Laugh Without Leaking

Picture this: You are in the middle of your new favorite workout class at the gym. It’s fun, it’s giving you great results, and (uh oh), it’s time for that one maneuver (burpees, star jumps, kettle bells, insert the move here). You know… the one part of the class you dread because, like clockwork, you leak urine during THAT move. You are frustrated, embarrassed, and now wet and uncomfortable.

If this sounds like you, or like something similar that you deal with, you are not alone. At least one in 10 adults experience some form of urinary incontinence, also referred to as “loss of bladder control”, “urinary leakage”, and sometimes “overactive bladder”. Although this is a problem of both men and women, young and old, it is more common in women.

Approximately 26% of women aged 18-59 years have a form of urinary incontinence.

One in 10 of these women will have a surgical procedure to help and, of those who undergo surgery, one in three risk re-operation.

There are several forms of urinary incontinence or leakage, only a few of which I will briefly discuss here:

Stress Urinary Incontinence: Involuntary loss of urine when coughing, sneezing, laughing, exercising, running, lifting, etc.
Urge Urinary Incontinence: Involuntary urine leakage after a sudden urge to go. This is often referred to as “overactive bladder” and you may find triggers, such as an urge to go as soon as you arrive at home, right before a long run or workout, or getting up in the middle of the night to urinate
Mixed Urinary Incontinence: Involuntary bladder leakage due to a combination of the above two types

So then, what’s the deal with all of this leakage going on? You might be saying to yourself “But I do my pelvic floor squeezes, so this is as good as it will get, right?”. Unfortunately, many of us are told to “do pelvic floor exercise” and nothing more is said about the topic. However, are any of us actually taught how to properly perform a pelvic floor exercise? How about form, repetition, sets….all of the things you would want to consider when building your biceps and triceps and butt muscles with weights at the gym should also be considered when strengthening the pelvic floor musculature. By the way, what exactly are we supposed to be exercising?

Pelvic floor exercises are designed to help strengthen the musculature of the pelvic floor.

The “pelvic floor” refers to several muscles, joints, ligaments, & other soft tissue in the groin area around the vagina (or penis) and anus that support the body’s weight, the organs of the pelvis (reproductive organs, bowel, and bladder), and function to prevent urine or fecal leakage. A research study of women with urinary incontinence found that nearly half of the women needed “hands on” coaching by a medical professional to help correctly use the pelvic floor muscles and perform a correct contraction. Additionally, 25% of these women actually performed the OPPOSITE of a pelvic floor muscle contraction when not provided with individual coaching. This means that they were actually doing exercises to make their urinary leakage worse! So no wonder some of you who have exhausted yourself with the pelvic floor muscles have not had success!

On the other end of the spectrum, some people may be performing perfect pelvic floor muscle exercises and feel that they have a strong pelvic floor, yet continue to have urine leakage. Urinary incontinence is not just a matter of muscular weakness of the pelvic floor. There may also be overactive pelvic floor muscles that have become tight or inefficient, thus preventing the bladder from filling with fluid and causing the sensation of needing to pee often.

Of course, nothing is ever perfectly compartmentalized. By this I mean that our bodies function as a whole unit from head to toe. It is extremely important to first recognize that just because the adverts say that “pee happens” doesn’t mean it needs to happen TO YOU. It is also important to have a candid conversation with your doctor or physiotherapist to rule out any serious medical problems that may be causing urine leakage and to discuss conservative options, such as pelvic floor physiotherapy, to actually take control of your symptoms. Ask your GP or consultant about being evaluated by a pelvic floor or women’s health physiotherapist who can perform an assessment of your pelvic floor, hip, & abdominal musculature in order to provide you with the help you need to be leakage-free and worry-free.

Many individuals with pelvic floor dysfunction have great success with pelvic floor rehabilitation and physiotherapy. You may not necessarily need to live with the cost of medications, adult pads and diapers, and the embarrassment and inconvenience of urinary leakage.

At Chichester Physio Ltd we have a physiotherapist on staff with advanced training in pelvic floor rehabilitation and women’s health who would be happy to discuss any questions you may have! Call today (01243 783040) for your consultation.

—Karen Irons is a Chartered Physiotherapist who specialises in pelvic floor rehabilitation in men and women and women’s health physiotherapy at Chichester Physio Ltd in Bosham.