Incontinence. Peeing in your pants. Leakage. Just a few ways to discuss the age-old problem that is rarely discussed but insanely relevant in pregnancy and postpartum life.
As opposed to having real conversations and seeking out help to deal with our incontinence, we usually just laugh it off, choose to wear black pants on jump rope days, or purchase those “leak proof” underwear we saw advertised on Facebook.
So, let’s dive a little deeper so we can have a better understanding of what it is, is it normal, and what can we do to fix it:
Urinary Incontinence (UI): any involuntary leakage of urine.
Stress urinary incontinence: any involuntary leakage associated with an increase of intra-abdominal pressure (coughing, sneezing, laughing, jumping)
Urge urinary incontinence: involuntary leakage associated with the urge/need to urinate.
Mixed urinary incontinence: some sort of mix of having both stress and urge urinary incontinence.
>50% of women associated with older age, obesity, and childbirth
>14% of men associated most post-surgical status (prostatectomy most common)
No. UI is not only “not normal” but is a symptom of potential abdominal/core pressure management issues as well as the strength of our pelvic floor and core musculature.
The good ol’ Kegel, or pelvic floor contraction, is used as the first line of defense against urinary incontinence. Don’t get me wrong, there is a time and a place for these. More often than not I see Kegels prescribed poorly and done alone with no change. I have patients report frequently, “I do Kegels all the time but have noticed no change in my leakage.” There are a few things wrong with a “Kegel a la carte” exercise program:
We do too many: our pelvic floor is skeletal muscle (the exact same as muscle like our biceps and quads) if we wanted to strengthen our biceps, do you go and do 200 bicep curls 5x daily? No. That over fatigues and causes dysfunction. Pelvic floor contractions need to be prescribed similarly in that they are exercised 3-4xweekly for a smaller set/rep scheme.
We only train them one way: Going back to those bulging biceps we want, if we were to want to strengthen them, do we squeeze and hold them as tight as we can for long periods of time? No. But that’s normally how people perform Kegels. For muscles to get strong, we need to work them through a range and with differing stimulus and weights.
Sometimes, weakness isn’t the issue: The biggest concern I have with women being told to just do Kegels every day is a lot of the time, it’s not that their pelvic floors are too weak, it’s the exact opposite, they are chronically tight and unable to fully relax. So, contracting over and over again a muscle that already is too contracted can cause issues quickly.
Pelvic floor muscles are a part of a team: As a therapist, yes, we will look at your pelvic floor. But what about your diaphragm? Your transverse abdominus? obliques? What about those glutes that are intimately related to your pelvic floor in the positioning of your pelvis and even the fascia they share. Our pelvic floor works all day long in concert with many other muscles in order to maintain pressure in our bellies, so we don’t leak. Not addressing the many other issues that accompany a dysfunctional pelvic floor is silly. And wrong. And outdated.
We are all so different: differing postures, different pregnancies, deliveries, and different job requirements to name a few. If we know this and acknowledge this, performing 30 Kegel contractions at every red light is so overwhelmingly generic and should be considered as poor advice.
Finding someone to help “you navigate you” specifically and help you gain control of your pelvic floor is imperative to give you freedom and the dry underwear you deserve.
If you want to be on the road to not peeing your pants, click here to schedule a free eval with me today, or find someone in your area to help! And as always, please follow along with me for more information like the blog above at:
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