A must read for all women who leak a little (especially those who have given birth)
Are you someone who leaks a little when you sneeze, cough, laugh too hard or during a training session that involves jumping?
How many times have you been told that it’s ‘normal’ because you’ve given birth or it’s inevitable with age?
Let’s give you all a bit more information and clear up the main misconception that leakage is normal.
Firstly, what is stress urinary incontinence (SUI)?
Simply put, it’s the leaking of urine during activities that increase the pressure within the abdominal space i.e. coughing, sneezing, laughing, jumping, physical activity and training that involves lifting heavy loads. SUI can happen to women who have or haven’t given birth, and they can occur to young and older populations.
But why is this happening?
In truth, there could be one of many reasons this is happening none of which are simple explanations.
Two Common Causes of SUI
1. an increase in pressure downward onto the bladder
In this situation, we aim to decrease this pressure to reduce leakage. In clinic, it could be to alter the way you’re using your abdominal muscles or providing soft tissue treatment through your rib cage to decrease any tightness you may have.
2. the deep pelvic floor or connective tissue’s inability to help support the bladder upwards.
If the bladder has minimal support holding it upwards when abdominal pressure is increase (i.e. during a cough or when laughing), the bladder will slightly drop causing leakage. It could also be due to weakness of the pelvic floor muscles at the entrance that help to provide a closing mechanism at the urethra (where urine travels down and out).
Whilst these are two common causes, the reasons for leakage will differ from person to person. It could be from…
- pregnancy,
- old age, or
- a combination of reasons.
HOWEVER, the main thing to remember is; just because it might be common amongst certain populations i.e. those who have given birth, those who are older; it
DOES NOT mean it has to be normal.
Common and normal are NOT the same thing.
The questions is…
What’s My Cause and How Do I Stop It?
That’s where a Women’s Health Physiotherapist comes in!
A Women’s Health Physiotherapist can do an assessment with the option of:
· An internal examination that provides us with details of how your deep and superficial pelvic floor muscles are activating, whether or not you’re activating them correctly (i.e. some women may think they’re squeezing but they’re actually pushing instead), what their strength is and how your bladder is moving as well.
· An external examination, specifically to assess how your ribs are moving and what your abdominal muscles are doing.
From there, we’ll know what treatment to provide and what exercises to prescribe you to help prevent leakage.
Treatment For Stress Urinary Incontinence
As mentioned, reasons for leaking urine will differ between individuals, therefore treatment will also differ. Just to give you an idea though, treatment can include:
Soft tissue releases through your pelvic floor muscles, followed by pelvic floor muscle exercises that help to retrain them to activate and optimally function when they need to
Improving your breathing
Release through your ribcage and how your ribcage expands during breathing
Retraining your abdominal muscles – being specific with which abdominal muscles we want to use for certain activities
Releasing and optimising function of other parts of the body that could be contributing to SUI
Advice about what you can and can’t do when exercising
Advice on how to promote optimal bladder function (such as to empty completely and effectively)
Referring on to specialists (if required)
It’s important to know that it’s not just about being told to do kegels and squeeze your pelvic floor. It’s making sure you’re receiving the most appropriate treatment to rectify the cause of SUI and then being prescribed effective exercises to self-manage it.
If you’re someone who is experiencing SUI, and you want some advice and guidance on what you can do to prevent leaking urine when training, laughing or any other activity you participate in that causes you to leak, book your assessment today and let us help you!
