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Understanding incontinence and ways to heal. Hi my name is Sandra Shevlin and I’m going to be talking today about stress urinary incontinence: what it is, how we evaluate it, and generally how we treat it. I first want to start off by showing you a model of the pelvis and the anatomy associated with the pelvic organs and the pelvic floor. Stress urinary incontinence in a nutshell is leakage with any activity where the abdominal pressure exceeds the pressure in the pelvic floor. The most common occurrences of SUI happen with coughing, sneezing, and laughing as well as activities with impact such as running and jumping. Stress incontinence might be common, but it is not normal. It is often seen after having a baby, sometimes after prostatectomy, and even with people who have issues chronic coughing, etc. In physical therapy some of the most common things we evaluate are your pelvic alignment, your pelvic floor muscle tone including your muscle strength which we grade a 1 to 5 on a 5 scale, your ability to be able to accurately recruit your pelvic floor muscles without substituting, and your pelvic floor muscle endurance. Treatment includes instruction on how to best recruit these muscles without substitution, how to coordinate them with the breath and the abdominal wall, and customizing a home program based on your strength and endurance at that time helping to expedite your recovery.