Stress Urinary Incontinence: Let's Talk About It + Ways to Help
Stress incontinence:
As a physical therapist, I have seen a lot of women with incontinence issues. We’ve previously posted about urge incontinence so now we’re going to talk about STRESS urinary incontinence. Keep in mind that many people have “mixed” incontinence where they will have elements of both “stress” and “urge incontinence” (you lucky ducks…).
Stress incontinence is defined by the International Continence Society as the “involuntary loss of urine during physical exertion” so exercise, lifting, running, and jumping. I would expand this definition to include involuntary losses of urine with any increase in intra-abdominal pressure (IAP) including cough/laugh/sneeze.
If you experienced ANY urinary leakage during your first pregnancy, this makes you 50% more likely to have incontinence problems later in life. This is why we get sensitive when women brush-off pregnancy incontinence. The presence of leakage (ANY leakage) means your system is not in balance— your body is trying to send you a message! Often women don’t categorize themselves as incontinent if they “only” leaked a few drops or it only happens when they sneeze or jump. Ladies… this IS incontinence and this makes you much more susceptible to having exponentially worse urinary incontinence issues later in life. At E&E, our hearts go out to the woman that can only wear dark pants, needs to use pads for urine leakage, uses perfume to cover their urine smell or reduces water intake for fear of leaking. This is stuff that is very fixable— let’s take hold of your pelvic floor health right now!
As a physical therapist, I cannot preach prevention enough. Whether you experienced incontinence or want to avoid it in the future, the Expecting and Empowered guides WILL be beneficial to you. You can TRAIN these muscles; I want to shout this from the rooftops! That is why the Expecting and Empowered guides have pelvic floor sections in them. Many women are told that incontinence during pregnancy and postpartum is normal; however, incontinence during any stage of life is NEVER normal.
Learn to contract and relax your pelvic floor:
Read HERE for how to activate your pelvic floor— pelvic floor strengthening is the first-line treatment for stress incontinence. Knowing how to contract your pelvic floor well is what’s needed first and foremost for you to be successful
Read HERE for how to relax your pelvic floor - being able to relax your pelvic floor is just as important as being able to fully contract it. Without relaxation, you are pumping your muscle when it is already tight— this not very conducive to strong function. We want this muscle to be relaxed when it is not being called upon and to contract fully and completely when we need it to be “on” so we can be dry!
Women’s health physical therapist:
My biggest recommendation for women who are struggling with incontinence is to go see a women’s health physical therapist. They can help create an individualized plan just for you. Click here to find a women’s health physical therapist near you.
I recently treated a woman that is a nurse. She had her babies many, many years ago, but since then she has struggled with incontinence. This woman found her incontinence to be paralyzing. She told me she knew where every single bathroom was wherever she went and carried a change of clothes with her everywhere. Tired of living like this, she decided to make an appointment with me. After ten weeks of rehab, we were able to get her to a much better place. She was able to live her life again without having to know where the nearest bathroom was at all times. This example may sound extreme, but treating women throughout the lifespan has really been eye-opening to us that issues that begin during pregnancy and postpartum often (unnecessarily) go untreated for long periods of time.
things you can work on yourself:
There are also lots of things you can do yourself to help with incontinence including:
1. Release tissue tension -
Learning to contract and relax your pelvic floor (as discussed above)
Side lying pelvic floor release
2. Re-strengthen - Your pelvic floor and hips are connected therefore if you don’t have proper hip strength then your pelvic floor is going to take on more of the work. You don’t want this! Hip strengthening exercises like happy star can help you strengthen your hips.
3. Dynamic control and incorporating this into everyday activities - You want to properly manage the pressure in your body.
Try to blow before you go, exhale before you do an activity like an exercise or lifting a child.
You also want to make sure you have proper posture. If you don’t have proper posture your organs don’t pull up and forward when you contract your pelvic floor. This up and forward movement is what closes your sphincter and keeps your urine in.