Stress Incontinence: Where to start

Stress urinary incontinence (SUI) is when someone leaks urine with exertion. This can be exercise (jumping, running, high impact, squatting etc) and/or coughing, sneezing and laughing. If you don’t fit into this category you can check out this blog to learn about the different types of urinary incontinence.

There can be many reasons someone has SUI and weakness of the pelvic floor is not the only one. Pelvic floor strengthening in solidarity is usually not a successful plan because there are so many areas of the body that can impact the pelvic floor. See this blog post for examples of why kegels are not for everyone.

If kegels have not been successful for you this is where I suggest to start:

Breathing: 

The diaphragm has an important connection with the pelvic floor. On inhale, when the diaphragm expands down and out, the pelvic floor also moves down and lengthens. If someone is not breathing well through the diaphragm, then the pelvic floor is not moving on a regular basis. This is a great place to start connecting with the pelvic floor through your breath. Try breathing so you expand 360 degrees around your abdomen and see if you can feel movement in your pelvic floor. This is something that should feel very subtle and you should never feel pain or pressure with this. 

Abdominal strengthening:

The deep core layer called the transverse abdominis has a co-contraction with the pelvic floor. Therefore, if we are properly activating the deep abdominals then we can assume that the pelvic floor muscles are also contracting (to some degree). This can take time to build like strengthening any muscle. Continued work on abdominal stability exercises is a good place to start. Check out this video for an example.

Exhale on the hard part:

When it comes to function and having good control of the pelvic floor we need to think about what we do on the hard part of an exercise. For example, I often see people holding their breath when lifting a heavy weight (or object) off the ground. Try practicing exhaling on the hard part of a movement. When we exhale, the deep core muscles (transverse abdominis), activate which has that co-contraction with the pelvic floor. If you don’t exhale that can cause an increased amount of pressure into the pelvic floor possibly causing leaking.

This is not an exhaustive list or applicable to everyone, they are only generalized suggestions. 

If you continue to have leaking contact Jaclyn Collentro at Jaclyn@q4pt.com or 203-520-4101 to set up a free consultation to see if pelvic floor PT is right for you!