Have you ever leaked with skipping, running or jumping jacks?
What about sneezing, coughing, or laughing? Bladder leaking with increased abdominal pressure or with activities is called stress urinary incontinence. You might relate with Sally’s case. She’s in her late 30s and has two children, one via vaginal birth and one via cesarean. Sally is noticing leaking with running, jumping jacks and sneezing. She says she used to leak a tiny bit with the occasional allergy sneeze before kids. But since having kids her leaking is getting worse. She will only wear black tights when running (just in case) and she runs only in the morning. She finds her leaking is worse if she runs in the evening. She feels embarrassed and worried that her running friends can tell somehow. She isn’t feeling confident that she can control her bladder when out and about. What if she leaks at a family gathering or social function?
How can Pelvic Health Physiotherapy help?
Sally came in for a Pelvic Health Physio Assessment with Jenny. With Sally’s consent, Jenny performed an internal pelvic floor assessment to verify what was really happening. She found that Sally had a strong ‘kegel’ or pelvic floor squeeze. However, she was actually holding too much tension through her abs and pelvic floor for them to work properly during her run. Jenny reviewed some sneezing strategies, as well as observed Sally’s running and jumping. She suggested ways to modify how she was doing those activities that helped decrease her leaking right away!
Sally started noticing changes between her first and second sessions and felt a lot more confident about her ability to control her bladder. Even better, she knows how Jenny can continue to help improve her performance going forward.
Do you relate to parts of Sally’s story?
Here are some questions to think about and things that you can try at home:
1) What posture/position is your body in when you skip, run or jump?
- Play with rib position – relaxing the ribs down (like a little slouch) or lift them up
- Look down or slight lean forward vs looking up/slight lean back – notice any changes
2) Where is your body holding its tension while you are doing your activity?
- Relax the jaw
- Skipping: think quick wrist flicks if you find you move your forearms/elbows a lot
- Notice if you are holding a lot of tension in the shoulders, ribs or abs – try letting this go
3) Does fatigue or intensity influence your symptoms and your strategies?
If you leak only after a few skips (let’s say 8 skips then you leak on the 9th), try doing sets only as long as you don’t have symptoms (i.e. double under to 8, single skip for 5, double under to 8, single skip for 5 etc)/
4) Are you holding in your sneezes?
Make sure you are not trying to hold in your sneezes. When you do this, all of the pressure is moving down into the pelvis! Let your sneezes out (into your elbow or mask, then wash your hands).
5) What is your pelvic floor strength and coordination like?
Having a Pelvic Health Assessment is the most reliable way to find out what is going on for you. But, you can try relaxing the pelvic floor or tightening pelvic floor with your activity and see if anything changes. Have no idea or too hard to tell while you’re moving? Let’s check it out together in a Pelvic Physio session!
6) Is there laxity/tissue stretch around the bladder inside the pelvis that we should consider?
Truly weak pelvic floor muscles and/or pelvic organ prolapse concerns can be a factor for bladder leaking. This is something we can find out with a Pelvic Floor Assessment and chat about management options.
Try these out and let us know how it goes!
Not sure where to start?
- Can physio help with stress incontinence? Yes! Physiotherapy can be very effective for treating bladder leaking, or stress incontinence. Pelvic Health Physiotherapists are specially trained to help treat this issue. An individualized assessment helps to determine the cause of stress incontinence, and from there the Physiotherapist can create an individualized plan that works toward your unique goals.
- What is the best exercise for stress incontinence? There is truly no one size fits all. Because stress incontinence can be caused by muscles that are holding tightly as well as muscles that are truly weak, it’s important to get assessed to figure out the cause. Once your Pelvic Health Physiotherapist has determined the cause, they can come up with an individualized plan and exercises to address your unique issues.
- What do they do in physical therapy for incontinence? Pelvic Health Physiotherapists are specially trained to help with incontinence. With a client’s consent, a Pelvic Health Physio may perform an internal exam to assess the muscles of the Pelvic Floor. Clients may present with muscles that are “too tight” or that require more strength, so it’s important to know what is really going on. The Physiotherapist will then work with the client to develop a plan to address the incontinence. This may include changes to posture, watching running or jumping, changing strategies during coughing or sneezing, and working on pelvic floor strength and coordination.