Leaking urine is not normal at any age or stage of life. People are often told that during pregnancy, after childbirth, or after a certain age, that leaking urine is normal. I am here to tell you: that is not true! Pregnancy, aging, or childbirth do not need to mean worrying about leaking urine while sneezing or being nervous to take a workout class with your friends. In fact, it is possible to return to running, dancing, weight lifting, and yes, even sneezing with confidence and without leakage.
Your pelvic floor muscles are always “on” to some degree to provide postural support as part of your deep core, and to help you maintain continence. When there is increased demand on the system, like with exercise or coughing, these muscles have to contract a bit more to give you some extra support. Leakage that happens with exercise or with coughing or sneezing is called stress incontinence. In the case of stress incontinence, your abdominal pressure increases with an increased demand on the system, like in the case of coughing, for example. Leakage happens when the pelvic floor muscles are unable to contract at the appropriate time or with the appropriate strength to manage the increased abdominal pressure.
The pelvic floor muscles work together in a system with the muscles that attach onto the pelvis including the hip flexors, abdominal wall, the thigh muscles, the glute muscles, and the low back muscles. When other muscle groups are impacted, perhaps due to an injury or during pregnancy or postpartum, there is increased demand on the pelvic floor. As a result, the pelvic floor muscles have to take on the role of other muscle groups. If they are unable to manage the demand, they may become overactive or weak, and as a result, may not be able to contract appropriately to maintain continence.
An evaluation with a pelvic floor physical therapist can help you return to activities you love without leakage. Your physical therapist will ask you questions to understand when you are leaking, learn more about your health history, and take the time to understand your goals. From there, with your consent, your pelvic PT will perform an internal vaginal or rectal assessment. This will give us a good idea about how your pelvic floor muscles are moving and coordinating. Your evaluation will also include a movement, strength, breathing, and posture assessment to gain a full picture of what may be contributing to your symptoms.
Once we have a clear understanding of what may be causing your symptoms, your physical therapist will create a treatment plan to help you towards your goals. A physical therapy treatment plan to treat leakage may include manual therapy treatment, movement or breathing retraining, targeted exercise, functional training including lifting and carrying, pelvic floor education and habit retraining, and postural correction. At Kaya, our goal is to help you return to functional activities and exercises you love with confidence and without leakage. To better understand how pelvic floor physical therapy can help you, schedule a consultation call with our team!
