Urinary Incontinence and Fall Risk
Falling is particularly dangerous, and unfortunately quite common, for people 65 years and older. According to the National Institute on Aging, more than one in three people in this age group fall each year. Falls could result in broken bones or other serious injuries that could keep someone off their feet for an extended period of time. In order to maintain musculoskeletal (bones, joints, muscles) and cardiovascular (heart, arteries, veins, lungs) health, we all need to be physically active. Unfortunately, recovery from fall injuries can be slow and other health complications could arise as a direct result of decreased activity. Luckily, there are many ways to decrease risk of falling. The list at the bottom of this article is a good place to start, but please talk to your doctor or physical therapist if you have any concerns or questions.
When considering fall risk, people often think about muscle weakness, poor balance, blood pressure changes, confusion, shortness of breath, and vision impairments as primary concerns. Footwear, environmental hazards, and medication side effects are also important to consider.
You might be surprised to know that struggling with urinary incontinence, or leaking urine, can also put someone at higher risk of falls.
Men and women dealing with urinary incontinence might make lifestyle changes in order to stay close to a bathroom, or to have quick access to a change of clothes if an accident does occur. This could result in isolation and decreased daily physical activity. Individuals might also decrease their physical activity if prolonged jogging, walking, or other aerobic exercises causes urine to leak. These lifestyle changes as a result of urinary incontinence can lead to muscle weakness, poor cardiovascular endurance, and lower bone density which we know are important factors for fall risk. Individuals who have urge incontinence or feel like they cannot hold their urine when they get a sudden urge, may find themselves moving very quickly to the toilet without being on the lookout for tripping hazards. This also increases their risk of falling. Many people feel a frequent need to void, but do not actually leak. Some of these people wake up multiple times per night to use the restroom which means they are walking while in a groggy state in the dark.
Vision is a huge component of balance and when this is altered due to darkness, the risk of falling goes up significantly.
Many people think that urinary incontinence is a "normal" part of aging. Leaking urine is common, but it is not "normal" and there are ways to treat it. Now that we know that urinary incontinence can contribute to increased fall risk, it is more important than ever to get the word out that urinary incontinence can be treated by a pelvic health physical therapist. Incontinence is often the result of dysfunctional pelvic floor muscles. If this is the case, your physical therapist can teach you where these muscles are, what they are supposed to do, and give you a rehabilitation program tailored to your needs. The pelvic floor muscles are muscles, just like anywhere else in the body and they can be trained to function properly. You can expect to see some improvement in the first two weeks of training as you improve your coordination. Timeline for resolution of symptoms varies from person to person, but you can expect to build muscle strength and see even more improvement after 6 to 8 weeks of consistent training.
If you or someone you know is over 65 and is dealing with incontinence, please consider seeing a pelvic health physical therapist in order to decrease this burden and decrease the risk of falls.
Steps to Decrease Fall Risk According to the National Institute on Aging
1. Stay physically active
2. Have your eyes and hearing tested
3. Find out about the side effects of all the medications you take
4. Get enough sleep
5. Limit the amount of alcohol you drink
6. Stand up slowly and find your balance before you start walking
7. Use an assistive device for walking if you feel unsteady
8. Use caution when walking over wet surfaces or uneven surfaces
9. Make sure your house is well lit including nightlights to the bathroom if you wake up at night to urinate
10. Remove all tripping hazards including area rugs, cords, or other walkway obstructions that could be tripped over
11. Use the railing when going up and down stairs
12. Wear non-skid, rubber-soled shoes that fully support your feet even if you are just walking around the house
Again, please talk to your doctor or physical therapist if you have any questions or concerns about fall risk. And please let your healthcare provider know if you have fallen in the past year, even if you did not get hurt.