Ankle position may help control incontinence in women

Certain ankle positions, by influencing posture and the tilt of the pelvis when standing, can facilitate pelvic floor muscle activity. The technique may be a useful add-on to pelvic floor training exercises intended to help women with stress Urinary Incontinence.

Dr. Gwo-Jaw Wang and colleagues from Kaohsiung Medical University School of Medicine, Taiwan, studied 39 women (average age 59 years) with clinically diagnosed stress Urinary Incontinence. The participants engaged in testing the changes in pelvic floor muscle activity during various pelvic tilt angles created by standing with the feet horizontal, flexed up, or flexed down.

The women stood in these positions with the help of an adjustable tilt platform that set the ankles at the appropriate angle. The researchers used an intravaginal probe to measure pelvic muscle activity.

Incontinence is the inability to control the passage of urine. This can range from an occasional leakage of urine, to a complete inability to hold any urine.

The two main types of urinary incontinence are:

     
  • Stress incontinence - occurs during certain activities like coughing, sneezing, laughing, or exercise.  
  • Urge incontinence - involves a strong, sudden need to urinate followed by instant bladder contraction and involuntary loss of urine. You don’t have enough time between when you recognize the need to urinate and when you actually do urinate.
Pelvic floor muscle contraction was greatest when the ankles were flexed upward, and least when they were flexed downward, the investigators report in the journal Urology. Overall, they observe that an upright standing position with the ankles flexed up facilitated the forward tilt of the pelvis, “which in turn increased effective pelvic floor muscle activity to its greatest point.”
Stress incontinence is an involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. Stress incontinence is a bladder storage problem in which the strength of the urethral sphincter is diminished, and the sphincter is not able to prevent urine flow when there is increased pressure from the abdomen. Stress incontinence may occur as a result of weakened pelvic muscles that support the bladder and urethra, or because of malfunction of the urethral sphincter. Prior trauma to the urethral area, neurological injury, and some medications may weaken the urethra. For more information check: Urinary Incontinence Stress incontinence
Also, they point out that “there is a connecting relationship among pelvic floor muscle activity, abdominal muscle strength, and pelvic tilt tendency, which is worthy of additional investigation.” SOURCE: Urology, August 2005.

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Revision date: July 7, 2011
Last revised: by Andrew G. Epstein, M.D.