Treatment Options for Incontinence & Pelvic Pain

An Active Lifestyle Without the Worry

Many people believe that urinary and bowel incontinence is an uncontrollable problem that they must accept and live with for the rest of their lives. Yet people with incontinence and pelvic pain can often benefit from rehabilitative therapy. As one of the few providers of this therapy in the state of Michigan, and the only provider in the Great Lakes Bay region, MidMichigan offers treatment options that allow patients to regain control and confidence in their daily lives.

What Is Incontinence?

Incontinence is the involuntary loss of urine, feces, or gas. It may be a symptom of an underlying condition, such as urinary tract or digestive tract infections, muscular weakness or a disorder of the nervous system. An examination by your doctor is the best way to determine the cause of incontinence.

Stress incontinence is uncontrolled loss of urine or feces that typically occurs with coughing, sneezing, laughing, or lifting. Weakness of the pelvic floor muscles that surround the urinary sphincter, urethra, vagina and rectum is the most common cause of stress incontinence. Urge incontinence is uncontrolled urine or fecal loss preceded by a strong urge to urinate or defecate. All of these forms of incontinence may occur in combination and can be effectively treated with therapy. 

What is Pelvic Pain?

Many men and women experience persistent pelvic or abdominal pain. The causes may include anything from organ dysfunction to lumbosacral dysfunction, muscle spasms or lack of muscle coordination in the pelvic floor.

Pelvic pain can include, but is not limited to, pain involving the genitals, rectum or lower abdomen and may also include the buttocks and lower back. Pain is nearly constant but may vary in intensity and with activity.

Evaluating Incontinence

The first step toward effective treatment is evaluation. Our specially trained physical therapists may use some or all of the following processes to arrive at the right treatment plan for you:

  • Medical History - By learning as much as possible about your medical history, the therapist can make a better determination about the origin and cause of your incontinence or pelvic pain. This aspect of your treatment will take 20 to 30 minutes and will include histories of gynecological problems, medical conditions, surgeries and births. The therapist will also carefully explain the next portion of the evaluation - your physical examination.
  • Physical Examination - The physical therapist obtains critical information such as sensation, pelvic muscle strength, pain and reflex activity.
  • Urinary Diary - After your first meeting, you will keep a diary of important information, such as when you empty your bladder, and whether you experience leakage at specific times.
  • Surface Electromyography (SEMG) - This educational tool can determine muscle strength and provide a better understanding of the cause of incontinence.

Regaining Control

Physicians oftern recommend rehabilitation to help you retrain and strengthen the muscles responsible for maintaining continence. Such therapy usually requires four to eight visits over a period of four to eight weeks and may include the following:

Therapeutic Exercise

When pelvic floor muscles are strong, they help control the passage of urine and feces. When they are weak, urinary, fecal or gas leakage may occur. If the muscles are too tight, they may cause pain and impair function. Your therapist may prescribe exercise programs to strengthen muscles weakened by injury or disuse, and use biofeedback or electrical stimulation to assist with exercises or relaxation and stretching of the pelvic floor if needed.


One of the critical components of treating incontinence or pelvic pain is education. Once you begin to understand why you have incontinence or pelvic pain, you will be better prepared to control it in the future. Areas of dicussion will include:

  • Anatomy and function of pelvic and abdominal muscles
  • Common problems associated with childbearing and menopause in women
  • Common problems associated with prostate procedures
  • Goals of exercise and home programs
  • Protection of pelvic muscles
  • Stress reduction
  • Relaxation exercises
  • Toileting habits

Education will also include instruction in self-management, individualized exercises, training in bowel and bladder control and guidance in the use of home therapies.

Manual Therapy

Many patients may also benefit from the use of gentle, hands-on techniques to help associated organs, soft tissues and joints function together in a more coordinated manner.

Costs, Insurance and Referrals

Rehabilitation services such as therapy are generally covered by Medicare, Medicaid or commercial insurance. If you have questions about coverage, your insurance carrier or employer's benefits department is the best source of information.

Your Next Steps

  • For more information about treatment options for incontinence, talk to your physician. For a physician referral, visit our Find a Doctor section, or call the MidMichigan Health Line at (989) 839-9090 or toll free at (800) 999-3199.

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