Let’s Talk About Leakage
June 25, 2018 8:13 pm
Do you ever pee a little when you cough? Do you avoid jumping because you know it will cause you to leak? How about rushing to the toilet as soon as you get home and still not making it in time?
If any of these descriptors apply to you, know that you are not alone! Incontinence. It’s a word we hear a lot about, but what does it really mean? It is estimated that 3.3 million Canadians experience incontinence, but it’s still an area that is full of myths and uncertainty. It is often something that is viewed as embarrassing, both to experience and to talk about.
Enter pelvic floor Physiotherapy. We get it! It’s not as easy to talk about your bladder issues as it may be to talk about your knee pain. But what if I told you that you could retrain your bladder and pelvic floor muscles just as you could retrain your knee? Sounds a little more appealing than “just dealing with it” right?
We know that every knee injury can be quite different. They’re individual to the person experiencing them. Incontinence is no different. Just as no two knees are the exact same, no two pelvic floors are identical. For that reason, there are different explanations for why you may be experiencing leakage, so let’s break them down shall we.
First, what exactly is incontinence?
Urinary incontinence is any involuntary leakage of urine from the bladder. The nature of this can be divided into three main groups
- Stress Urinary Incontinence (SUI): leakage with increased intra-abdominal pressure from coughing, sneezing, laughing, jumping or movements
- Urge Urinary Incontinence (UUI): a sudden, strong urge to urinate that comes on quickly and is difficult to delay
- Mixed Urinary Incontinence (MUI): can include a little bit of both
Lots of people come into the clinic under the impression that once they have incontinence, that’s just the way it’s going to be for the rest of their lives. Would they say the same thing about knee pain? Probably not. There’s lots of well known rehab options available for knees, so it’s easy to seek out help. This is true of pelvic floor Therapy; however this is an area that not as many people are familiar with.
One biggest pelvic floor myth that physios bust every single day is that incontinence is “normal”. Is incontinence common? It sure is. Does that make it normal to pee every time you sneeze? Nope.
So now we know a little more about incontinence, it’s time for the big question – what can you do to stop the leakage?
This is when a detailed pelvic health exam with a trained professional is beneficial. To understand how to address the leakage, you first have to know what’s causing it. Back to the knee pain – you have to understand what’s going on before you can make a plan to change it. A pelvic floor assessment can give you the most detailed information about the best treatment options for your pelvic floor.
This leads us to another very common myth in regards to incontinence – “if I just do my kegels, that will solve the problem?” What if I told you in some people that may actually make the problem worse…intrigued?
Like we talked about before, incontinence can have different causes. We break down a few of the main ones below.
- Pelvic floor muscles that are weak
- In this case, kegels can be helpful! However, many women are actually doing their pelvic floor contractions (aka kegels) incorrectly.
- Pelvic floor muscles that are tight
- To go to the washroom effectively, the pelvic floor muscles need to relax while the bladder is contracting. Muscles that are too tight can cause irritation to the bladder and the urethra (the tube the urine travels through from the bladder to exit the body). In this case, kegels can actually cause more irritation to the bladder and make incontinence symptoms worse.
- Bladder irritation
- This can be the result of irritants in the bladder or irritation around the urethra. This can cause contraction of the bladder at an inappropriate time and result in leakage.
A pelvic health Physiotherapist can help you determine which one of these factors is contributing to your incontinence, then give a more detailed plan on how to change it.
We’ll finish off with a few suggestions to optimize your time spent in the washroom. We go to the washroom multiple times per day, but are we really thinking about our washroom habits and the effect it has on our bladder? Probably not. The list below goes over some simple changes that you can make to help keep your bladder happy.
- Avoid the “Just in Case” pee!
- We’ve ALL done this one. Getting into the car? Going for a long walk? Better go to the washroom, just in case. We should urinate 5-8 times per day – yup, that’s it! The “just in case” pee actually trains your bladder to sense that it is “full” earlier, resulting in you having to get up and go to the bathroom more often. It is important to listen to the cues of your body and only go to the washroom when you feel the urge.
- Avoid the “Hover”
- To allow the bladder to fully empty, the bladder must contract and the pelvic floor muscles must be able to relax. It’s pretty hard for them to relax if your hips are hovered a few inches above the toilet seat. Sitting down, having your feet flat on the floor and relaxing will allow your bladder to empty well without irritation. Make your washroom visit a relaxing one!
- Don’t drink less water as a way to avoid the leakage
- Did you know the bladder ALWAYS has a bit of residual liquid in it? This means that despite your best effort to keep your bladder empty by avoiding water, you may still get leakage. Having less water in your bladder can actually cause more irritation and increase the chance of incontinence. This is especially true when consuming liquids that can be more irritating to the bladder (alcohol, caffeine, acidic drinks)
- Make sure to breathe!
- Tightness in the diaphragm (the main muscle that helps us breathe) can put more pressure on the pelvic floor muscles and bladder. Often people who experience leakage will keep their muscles tight as a way to try to prevent it. This can actually make it a bit harder to breathing and increased pressure in your abdomen and pelvic floor. So make sure to take lots of deep belly breaths throughout the day!
Intrigued with what you’ve been reading? A pelvic floor Physiotherapist is an excellent resource to answer more of your detailed questions and give you specific information on how you can optimize your pelvic floor and stop the leakage for good!
MPT, BKin, CAFCI, Pelvic Health Physiotherapist,
Dry Needling Certified