Urinary Incontinence Protocol

In the treatment of urinary incontinence, it is essential to strengthen the weakened pelvic floor muscles with exercise to maintain proper urethral sphincter control.

The patients often have difficulty finding and contracting the "right" muscle groups and often find they "fight against themselves" by bearing down or contracting antagonistic muscle groups.

To enable the patient to locate the "right" muscles, we provide the use of the Myoexerciser Software Program for both visual and auditory feedback.

Repetitive isometric contraction of the pelvic floor alone is often not enough. To regain control of the pelvic floor and prevent urinary incontinence, Kegel's exercises must be performed in conjunction with Functional Activities including transfers and bed mobility, marching, jumping, strengthening of the pelvic girdle using the Physioball, and expulse breathing or "Ha" exercises to mimic activities of increased abdominal pressure.

Electrical stimulation is also used to strengthen the pelvic floor with electrodes placed perianally using a muscle re-education setting approximately 20-30 minutes per treatment. Electrical stimulation using interferential urinary incontinence settings can also be used to increase functioning of the pudendal nerve and increase sensory awareness of the "right" muscle groups.