary contraction of the pelvic muscles. Muscle training should have a frequency and intensity, from the easiest to the hardest, starting in a gravitational position and progressing to an anti gravitational position until arrive on an unstable basis. And the training should be done for a period
Along with the exercises, pelvic floor musculature contraction training should include the use of repetitive contractions in response to specific situation such as sneezing, coughing or another physical activity
In addition, behavioral cognitive therapy is important to increase urination intervals (which should be done gradually) and decrease urination anxiety.
