There are 2 main types of incontinence: Fecal Incontinence and Urinary Incontinence. Urinary Incontinence has its subgroups that will be discussed below. Please make sure to review my other blogs that have to do with incontinence and pelvic floor dysfunction in general.

Fecal Incontinence

When it comes to fecal incontinence, the challenge is controlling the evacuation of fecal matter. This condition often can be due to factors like trauma, underlying medical conditions affecting nerves or overall health, dysfunction of the sphincter muscles, walls, and floor of the pelvis, chronic diarrhea or constipation, or specific nerve disorders.

A comprehensive evaluation is important to identify all contributing factors to fecal incontinence. While your primary care physician may be your initial point of contact, assessing pelvic stability and the muscles of the pelvis is important to identify the functionality of the pelvis. This is typically done not by digital internal exam but by observing, testing, and observing different movements related to the pelvis, spine and lower extremities.

In my practice with a focus on Postural Neurology and Functional Movement, I can look at the frequently overlooked role of posture in fecal incontinence. In the video below, I discuss the interconnection between posture and constipation, illustrating how posture directly influences certain health conditions. It’s essential to remember that chronic constipation can contribute to fecal incontinence by impacting the sphincter.

Urinary Incontinence

There are many different types of urinary incontinence, some making the bladder relax and others leading to contraction of the bladder itself. Most incontinence falls under this category and includes:

    • Overflow incontinence
    • Urge incontinence
    • Functional incontinence
    • Stress incontinence
    • Reflex incontinence

Urinary incontinence is not a woman’s problem, a pregnancy problem, or a childbirth issue only; it is also not just for smokers and overweight individuals. It is easy to blame many things as the cause but the solution happens with a focus on resolving the cause. I have written a blog on the subject of pelvic floor dysfunction addressing this very important and yet overlooked approach.

Working on the ‘floor’ of the pelvis as the solution to urinary incontinence is not the complete solution. Regardless of the type of incontinence, it is the pelvis instability that is the common denominator. Why do we skip stabilizing the pelvis when it comes to the treatment of incontinence? Should we not stabilize the ‘house’ that the pelvic floor is the ‘floor’ of?

Who Treats Pelvic Floor Dysfunction?

While most pelvic floor therapists are physical therapists, thankfully we are seeing more and more chiropractors getting involved in pelvic floor dysfunction treatment. Not all chiropractors have a similar practice style so do your due diligence to find a chiropractor who is familiar with postural improvement through concepts of functional movement to help stabilize the pelvis. There are times when collaborations between different specialties are necessary to address different ‘feeders’ of the incontinence problem.

The most important take-home message is that if manual pelvic floor treatment is all the rehab you are receiving, you are not addressing the problem thoroughly.

If you have pelvic floor dysfunction and are not happy with the results you are getting, contact me.

Dr. Shakib

Recommended Reading:

The Top Pelvic Floor Exercises For A Healthy Core And Beyond

The Telltale Signs of Pelvic Floor Dysfunction You Ought to Know