Ask Dr. Etingin: Step-Counting Apps and Urinary Incontinence
Are smartphone step-counting apps accurate?
Smartphone step-counting apps are quite accurate for general activity tracking, but they’re not flawless. These apps rely on your phone’s built-in sensors—mainly the accelerometer and gyroscope—to estimate movement and steps. If your phone is in your hand or pocket, it typically measures steps more reliably than if it’s tucked away in a purse. One study found that phones capture steps best when placed in a pants pocket or on a waistband, as these positions closely mirror body movement. However, the accuracy of smartphone apps can vary. They may undercount steps if you’re walking slowly or frequently stopping, as in a shopping mall. Similarly, individuals with slower gaits or limited arm movement might notice some discrepancies. While smartphone step counters can differ by about 10 percent from actual steps, they still offer a helpful baseline for daily activity trends.
If you need more precise tracking, wearable devices like a Google Watch or other fitness trackers are often more accurate than smartphone apps. These wearables, designed to be worn on the body, feature high-precision sensors and specialized algorithms that allow continuous tracking, even distinguishing between activities like walking and running. So, if you’re serious about tracking steps for health reasons, a wearable may be worth considering for its reliability and accuracy.
Sometimes I have a bit of urine leakage when I laugh or cough. It’s embarrassing to talk about, so I have not discussed it with my doctor. Is this normal?
Occasional leakage when you laugh, sneeze, or even cough may be stress urinary incontinence (SUI), a common condition in women over 50. Stress incontinence occurs when pressure on the bladder—like that from sudden movements or physical exertion—causes a small amount of urine to leak out. This happens because the muscles and tissues that support the bladder and urethra may weaken over time, especially due to age, childbirth, and hormonal changes during menopause. But other types of incontinence, such as urge incontinence, might also cause similar symptoms, though urge incontinence is usually associated with a sudden, strong urge to urinate that’s hard to control. Mixed incontinence, a combination of stress and urge types, can also be a possibility.
Fortunately, there are strategies to manage and even reduce these leaks. Pelvic floor exercises, or Kegels, are one of the most effective nonsurgical treatments for strengthening the muscles supporting the bladder and urethra. To do a Kegel exercise, tighten the muscles you’d use to stop urinating mid-flow, hold for a few seconds, and then release; it should feel like a gentle lift and squeeze of your pelvic area, similar to the sensation of holding back gas. Another way to think of a Kegel exercise is to imagine you’re lifting a small marble with your vaginal muscles—gently squeeze as if you’re lifting it upward, hold, and then release.
Research shows that women who practice regular pelvic floor exercises report fewer leakage episodes. You might also consider bladder training, in which you gradually increase the time between bathroom visits to help improve control. If exercises alone don’t reduce symptoms, another option is a pessary. This is a small silicone device that is fitted by a health-care provider; it is inserted into the vagina to physically support the pelvic organs. Since the causes and solutions can vary, discussing your symptoms with a health-care provider can guide you to the most suitable approach. By exploring these options, you can take practical steps to manage incontinence effectively and feel more confident in day-to-day life.
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