Leak No More

by Jana Jensen, RN MSN & Karen Bauman, MA NMT

Are you one of the millions of people who plan their lives and activities around having to know where the closest bathroom is located? Do you no longer dance, play, or laugh as spontaneously as you once did because you are concerned that your bladder will leak urine and embarrass you? Are you one of the 25 million Americans who contribute to the $12.6 billion dollars spent on incontinence products each year? Although incontinence is not life-threatening, you know the toll it takes on your social, emotional and physical life.

Incontinence is not normal and conservative (non-medical, non-surgical) approaches, like those offered at Serenity Wellness Center through the Integrated Pain Relief division, can dramatically restore function and improve quality of life.

According to the Association of Continence Advisors incontinence is “the involuntary loss of urine and/or feces at an inappropriate moment or in an inappropriate place. The leakage volume can vary from very small to considerable. Incontinence is not an illness; it is a symptom that indicates a disturbance in your body functions."

This widely experienced, underreported health condition is incorrectly considered inevitable and irreversible, especially if you are a woman, have been pregnant, have delivered children and/or are aging.

Although incontinence affects both genders, approximately 75% of reported cases are women. In men, incontinence most frequently is a result of an enlarged prostate or occurs following surgical procedures to remove the prostate. For both men and women, incontinence may also follow pelvic surgeries, injury to the pelvis, tail bone, or spinal cord, or result from infections, neurological diseases, diabetes, or medications.

As you seek information on incontinence, you will learn that the bladder is similar to a balloon, expanding and contracting as it fills and empties. It fills with urine that has been filtered by the kidneys at a rate of about 1-2 tablespoons per hour until about 2 cups of urine signals the need to void. To accommodate the constantly changing size and shape, the bladder is suspended by ligaments in the pelvic cavity that stabilize it while still allowing the bladder to expand upwards.

What supports the bladder from below is the pelvic floor muscles collectively called the levator ani. When these muscles have proper tone and strength, they securely support the bladder. However, when these muscles weaken, or when pregnancy stretches the sling created by the levator ani, then the bladder falls below the pelvic floor and lacks the necessary support.

What this routine understanding of the physiology doesn’t take into account is the most prevalent tissue in the body—the fascial system.

The fascial system surrounds and interpenetrates every muscle, bone, organ, vessel, duct, and nerve down to the cellular level. Pelvic torsions, falls on the tailbone, trauma, inflammation, surgical scars, as well as childbirth can cause the fascial system to tighten and harden around sensitive pelvic structures. This tightening is what is called “fascial restrictions” and is known to exert up to 2000 pounds of pressure per square inch.

In the case of the bladder, fascial restrictions can inhibit the expansion of the bladder or tighten around the urethra causing incontinence or an environment for chronic infections, inflammation of the bladder’s lining, and pain.

Only one treatment modality specifically addresses the fascial system and helps to release restrictions by following the principles for how the fascial system lengthens, softens, and becomes more fluid. Myofascial Release, as taught by John F. Barnes, is a non-traumatic, gentle treatment that can free the structures contributing to incontinence, as well as reduce pain. This effective work will not worsen symptoms or cause harm, making it an important added dimension to treatment for incontinence and may be the missing link in resolving urine and fecal leakage.

Because not all incontinence problems have a fascial origin, it is beneficial to seek your physician to rule out any serious health concerns. But when the tests come back negative, Myofascial Release has helped out many women and men become free of the embarrassing experience of untimely leakage.