Physiotherapy in Urinary Incontinence During Pregnancy

Pregnancy is a normal physiological process in women. During pregnancy, the body undergoes various changes. Hormones are released during pregnancy to help expand the pelvis but this affects the strength of some muscles, especially the pelvic floor muscles. Pelvic floor dysfunction can lead to a number of problems including urinary incontinence. Urinary incontinence is the involuntary leakage of urine. In normal adults, when the bladder is filled with urine, it signals the brain and the person goes to the right place to urinate, but in urinary incontinence, this mechanism is disrupted. There are many strategies used to prevent and treat urinary incontinence including physiotherapy. Pelvic floor muscle training is very effective. It should be started during pregnancy and continued some months after delivery.

Kegel Exercises

Arnold Kegel first described Kegel exercises in 1948. It strengthens the pelvic floor muscles. It is used to treat or prevent many pelvic floor disorders, including urinary incontinence.

Basic Procedure for Kegal Exercises

The pelvic floor muscles are located at the bottom of the pelvis. During exercise, the movement is not very visible, but a woman can feel it. Kegel exercises are performed with empty bladder. Kegels while urinating can weaken the muscles. The three-second rule can be applied in the early days of exercise. The pelvic floor muscles are squeezed or tightened inward and upward for three seconds and then relaxed for three seconds. Squeezing inward and upward simultaneously can be difficult in the early days. A woman can do this step by step. The squeeze and rest periods can be up to 10 seconds after some days. 7 to 10 repetitions of these exercises 1 to 3 times a day can give good results. Kegel can be performed in the upright, sitting, lying down, hook lying and quadruped positions as directed by the physiotherapist. The repetitions, timings, position, and proper procedure should be guided by a skilled physiotherapist or health professional.

Knack Techniques

Certain activities including sports activities, coughing or sneezing can increase downward pressure within the abdomen which can cause urinary incontinence. The knack technique can be used to prevent and treat urinary incontinence. In this strong and well-timed pelvic floor muscle contraction is performed before and during these activities.

Awareness about urinary incontinence 

Some women have the misconception that urinary incontinence can recover itself without any treatment or that it is normal to have urinary incontinence during pregnancy. All such misconceptions should be cleared. Some women are embarrassed to talk about urinary incontinence. Educational programs through various platforms, including workshops, brochures, and the Internet, can provide information about pelvic floor muscle function, dysfunction, and treatment options. These strategies may encourage women to seek appropriate treatment for urinary incontinence.

Conclusion

During pregnancy, every woman should try to take extra care of her health to avoid complications including urinary incontinence. There is a misconception that all exercise during pregnancy is dangerous. According to the American College of Obstetricians and Gynecologists, physical activity and exercise benefit the majority of pregnant women, although some modifications to exercise routines are necessary due to normal physical changes, physiological changes and the needs of the fetus.