Stress and Urge Incontinence
What is Incontinence ? It is when you leak urine or feces. We are going to talk about urinary incontinence here. There are two types -Stress and Urge incontinence.
Stress incontinence is when you increase demand on the bladder through impact or abdominal force. This happens with things like running ,laughing jumping, sneezing ,singing ,speaking or coughing. It is leaking with no urge. Muscular system is not strong enough to handle the stress placed on it ,the ability to close off the urethral sphincter (opening for urine to come out of body ) to prevent leaking is not strong enough . There can be two types of stress ->Impact or pressure stress. Impact stress with running ,jumping is different from sneezing ,yelling , valsalva lifting which is more of pressure stress. Both endurance or maximum strength can be a problem. It’s extremely common, especially after childbirth. It’s not how your body should function. Way too often women are told there’s nothing they can do about leakage, that it’s a “badge of honor” and you need to live with it. In reality, there are some pretty straight forward exercises you can do, (not just Kegels). Physical therapy is the solution most people don’t know about, not even your physician! Some tips to help with stress incontinence –
- Make sure you are correctly performing the pelvic floor contractions , have proper endurance and strength. Pelvic floor therapist can help you with checking for proper endurance and strength.
- Check for pelvic floor tightness. Again pelvic floor therapist can help you with this.
- Do not hold pelvic floor contractions during the impact activities as pelvic floor muscle will get tired and can fail which will cause leaks. Holding kegels the whole time is the worst strategy ever.
- During impact activities like box jump or running try the following tips.
Short quick exhale while hitting the ground during jump rope. With box jumps try exhaling before leaving the ground. So basically utilize exhale for hard parts.
Work on proper running form with ribcage stacked over pelvis, tall,chin tucked,neutral spine ,push off from glutes. Focus on decreasing ground reaction forces with forefoot strike and shortened stride length.
Urge Incontinence is when you feel like you might or might not make it to the bathroom and it may or may not be associated with leaking. It is getting the sudden urge to pee before your bladder is full and truly needs to go. Bladder is the most trainable thing in the body. First what we need to do is identify the trigger and then retrain the bladder.
Few tips for Urge Incontinence-
- Stop the “Just in case” pee. When you habitually urinate “Just in case “ you may be emptying your bladder when it is less than half full. Constantly doing this will train your bladder to think it is full when it is not.
- Do quick flicks where you perform quick tiny contractions of pelvic floor and then let go quickly. This can disrupt the signals and most likely will get the urge to pee to pass.
- Can try decreasing bladder irritants like caffeine, coffee, alcohol ,tomato, citrus fruits etc. Quitting smoking can help.
- Identify pelvic floor tightness or nerve irritation as too much tightness in the area can be a problem. Seek for help by a pelvic floor therapist to attain this.
- Too much liquid can be a problem. So keep a journal and measure your fluid intake.
- Use clock and distractions to train your bladder . Once you are training your bladder to wait for 30 sec or one extra minute and progress from there you are going in the right direction. When you reach home you can distract yourself by looking at your phone before heading to pee or check mail or count backwards from 100. Making your bladder to wait.
- Check with your doctor about possibility of an infection or medication side effects.
Also ,to avoid accidents while training your bladder you can wear pads so you can avoid worrying of fear of accidents and it makes retraining your bladder easier.
Bladder retraining is faster than you might think. It usually takes 3 days to see some changes before you can start seeing some difference.
Again ,make sure to see a pelvic floor therapist for help to come up with a plan of care and get back to things you love without worrying about leaking.