Pssst … Come closer … We need to talk about an embarrassing problem

Do you find yourself talking to your friends about how you used to be a runner? You may have run 5k’s, Half Marathons, and even a full 26.2, but now you haven’t run in years because you know when you do, you are going to experience urinary leakage somewhere along the way? You are not alone. One in every 3 women experience this problem, which Physical Therapists call stress incontinence.

Stress Incontinence is a condition where a person experiences involuntary expulsion of urine when pressure within the abdomen increases suddenly, as in coughing, sneezing, jumping, or running. Stress Incontinence is not related to psychological stress, but it can add a significant amount of stress to our lives. It can be so embarrassing it becomes debilitating. It can keep us from wanting to move, much less exercise, compounding the problem. When we become less active we lose our previous fitness level, we get depressed, eat more, and gain weight, making harder to do the things we want to do. It’s a vicious cycle, and it happens to So. Many. Women.

Unfortunately, due to the frequency of its occurrence, stress incontinence is joked about amongst friends and accepted as a normal occurrence of aging and post-partum bodily changes. But just because it’s common doesn’t mean it’s normal, and it doesn’t have to continue to be a part of your life.

The answer is simple. Exercise. Knowing which exercises and how to do them without increasing the problem can be more difficult. That is where physical therapy comes into play. Just as with any other muscular injury/dysfunction, physical therapy may help you regain control of the muscles being affected by stress incontinence: your pelvic floor.

Your pelvic floor is a network of muscles that SHOULD act like a taut trampoline, holding your abdominal organs up inside and resisting increases in abdominal pressure even when coughing, sneezing, jumping, or running. When this network of muscles loses its tone, (due to 9 months of continuously building pressure or any other cause) it descends and can start to act more like a hammock. When muscles are too lax they aren’t as strong and don’t contract as well.

What would I do in physical therapy to help with urinary leakage problems?

• Exercises for postural correction that put your pelvis and therefore, the muscular network that is your pelvic floor, in a better position for functional strengthening
• Learn how to complete core strengthening/stability exercises without increasing intra- abdominal pressure
• Learn specific types of breath work and the connection between the diaphragm and pelvic floor
• Learn how to control intra-abdominal pressure whenever possible
• Learn how to properly complete a Kegel using the right musculature, and how to progress incorporating them while engaging in functional activities
• Create lifestyle changes to decrease frequency/urge for urination; for instance, nutritional changes and scheduled voiding times
• Learn voiding positions that decrease intra-abdominal pressure to avoid worsening of symptoms

It takes one bold move. You have to start talking about your symptoms of stress incontinence outside of your social circle. Talk about it with someone who can help. There are many different resources. While your primary care physician, OBGYN, or urologist, may have suggestions for how they can help with this issue, they may not be aware of physical therapy as an option. Physical therapy is less invasive than many medical treatments available, and it makes sense to start with the simplest, least invasive method to get you back on track.

You were a runner … You can be that runner again. Let us help you get there. At Sarasota Orthopedic Associates our commitment is to get you back on your feet, back to work, back in the game and back to life. With four locations and same day appointments when necessary, our team of physical therapists and orthopedic physicians treat people of all ages. Learn more about us at www.SOA.md or give us a call at 941-951-2663. Appointments may also be made on our website.

Source: Jennifer Clarkson, DPT, L/CNMT is a Doctor of Physical Therapy at Sarasota Orthopedic Associates, as well as a Licensed Massage Therapist with certifications in Neuromuscular Therapy and Integrated Pregnancy Massage.