“I leak during double-unders,” “I leaked during my training runs for the Cellcom marathon,” “I have issues jumping on the trampoline with my kids.” These are common responses we hear from females that come to us with a diagnosis of stress urinary incontinence. Although each woman experiences her issues of urinary incontinence differently, they all share a common underlying issue — their pelvic floors are not functioning properly, and they are not alone! In fact, research has found that approximately 47 percent of exercising women experience stress urinary incontinence in their lifetime.
What is it?
By definition, stress urinary incontinence is the involuntary loss of urine when there is an increase in abdominal pressure. This can include, but is not limited to, activities such as running, jumping, coughing, sneezing, laughing, and transitioning from sitting to standing. It can not only affect an individual physically, but psychologically as well. Imagine not be able to attend your favorite boot camp class because every time you attempt a squat jump you leak, or not running with your favorite running partners for fear of the post-run wetness. You may be reading this and nodding your head in agreement.
So what causes this involuntary loss?
Most individuals feel this can only occur to those that have given birth. While we may see that more frequently, that is not necessarily the case. Research has also found that 25-28 percent of high school and collegiate nulliparous (never been pregnant) athletes reported incidences of stress urinary incontinence.
Stress urinary incontinence is generally caused by a pelvic floor dysfunction. In brief, the pelvic floor consists of three layers of muscles, ligaments and fascia that work together to provide sphincter control, support for the pelvic organs, stability for the pelvis and lower spine, and sexual function. Together with your diaphragm, deep abdominals and back muscles, these components make up your core. Your core, however, is not that 6-pack that everyone is striving for, but rather the coordination of those four components. Your pelvic health physical therapist will educate you on proper activation and coordination to ensure you are engaging the correct muscles, and modify your current program if needed.
Is it normal?
Despite the myths that often mislead individuals into thinking that unless they leaked, they didn’t work hard enough, this is not normal! It is possible to perform box jumps without leaking, or execute 20 jumping jacks without stopping to use the restroom, and it all starts with having a proper understanding of the central stability system. Sometimes, it’s not necessarily having the strongest pelvic floor, but rather having a properly coordinated system. One very important component when addressing the pelvic floor is realizing that the muscles need to work just like any other muscle. You wouldn’t sit around all day with your elbow bent in a tight bicep curl, so why would you assume that your pelvic floor should be contracted all day? It has to be able to contract and relax just like the bicep. When you have a properly functioning pelvic floor and appropriate form, there is no need to leak.
How is it treated?
If you are reading this and feel like it applies to you, don’t worry, there is a treatment! Pelvic physical therapy can help you. Together with your physical therapist you can learn proper kegels to improve the strength and coordination of your pelvic floor, correct muscle imbalances contributing to the condition, discuss lifestyle choices that could play a part in the condition and learn proper breathing mechanics. Research is favorable for those individuals that sought out treatment, versus those who did not.
Don’t sit around and hope that your symptoms will go away, be proactive and address the issue now so you can return to your favorite exercise class and live a drier life.