The success stories physical therapist Heather Brewer hears are usually related quietly, and privately.

“People will take me aside and say ‘Oh, I did some of the things you mentioned and they helped,’” Brewer said.

But while relatively few people feel comfortable talking about incontinence, the problem is widespread; affecting an estimated 17 million Americans of all ages, but especially people over 60.

Perhaps the biggest hurdle in treating the condition is simply talking about it. The good news, said Brewer, is that incontinence can almost always be treated non-invasively through therapy.

“Incontinence is not something that people should think of as an inevitable part of aging,” Brewer said.

For people who suffer from incontinence, normal everyday activities, like attending a high school basketball game or going for a long drive can be difficult or impossible. The first step in dealing with it is talking to your doctor. Not only is incontinence most often treatable, but in some cases, it can be a sign of a more serious condition.

Addressing the problem can be as simple as understanding what stimulates the urge to urinate and also strengthening muscles in the pelvis and hip area.

One of the most common causes of incontinence is weakened or damaged muscles in the pelvis due to childbirth, surgery or a sedentary lifestyle. In some cases, too much exercise can cause the condition. Ballerinas and equestrians both sometimes suffer from incontinence and in each case, the solution is exercises designed to balance the musculature of the hips and pelvis.

Common types and symptoms of incontinence include: stress incontinence occurs due to activities that increase pressure in the abdomen such as lifting, laughing, sneezing or coughing; urge incontinence is defined as a strong need to urinate that is sudden and frequent; mixed incontinence combines symptoms of both stress and urge incontinence.

The initial evaluation includes discussion of incontinence patterns to determine the possible cause.  Muscles of the hips and pelvis are tested to determine strength and flexibility.  No internal exam is performed.

Therapy includes a discussion of factors that may affect the bladder, such as caffeine or nervous tension. Exercises such as Kegel exercises, are used to strengthen the floor of the pelvis and biofeedback may also be used to help build awareness of pelvic muscles. Beyond Kegels, exercises that involve the hip muscles that support the floor of the pelvis, are also sometimes useful.

For more information about pelvic health or therapy options for incontinence, please call St. Andrews Hospital Wellness and Rehabilitation at 207-633-1928.