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Urinary Incontinence, No Laughing Matter

August 30, 2014

incontenence_490X327.145219If peeing during a workout is no laughing matter, why do we sometimes pee when we laugh or when we workout? As Toretto said in Fast and Furious 6, “We all got a weak spot.”

Urinary incontinence is the unintentional loss of urine. Stress urinary incontinence (SUI) is prompted by a physical movement or activity such as coughing, sneezing, running or heavy lifting that puts pressure on your bladder. SUI is usually associated with dysfunctional pelvic floor muscles. Often pelvic floor muscles fail to properly activate when a force such as a heavy lift or jumping occurs. Other contributing factors may include too much pressure from poor or dysfunctional respiration. This can be further complicated by extra abdominal weight, pelvic organ prolapse and/or chronic constipation.

If you or someone you know is experiencing SUI, don’t panic.
This happens to between 20% & 40% of (postpartum) women depending on which research you read. Men, don’t feel left out, since up to 11% of men have urinary incontinence, too. Therefore, you’ll likely feel better if you remove feelings of shame and embarrassment from your repertoire surrounding this topic. Contrary to popular beliefs, you also shouldn’t wear your incontinence as a badge of honor when you lift heavy weights.

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Stress urinary incontinence is not something you have to live with. Seek professional help from a physical therapist. You may need to wear pads or liners for a short period of time, but make your ultimate goal to be leak free.

Always try conservative treatment first without immediately seeking pharmacology or surgery. Physical therapy is one of the most effective treatments available for stress urinary incontinence (SUI). We use a variety of techniques and approaches. Not just Kegels!

Your physical therapist will fully assess how your body is functioning as a whole, including if you are contracting the right muscles through the pelvic floor and sphincters. PTs also consider things like bowel (i.e. constipation) and bladder function, strength, function of the diaphragm, back and abdominal muscles, hip muscles, respiration, surgical history, fitness level, and much more! PT will help optimize your movement, improve your function including pelvic floor retraining, decrease excess stress and abdominal pressure, and provide education regarding bowel and bladder habits that can impact your progress. Sometimes we utilize pelvic floor biofeedback, pelvic floor electrical stimulation, real time ultrasound and other modalities.

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You see? It’s a lot more than just Kegels! Give yourself the freedom to laugh a lot pee-free.

 

References:

Bo. Regular pelvic floor muscle training before/during pregnancy does not affect labor and delivery negatively. 2009.

Morkved. Pelvic floor muscle strength and thickness in continent and incontinent nulliparous pregnant women. Int Urogyn J and PF Dys. 2003;15:384-90.

Reilly. Prevention of postpartum stress incontinence in premigravidae with increased bladder neck mobility: a randomized controlled trial of antenatal pelvic floor exercises. Br J OB Gyn. 2002; 109:68-79.

Sampselle. Effect of pelvic muscle exercise on transient incontinence during pregnancy and after birth. Obstet Gyncol. 1998;91:406-12.

Hay-Smith. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women (Review). Cochrane Database of Systematic Reviews. 2009, Issue 4. Art. No.: CD007471. DOI: 10.1002/14651858.CD007471.

Ko. A randomized controlled trial of antenatal pelvic floor exercises to prevent and treat urinary incontinence. Int Urogynecol J. 2011; 22:17-22.

Bo. Effect of antenatal pelvic floor muscle training on labor and birth. Obstet Gynec. 2009; 113:1279-83.

Rortveit. Urinary incontinence, fecal incontinence in a population-based, racially diverse cohort: prevalence and risk factors. Fem Pelvic Med & Rec Surg. 2010; 16(5): 278-83.

Ewings. Obstetric risk factors for urinary incontinence and preventative pelvic floor exercises: cohort study and nested randomized controlled trial. OBGYN. 2005; 25(6):558-64.

Burgio. Urinary incontinence in the 12-month postpartum period. OBGYN. 2003;102(6):1291-98.

Rogers. Postpartum genitourinary changes. Urol Clin North Am. 2007 Feb; 34(1):13-21

Brown. Prevalence of urinary incontinence and associated risk factors in postmenopausal women. 1999; 94(1):66-70.

Chaliha. Urological problems in pregnancy. BJU International. 2002; 89:469-76.

El-Hefnawy. Severe stress urinary incontinence: Objective analysis of risk factors. Maturitas. April 2011; 68(4):374-7.

McLennan. Patients’ satisfaction with and attitudes toward vaginal delivery. J Reprod Med. 2005 Oct 50(10): 740-4.

Figuers C. Unpublished abstract. A Study of Postpartum women: Description of reported health issues within the first 3 months post-pregnancy. Duke University, Durham NC 2004.

Dunbar et al. Understanding Vaginal Childbirth: What do Women Know About the Consequences of Vaginal Childbirth on Pelvic Floor Health? JOWHPT. May 2011; 35(2):51-56.

Viktrup. Risk of stress urinary incontinence twelve years after the first pregnancy and delivery. OBGYN. Aug 2006; 108(2):248-254.

Dolan LM, et al. Stress incontinence and pelvic floor neurophysiology 15 years after the first delivery. BJOG. Dec 2003, 110: 1107-14.