Urinary Incontinence Part 2

We’re back!

So last time we discussed 𝙩𝙝𝙚 𝙡𝙚𝙣𝙜𝙩𝙝-𝙩𝙚𝙣𝙨𝙞𝙤𝙣 𝙧𝙚𝙡𝙖𝙩𝙞𝙤𝙣𝙨𝙝𝙞𝙥 and how it relates to your pelvic floor muscles as well as a short 𝒜𝓃𝒶𝓉𝑜𝓂𝓎 𝑜𝓋𝑒𝓇𝓋𝒾𝑒𝓌. If you haven’t read the last post, I’d suggest you do because this post will make a lot more sense.

Now that you have a basic understanding of how the pelvic floor muscles work to maintain your continence, how do we get to the point of having issues with urinary incontinence? Well, depending on your age, activity status, history of pregnancy, or sexual trauma, the pelvic floor muscles must react. Below, I have provided three different examples of how incontinence can occur but I must remind you, everybody and every BODY is different and will react differently to each scenario. 

ᴇxᴀᴍᴘʟᴇ 1: Young woman that participates in high impact sports (gymnastics, running), no history of pregnancy but demonstrates general hip and abdominal weakness. 

-        This example is a potential for experiencing incontinence but it is not always 100%. Her history of high impact sports leads to excessive force through the legs and increased tension in the pelvic floor to maintain continence during repetitive impact. Although this was not discussed in the last post but general hip and abdominal weakness also plays a factor; we’ll leave that for another day.

ᴇxᴀᴍᴘʟᴇ 2: 3 months post-partum woman that has returned to her original exercise programming from prior to pregnancy.

-        With this example, I didn’t state whether this woman gave birth vaginally or by c-section because it honestly 𝐝𝐨𝐞𝐬𝐧’𝐭 𝐦𝐚𝐭𝐭𝐞𝐫. She has carried her child to full-term and gave birth after 9 months of holding this baby in her belly. The pelvic floor muscles are working overtime during those last few months of pregnancy because the abdominal muscles and diaphragm that once assisted with maintaining intra-abdominal pressure, along with the pelvic floor are no longer at their “optimal length” After 3 months, the doc has long since cleared her to return to exercise (barring any complications), and she decides to jump right back in to the exercises and resistances she used prior to pregnancy. At this point, her pelvic floor muscles may still be overstretched from childbirth, she also has not trained the intricate muscles that must work together to not only protect other areas of her body, such as her back and hips, or her pelvic floor muscles which leads to leakage with activity. 

ᴇxᴀᴍᴘʟᴇ 3: 70 year old woman with history of multiple births and inactivity

-        As we age, we lose a lot of water content in our bodies, leading to many things, including dried and tightened muscles. This woman’s history of multiple births (ᴡɪᴛʜ ᴛʜᴇ ᴀꜱꜱᴜᴍᴘᴛɪᴏɴ ᴏꜰ ʟɪᴍɪᴛᴇᴅ ᴘᴇʟᴠɪᴄ ꜰʟᴏᴏʀ ᴛʀᴀɪɴɪɴɢ ʙᴇᴛᴡᴇᴇɴ ᴇᴀᴄʜ ʙɪʀᴛʜ) predisposes her to future pelvic floor weakness and potential pelvic organ prolapse. Her inactivity also leads to further weakening of the supporting tissues of the hips and abdominals. One or all of these factors could have been the cause of this woman’s leakage but she does not have to live out her future dealing with this leakage.

To be honest, there are a million different scenarios in which someone could develop incontinence but you do not have to deal with it alone, or with surgery. Pelvic floor physical therapy can help reduce the likelihood of future incontinence with young women as well as improve the symptoms of those in their “golden years.” 

Soap box moment/Plea as promised: 

Circling back to the pelvic floor weakness and tightness aspect from last time; just because you have incontinence DOES NOT mean you should be doing “kegels” to improve your symptoms, unless you have had an internal assessment completed by a pelvic floor physical therapist. If you have been provided kegels in the past, without internal assessment, and have not found results with such exercises, you may have muscle tightness that is preventing the strengthening of your pelvic floor. Notice how I keep saying “𝒾𝓃𝓉𝑒𝓇𝓃𝒶𝓁 𝒶𝓈𝓈𝑒𝓈𝓈𝓂𝑒𝓃𝓉.” An internal assessment of your pelvic floor muscles 𝗺𝘂𝘀𝘁 be done to accurately determine the cause of your symptoms. If your tissues are tight, kegels won’t do a thing to help you and could potentially cause other issues, like muscle spasms or pelvic pain. 

These two posts only scratches the surface of incontinence; there’s also different types of incontinence, and I don’t mean fecal vs urinary. There’s stress, urgency, frequency, and mixed incontinence.

If you have questions or concerns, please feel free to call the office at 904-516-8121 or email me at Lauren@vighettiPT.com and we can discuss next steps.