August 15, 2015

A Secret I Have Kept for 11 Years

There is a stroke issue I have never shared with doctors, family, or friends - urinary incontinence.
After I feel the urge to urinate, I have 5 minutes to get to a toilet before I begin to slowly leak urine no matter how hard I squeeze my muscles.  I did Kegel exercises that tighten the muscles of the pelvic floor, but they did not make the problem go away. So I managed this problem by memorizing the location of every bathroom in the places I visit in the community.  I do not shop or sit down for a performance until I know where the bathroom is.

Then I came across a blog post that takes a different approach to urinary incontinence -

The authors say "focusing on the [pelvic] floor does not take into account the floor's synergistic relationship with the adductor muscles."  This got my attention because I have weak hip adductor muscles
(see arrow in diagram).  The authors say "hip adductors attach to the pelvis ..... and strongly influence the urogenital muscles of the pelvic floor."  They suggest strengthening the adductor muscles by squeezing a ball between bent knees while lying on your back.

Bottom Line: I started doing the ball exercise and discovered 2 things.  The window I have to find a toilet has increased from 5 to 10 minutes. 
If I feel the urine start to flow I can stop it long enough to get to the toilet by picturing myself squeezing the ball between my knees.

I'm amazed by my ability to regain another skill 11 years after my stroke.


  1. I difficulty to hold my pee (after my stroke); I will read your article / "Addendum to OT Practice Article”. I think that will work. Thanks!

  2. What wonderfully useful information! Methinks i'll try that exercise. As a person of a certain age who is occasionally troubled by not having enough time to find the bathroom, I could use any exercise that increases my window of safety.

  3. Hi Rebecca,

    I am very happy to hear that you have been able to improve your continence with the approach that we outline in the ot practice article and our blog (ot practice was not able to accommodate the whole article).

    Warmest Regards
    Bill Gallagher PT, CMT, CYT
    Director, East West Rehabilitation Institute