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Understanding incontinence and treatments to heal. Hi, my name is Molly Barfield and today I’m going to be talking about urinary urgency and associated urge incontinence: what it is, how we evaluate it in physical therapy and how we generally treat it. First I want to start off by introducing you to the anatomy of the pelvic floor and the urinary system. Urinary urgency is a strong uncontrollable urge to urinate, often times out of the blue. At times this uncontrollable urge to urinate results in urge incontinence. There are many possible mechanisms of why a person might end up with urinary urgency and it is recommended that people with urgency be evaluated by a urologist to determine the cause. In physical therapy we commonly see patients that have urgency due to a timing issue with the bladder sphincter and the pelvic floor and/or also the pelvic floor muscle group and the lower abdominal wall being tight, short and sometimes in spasm. During a typical PT evaluation we might look at your pelvic alignment, look for trigger points in the abdominal wall and the pelvic floor, and check the ability of your pelvic floor muscles to relax. In addition we also like to examine behaviors such as your voiding schedule and fluid intake. Treatment may consist of education on relaxation of the tight areas, behavioral techniques to defer the urgency, and manual work commonly in the abdomen and pelvic floor to decrease the trigger points and subsequently the urges and the incontinence that may come along with that.