Functional incontinence, or functional urinary incontinence, occurs when individuals struggle to reach the bathroom in time due to a lack of functionality. It’s essential to recognize that incontinence is just one facet of pelvic floor dysfunction. Focusing solely on incontinence overlooks other critical aspects of effective treatment, often leaving patients feeling frustrated and hopeless.

Addressing functional incontinence begins with identifying what impedes the individual’s ability to reach the bathroom promptly. Are there physical limitations hindering their mobility? Perhaps lower back pain, knee issues, or other musculoskeletal conditions are factors. Additionally, difficulties with clothing or navigating a cluttered path to the bathroom can contribute.

Neurological conditions like MS, Parkinson’s, or dementia can also lead to incontinence. Sometimes, medication side effects such as drowsiness can further complicate matters by delaying bathroom trips or impairing the individual’s ability to transfer to the toilet safely.

The key is to tackle the underlying cause first. For instance, in cases involving musculoskeletal issues, addressing the physical condition is paramount. In this discussion, we’ll explore available options, recognizing that even individuals with conditions like multiple sclerosis may benefit from tailored approaches suited to their varying levels of neurological decline.

What Is Pelvic Floor Dysfunction?

As stated in the blog “What is Pelvic Floor Dysfunction”, you can see that pelvic floor dysfunction can be due to various issues related to pelvic floor muscles, lower back, sacroiliac region, lower abdomen, and hips. It’s important to note that while pain may not always be a factor, chronic dysfunction in any of these areas can contribute to pelvic floor dysfunction, regardless of whether incontinence is present or not.

Functional Incontinence Treatment

Treatment varies from one cause of dysfunctional movement to another. In my practice, all incontinence cases are evaluated for the extent of pelvic floor dysfunction as explained above.

What Is The Start Of Pelvic Floor Dysfunction Treatment?

  • Step one is the evaluation of the patient including Postural Neurology and Functional Movement. This allows evaluation of the whole path of movement, from the brain and the resources that allow the brain to get information to balance and coordinate movement to the body parts that ultimately have to perform the command coming from the brain. This type of exam is fully missed when it comes to incontinence of any kind.
  • Evaluating medication and side effects to see the side effects that are contributing to functional incontinence. Collaborating with the prescribing physician is needed in this case to consider other options or full elimination of medication if indicated.
  • Strengthening and relaxing the muscles inside the pelvis which includes the floor and the walls of the pelvis. Naturally, with Biological breathing, we do this but the question is are you breathing biologically?

Only after proper breathing is established you can do the basic Developmental Kinesiology exercises to stabilize the pelvis, I use the Emsella chair, FDA-approved for incontinence to strengthen the muscles inside the pelvis even more. It only makes sense to use the technology when you can sit on the chair, under proper supervision, and engage your muscles correctly so the machine has a chance to take the muscles of the pelvic floor and pelvic wall to contract together, to stabilize the inner reinforcement of your pelvis for optimal final stability.


Emsella Chair

Emsella Chair

  • Manual Pelvic Floor Therapy in my opinion is helpful to address scarring more than anything else. Pelvic floor dysfunction involves pelvic instability so stabilizing the pelvis is the first step. While manual internal pelvic floor therapy is the standard treatment for pelvic floor issues, to me it means that we are more focused on the relaxation or strength of the ‘floor’ when the ‘house’ is still unstable!

If you experience pelvic floor dysfunction, contact me.

Dr. Shakib

Recommended Reading:

What Are Different Types Of Incontinence?

Pelvic Floor Dysfunction And Ergonomics