Updated: Aug 19
We live in a society where we have normalized incontinence for almost all women; athletes, moms, pregnant women and anyone over the age of, say 55. Even younger girls, well past the potty-training years are leaking. We laugh about peeing our pants when we sneeze or run, but secretly wish it didn’t happen. But hey, it is “normal”, so we keep going, making sure to swing into the local drug store to pick up some pads on our daily run. Leak pee, in any amount is your bodies cry for help. It is a signaling a dysfunction within the core system, or that the movements and exercises we are engaging in are creating too much pressure for our system to manage, meaning we may have some work to do, in order to safely manage the demands of that activity. It is important to realize that just because your body is struggling with a certain exercise today, it does not mean you are weak and you can, in most cases train your body to excel at whatever it is you want to do safely.
There are few situations that we may “allow” leak pee without being overly concerned about the function of the core and pelvic floor, mainly during the first 4 – 6 months postpartum or after a surgery or injury to tissues of the core. In these cases, we have to allow the bodies to go through their own natural healing process. However, accessing support and treatment to encourage this healing process, such as services provided by a Pelvic Floor Physiotherapist is always a good idea, especially if symptoms continue long term.
Why Do People Leak Urine?
Like I stated above, leak pee is a signal that there is some dysfunction or excessive pressure/strain within the core system. The core, which includes the pelvic floor is comprised of different muscles, tissues and nerves, that are meant to work together to manage and utilize intra-abdominal pressure to help stabilize the spine and pelvis during movement, as well as holding their own individual functions. In terms of the pelvic floor, one of it’s roles is to support continence, allowing urine to release when we are ready and not before. It should function almost like a trampoline, tensing and releasing in response to the activities of the body, for example a sneeze or carrying a child. These activities may require endurance, strength and appropriate timing. For various reasons our pelvic floors can become less functional. The pelvic floor can become less “bouncy” and get stuck in a pattern of tension, or relaxation. Often times there can be a combination of both. It may also fail to respond in a timely fashion, or easily fatigue. All of these scenarios compromise the integrity of the core and pelvic floor, making us more susceptible to leak pee among other things.
Every part of the core system has a role to play and when, even one member of this team is “offline” or slow to respond to the demands of the body, the entire system is in trouble. Now I know this sounds scary, but our bodies are very smart and adaptable, so when one area of the system is dysfunctional, other areas will often pick up the “slack” and we may be able to continue doing the things we love with little to no limitations or discomforts. However, sometimes we start to notice things like increasing back pain, pressure in the pelvis or leaking urine. Please don’t panic if you experience any of these symptoms as with the right treatment, like a Pelvic Floor Physiotherapist, Body Worker or Qualified Fitness Professional these symptoms can be improved or corrected, allowing you to go back to doing the things you love and feeling more like you.
What causes these dysfunctions within our core system?
In most cases I do not believe there is a single factor that causes core/pelvic floor dysfunction. I believe in general it is a combination of factors that contribute to this weakening of the system such as; constipation, genetics, inflammation, pregnancy, birth, core compromising movements and exercises, breathing mechanics and stress. Often times it can take several years of pressure and strain being put on our tissues before we notice any symptoms. This is why we often associate body aches and pains with aging. However, it is not the aging in itself, but more of a tissue tolerance issue that results in these discomforts within the body. All tissue has a breaking point.
In terms of pregnancy, which is often blamed for causing incontinence, prolapse and other symptoms within the body, I believe in many cases, pregnancy is the “straw that broke the camel’s back”. If pregnancy caused these issues, then every single woman who has ever given birth would be peeing their pants, and this is simply not true.
Why is leak pee such a big deal?
Ok, so you probably know at least a few women who occasionally or regularly leak pee. It just seems like such a common issue and one which is often talked about with a lot of laughter and a sense of “we are all in this together”, like common ground for a group of women. If it is so common and at times “funny”, how can it be such a big deal? Especially if it is just a little when you sneeze or jump on the trampoline.
Leak pee is a big deal, because like I mentioned above it indicates a dysfunction or excessive strain within the core system. And although a little bit of occasional urinary leakage may not feel like a big deal, if we continue to ignore it, over time the issue may become greater, interfering with our daily activities and self-confidence. As urinary incontinence is a symptom of dysfunction or excessive strain on our tissues, without treatment we may start to experience not only an increase in the amount of urine we leak, but other symptoms associated with a core system that is in need of some TLC. Things such as hip, pelvic and back pain, instability, poor co-ordination, fatigue, poor concentration, prolapse, foot pain and even fecal incontinence, to name a few. It is also important to know, that next to dementia, incontinence is the second leading reason women are admitted in to long term care facilities. Incontinence can also contribute to things such as anxiety and depression.
What can we do about it?
The great thing about leak pee is that is in most cases it is very treatable and even preventable. The very first thing I recommend to any woman who is concerned about the function of her pelvic floor is to see a Pelvic Floor Physiotherapist. Other practitioners who can be helpful in restoring and protecting the function of the pelvic floor are, Dieticians, Naturopaths, Osteopaths, Massage Therapists, Occupational Therapists and Qualified Fitness Professionals.
My approach as a Pre/Postnatal Pilates Trainer and Functional Core and Pelvic Floor Training Specialist to core and pelvic floor dysfunction is to treat it as an issue that not only effects the function of the entire body, but one that is effected by the function of the entire body. Therefore, when working with women experiencing incontinence, I help them re-awaken, connect to and strengthen their entire bodies, not just the core and the pelvic floor. There are many strategies I use to do this including; encouraging frequent movement and movement variety, proper footwear, avoiding restrictive clothing, healthy diet, hydration, stress management, restorative re-training and training exercises, optimal breathing and alignment. Healing can be highly influenced by the ways we move, breath and align our bodies. We are all powerful and capable of healing we sometimes just need a bit of guidance and support. And in some rare situations surgeries or medications may be needed to treat incontinence, but in my non-medical expert opinion these should be used as a last resort.
My hope for those who have made it to the end of this blog are that you never experience leak pee, but if you do you now realize that it is no laughing matter. However, although an indication of an excessive strain or dysfunction, it is not all doom and gloom. Incontinence is something that is preventable and treatable. Incontinence is not a life sentence and you do have the power to live the life you want, do the activities you love and stay dry all at the same time.