Have you ever sneezed or started laughing and realised you wet yourself? After having a baby, have you experienced leaking when bending over and standing upright? Maybe you’ve been at the gym and performed a heavy lift and realised you had a small leak. You are not alone! Nearly 6 million Australian men and women experience urinary incontinence.
Furthermore, research has shown that one in four women will experience incontinence post -natal. Incontinence can impact the individual’s life, increase falls, and can sometimes cause depression. In this post we will discuss what is incontinence, how the pelvic floor impacts the bladder causing urinary incontinence, and the benefits of pelvic floor exercises to prevent and improve the impact of urinary incontinence.
What is incontinence?
Incontinence is a term that is described as any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faecal or bowel incontinence).
Incontinence is a widespread condition that ranges in severity from ‘just a small leak’ to complete loss of bladder or bowel control. This condition is commonly associated with pregnancy, childbirth, menopause or chronic conditions such as asthma, diabetes, or arthritis. Occasional leaks can occur when laughing, coughing, or exercising onset by poor bladder control. In addition, you can experience constant need to urgently or frequently visit the toilet, associated with “accidents”. There are two main types of common types of urinary incontinence:
- Stress incontinence is the leaking of small amounts of urine during activities that increase pressure inside the abdomen and push down on the bladder. This occurs mainly in women and sometimes in men (most often as a result of prostate surgery).
– Common with activities such as coughing, sneezing, laughing, walking, lifting, or playing sport. Other factors contributing to stress incontinence include diabetes, chronic cough (linked with asthma, smoking or bronchitis), constipation and obesity.
- Urge incontinence is a sudden and strong need to urinate. You may also hear it referred to as an unstable or overactive bladder, or detrusor instability.
What is the pelvic floor?
The floor of the pelvis is made up of layers of muscle and other tissues that help you to control your bladder and bowel. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in front. A woman’s pelvic floor muscles support her bladder, womb (uterus) and bowel (colon). The urine tube (front passage), the vagina and the back passage all pass through the pelvic floor muscles. A male’s pelvic floor support the bladder and bowel.
Pelvic strength exercises training guide:
Strengthening the pelvic floor muscles can assist in providing support of the reproductive organs and additionally providing urinary control. Although we can’t see our pelvic floor muscles we can palpate (feel) the transversus abdominis (TrA) muscle to ensure activation in some circumstances.
Let’s give it a try:
- Sit or lie down in a relaxed position, make sure your thighs, buttocks, and stomach are nice and relaxed.
- Place your hands gently at the “x” marked position presented in the picture, with skin contact.
- Gently squeeze the ring of muscle around the back passage as if you are trying to stop passing wind. Slowly relax this muscle. You should feel the muscle activate underneath your fingers. Perform this same sequence a few times until have found the right muscle. Ensure that you are not squeezing your buttocks.
- If you are unable to palpate, as you are urinating on the toilet, stop the flow of urine and start the flow again. It is important to do this only once per week to maintain urinary flow.
Our pelvic floor muscles have the capacity to improve in strength and endurance as if we were training a bicep (arm) or hamstring (leg) muscle. Once you have identified the pelvic floor muscles repeat the squeeze and lift and relax.
- Begin by performing a 2-3 second hold. Perform up to 10 squeezes, ensuring that you are completely relaxed between each squeeze before beginning.
- 3 sets of 10 squeezes (3 – 10 sec hold).
It is important to notate that pelvic floor exercises is a general guide and must be individually tailored and monitored as incontinence may require learning to relax the pelvic floor muscles or benefiting from pelvic floor exercises. Physiotherapist can assist providing an individually tailored and monitored program based on your specific needs.
If you or someone you know is suffering from urinary incontinence or experiencing leaking during coughing, sneezing, or laughing give us a call at Generation Physio, we have a friendly team of professionals that are dedicated to changing the lives of our clients. All of our clinicians are mobile and come to your own home to conduct an examination. Give us a call on 1300 122 884 to book a consultation today.
Continence.org.au. (2019). Continence Foundation of Australia. [online] Available at: https://continence.org.au/pages/what-is-incontinence.html [Accessed 25 Jul. 2019].
Navarro Brazález B, Torres Lacomba M, de la Villa P, Sanchez Sanchez B, Prieto Gómez V, Asúnsolo del Barco Á, McLean L. The evaluation of pelvic floor muscle strength in women with pelvic floor dysfunction: A reliability and correlation study. Neurourology and urodynamics. 2018 Jan;37(1):269-77. available from : https://www.ncbi.nlm.nih.gov/pubmed/28455942
Picture 1: Continence.org.au. (2019). About your bladder? · The facts · Continence Foundation of Australia. [online] Available at: https://continence.org.au/pages/what-is-incontinence.html [Accessed 25 Jul. 2019].