Sneezes are scary sometimes. The truth about pelvic floor dysfunction.
Posted by Liz Sims, PT, DPT - Redpoint Physical Therapy, Plymouth, Massachusetts
You see commercials for it all the time. Happy women dancing with their new found confidence, thanks to pads to help with urinary incontinence (UI).
For much of my life up until recently, this was something that only applied to "old people". Well, I guess I'm “old” now... I still remember the first time I sneezed while pregnant and peed my pants a little. And every sneeze since then, continuing to this day causes a similar and justified fear. Heaven forbid a sneeze catches me off guard and I don't brace myself in time!
But it goes beyond that, sadly. 50% of the time, running has a similar effect (that's one more valid excuse to skip it!). I can avoid an incident if I remember to contract my abdominal muscles and perform kegal most of the time.
And I'm not alone. According the the National Association for Continence (NAFC, nafc.org) 25 million Americans experience signs and symptoms of UI - close to half of which experience severe symptoms. While an estimated 81% of these reported cases are women, men are not in the clear, with roughly 2-15% reporting issues with incontinence.
UI doesn't have to be a dramatic pants-wetting event. Just because you don't need a diaper doesn't mean you're in the clear.
While leakage is common, it is *not* normal. It is *not* a normal side effect of aging, and should *not* be a result of exercising. EVER. It is a sign of pelvic floor dysfunction (PID), meaning the muscles in your pelvic floor are not working the way they’re supposed in conjunction with the rest of your core stabilizing muscles.
Here’s how the pelvic floor should work:
Can Physical Therapy help?
A PT can help you learn to control your pelvic floor muscles again, as well as improve core stability, helping to minimize leakage. This works for men and women! Below are 2 exercises to get you started.
Per Julie Wiebe, PT, the “ski jump” is a neat way to recruit your “kegal muscles”:
An important step in learning to control your abdominal and pelvic floor muscles is to learn "diaphragmatic breathing":
There are some great resources floating around the internet these days. Julie Wiebe, PT, is a sports medicine and women's health therapist who is doing a great job mainstreaming treatment for pelvic floor dysfunction.
Depend has a "community & support" section containing useful advice and resources.
The National Association for Continence has links to find healthcare providers, clinical trials, and educational materials.
As always, I am happy to advise. If you have any questions or concerns, don't hesitate to call or email! As usual, I vow that if I can't help you, I'll find someone who can :)