Women are affected twice as much as men with urinary incontinence. Specifically, 4 in 10 women have urinary incontinence from pregnancy and over the age of 65. In recent years, this problem has been de-stigmatized by health care professionals being more educated on urinary incontinence and what to do about it along with more affected people speaking out about.
The Pelvic Floor:
The pelvic floor is the hammock-like muscle that supports the bladder, bowel, and uterus (in women-- you can see it referenced in the above diagram.) This is also the muscle that helps control the downward pressure in the abdomen when lifting or straining. Contraction of this muscle lifts the internal organs of the pelvis and tightens the openings of those organs while relaxing the pelvic floor allows the passage of wastes from the bowels.
What goes wrong?
The pelvic floor muscles can either be too weak, resulting in incontinence, or too tight, resulting in the inability to properly empty the bowels. In this blog post, we are going to be focusing on the former.
Common causes of pelvic floor muscle weakness can include pregnancy (this is a huge one!), menopause, straining on the toilet, ongoing cough, pelvic surgery, a fall, heavy lifting, high impact exercise, age, and weight. With this many causes; it seems less surprising how common urinary incontinence can be. While urinary incontinence may be a widespread condition, it is a problem that can and should be addressed.
The two most common types of urinary incontinence include stress incontinence and urge incontinence. Stress incontinence describes incontinence that involves everyday stress on the bladder from actions that put stress on the pelvic floor such as coughing, sneezing, laughing and even physical activity. Urge incontinence describes a leakage after a strong sudden urge to urinate and before the person can get to a restroom—often called an overactive bladder. This usually happens more than 8 times a day and often the person does not urinate much once in the restroom. Many women suffer from a mix of these two, especially with age and after childbirth.
What do I do?
Always see your primary care doctor or OBGYN to diagnose and start the treatment of potential urinary incontinence. This includes medication, referral out to a urologist or pelvic floor specialist. From home, there are exercises that can help.
- Kegel exercises: Kegel exercises are exercises for the pelvic floor muscles that help prevent or reduce stress urinary incontinence. To do these, start laying down or seated (even on a toilet if needed!) and relax the muscles in your pelvis like you are letting go of wind then squeeze and lift those same muscles as you are trying to stop passing wind or stopping peeing. Be sure not to squeeze any other muscles such as your quads or glutes and do not hold your breath. Do this often, as it is a lifelong practice.
- Training your bladder: This can be done by only going to the bathroom at set times. Start by tracking when and how often you go to the bathroom each day. From there, add 15min between each visit, therefore slowly increasing the amount of time between visits and training the bladder to hold more urine before signaling the need to go again.
- Pelvic floor exercises: Core exercise that are pelvic floor friendly are: modified plank with a slight bend at the hips, ball bridge, bird dogs, standing balance work, and various exercise ball movements. Avoid doing strong abdominal exercises and work core exercises that protect the pelvic floor. Exercises to avoid can include sit ups, crunches, v-sits, leg lifts, abdominal machine exercises, and other exercises that put excess stress on the pelvic floor. To help, avoid breath-holding on lefts and breathe out with exertion. Like any other muscle, the pelvic floor exhausts after so much use and more rest may be needed between sets and repetitions on certain exercises until your pelvic floor fitness improves.
Leina Greenwalt coaches at Freedom Fit Gym. She's an ACE Certified CPT with a BS in Human Nutrition, Foods, and Exercise from Virginia Tech. She can be reached at firstname.lastname@example.org