I know it's not something we want to talk about, but sometimes post-surgery, after having a baby, or as we age, we might have trouble with bladder control. Maybe you are trying to get discharged from the hospital after surgery, laughing with your friends, or trying to climb the steps to your front door when all of a sudden, your bladder doesn't want to work right.

Urinary incontinence is the most common type of bladder issue. It is described as an involuntary leakage of the urine. There are two primary types of urinary incontinence: stress and urge (overactive bladder) incontinence. There are other types of bladder issues that may involve the bladder - cystitis (an inflammation of the lining of the bladder), urinary retention, infection, or pain that's related to other health issues - that can affect the bladders health, too.

Stress incontinence usually happens when people laugh, sneeze or cough. It may occur with certain exercises like jumping or running, or with any increase in abdominal pressure. Often it is the muscles of the pelvic region that are the problem with stress incontinence, or problems with the muscles in the bladder itself. The bladder often drops down due to the weakened muscles, and then the urethra does not close completely. Other changes can happen with pregnancy, during childbirth, menstruation and menopause, or due to certain surgical interventions.

Urge incontinence happens when your bladder contracts involuntarily - often at the sign of a "trigger" - and releases urine. It often occurs when the nerves are somehow affected, like after surgery, or with irritation to the nervous tissue as with an enlarged prostate, where the nerve is compromised.

Many times, we think there is nothing that can be done for these types of issues. That can't be further from the truth. Your doctor/urologist and then your physical therapist can be of great benefit. The doctor will diagnosis what the issue is, and then a physical therapist who specializes in this type of care will do an extensive evaluation to help you regain control of your symptoms and reduce the need for the daily use of your pads, medications and possible surgery.

The physical therapist will show you how to utilize the right muscles and facilitate those muscles in the correct patterns. The pelvic floor muscles strengthen the muscles that surround the bladder so you can control the bladder better. These exercises include the "Kegel" exercises, but are not limited to them. You want to include exercises for the buttocks, thighs and stomach as well so they can support proper bladder function. We often use Biofeedback to ensure that the right muscles are firing, and electrical stimulation to facilitate the pattern of those muscles firing.

Your physical therapist can help you with information about your diet and nutrition, and identify the food and drink that may be irritating your bladder. It is evidenced that certain behaviors make symptoms worse; there are ways to decrease the urinary urge and frequency by changing these behaviors.

The more knowledge you have regarding this, the better. So don't suffer and be afraid to laugh, run across the street or leave your house. Visit your doctor and then see your physical therapist.

Sheree DiBiase, PT, is the owner of Lake City Physical Therapy. She and her staff can be reached in Coeur d'Alene at (208) 667-1988 and in the Spokane Valley at (509) 891-2623. We are trained in the care of incontinence, and want you to live a full life.