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February 2008 Vol. 27. No. 2
Published by the Humboldt Senior Resource Center in Eureka, California. HSRC is a non-profit community-based organization offering services for senior citizens, multi-generational families and caregivers.
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Humboldt Senior Resource Center Back issues Table of Contents
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Healthy innards Roughly 10 million Americans suffer from urinary incontinence and its resulting social and hygienic problems. The majority are women — six out of 10 — but men are affected also. Pregnancy, childbirth, extra weight, hormonal changes and too much sitting can weaken pelvic muscles. Incontinence is an expensive problem, as it requires protective pads, caregiver attention and occasionally, surgery. It is one reason family members start to consider nursing facility placement, as it is an omnipresent problem that taxes even the most dedicated caregiver. The acidity of urine can cause skin breakdown. It affects dignity and quality of life and often leads to depression and social isolation. There are two different types of incontinence — stress and urge — and both are involuntary. Stress incontinence is the leakage of urine when coughing, laughing, sneezing or standing up suddenly. Urge incontinence is characterized by a sudden, strong sensation to void — usually a large volume. “I just couldn’t hold it” is often the subjective response. The embarrassment causes shame and reluctance to participate in fun activities for fear of having an accident. How it works Located underneath the pelvic area and consisting of several layers of invisible skeletal muscle fibers and connective tissue, the pelvic floor muscles “cradle” the pelvis. Two main muscles, one like a hammock and the other like a triangle, stretch across the legs to secure and support the pelvic organs (bladder, vagina, rectum and uterus) from all directions — front, back and both sides. They control both urinary and anal sphincters and are important for sexual function. During birth, these muscles must be flexible enough to deliver a baby. They are important muscles to keep strong. Despite the complex, neuromuscular function of the pelvic floor, until recently most rehabilitation has only consisted of the traditional Kegel exercises which women will remember from their childbearing days. The protocol for these exercises is as follows: • Isolate the correct muscles by consciously stopping and starting the flow of urine. • Contract (count to four) and relax them repeatedly during the day to strengthen. • Continue for the rest of your life. Unfortunately, significant improvement is rarely reported because the pelvic floor muscles do not function alone. They are assisted by a whole array of accessory muscles including lower abdominals, hip adductors, flexors and external rotators and gluteals. By exercising all the muscles within the same functional unit, the encouraging test results indicate, if the muscles are neurogenically intact, they can be rehabilitated enough to regain voluntary control of urine. Begin exercising now even if you currently do not have a problem, especially if you tend to be sedentary. The best daily exercises • The squat — With hands holding onto a stable bar, railing or counter, bend the knees slowly, squat down and pull up. • Leg scissors and lifts— lie on mat with legs outstretched and “scissor” legs out and in, up and down. • Abdominal breathing — slowly fill lower abdomen with air, hold three seconds, and slowly exhale. • Trunk rotation — standing, rotate around, or lying down, bend your knees and lift your buttocks up and down. Marilyn Brende is a registered occupational therapist and owner of Curves on Broadway, 442-7750. |
Senior News