Urinary incontinence is definitely one of the primary diagnosis’ we see in the clinic.  But, did you know that there are different types?  And depending what type you may be experiencing, the physical findings and treatment vary significantly.  In this blog post, I hope to clarify what the different types of urinary incontinence are and why a one size fits all is not going to work!


Stress urinary incontinence (SUI)

This type of incontinence is characterized by the involuntary leaking of urine with an activity (ie. a stress!).  It basically means you pee a lot or a little when you did not plan to.  Typical activities that cause this leaking of urine are generally activities that are high impact or cause a large increase in pressure in the abdomen.  Some more common examples are:  coughing, sneezing, lifting, running, jumping, trampoline, etc.  What happens is the pressure in the abdomen becomes so big, the pelvic floor and deep core can’t control it and leaking happens.  An analogy is a tube of toothpaste.  If you had a quick hard squeeze to the middle of the tube, some toothpaste is going to come out, whether you like it or not!

There are a number of potential causes for this.  Some more common ones are a weak pelvic floor and/or core or a deep core that isn’t coordinated/coming on at the right time.  Treatment can sometimes look like a progressive strengthening program of the deep core or a program where we focus on getting the muscles to contract at the same time.  Depending on your goals and what the physical assessment findings are would depend on the type, frequency and intensity of the home program given.


Urge urinary incontinence (UUI)

Urge urinary incontinence is when there is a large need (urge) to pee that comes on quite suddenly that the person is unable to control.  Often times it happens at the same location or time.  An example is getting home from the grocery store.  The whole ride home, you may have to pee a little but as soon as you pull in the driveway the urge to go becomes quite big.  When you get out of the car to open the front door, you can’t control your bladder any longer.


So what’s going on here?  Typically we see the muscles of the pelvic floor and deep core in a resting position that is a little too high.  In the physio world we would say the muscles are “hypertonic” which basically means tight.  Why the muscles are hypertonic is a whole other blog post!  Treatment for UUI is usually a combination of strategies to get the muscles of the pelvic floor and core to relax, addressing any strength imbalances we see and incorporating ways and strategies to control the urge that may be more driven from the brain then the body.  Simply doing kegels won’t cut it here and typically would worsen the symptoms initially.


Mixed Urinary Incontinence


This is what the name implies, a mix of SUI and UUI!   Sometimes there’s leaking with a sneeze, other times it’s a race to the bathroom when you get home and sometimes you’re ok.   Symptoms and treatments vary depending on the person.  Typically treatment is a combination of cognitive strategies, stretching, strengthening and motor patterning work.


If urinary incontinence is something you are suffering with, please reach out!  The staff and KW Pelvic Health are here to help!