Stress Incontinence

Worrying you’ll leak when you cough, sneeze or laugh

Pelvic floor and incontinence issues are common, with one in three women experiencing problems in their lifetime. The most common type of incontinence is stress incontinence. The good news is that this form of incontinence is usually and easily treatable.

When you cough, sneeze or run, the pressure in the abdomen increases and exerts force on the bladder. The pelvic floor and urethral sphincters must contract forcefully to keep the bladder closed and prevent leaking. If they’re weak, or if there’s movement of the bladder and urethra (normally as a result of childbirth or the menopause), urine will leak out of the bladder and down the urethra.

Studies have shown that tailored pelvic floor strengthening exercises can reduce or resolve stress incontinence in up to 75% of people.

To engage and strengthen the pelvic floor muscles, gently squeeze and lift through the rectum, vagina and urethra, as if you are trying to stop breaking wind and passing urine. For some, imagining pulling up a blueberry into the vagina is a better way of visualising and feeling the lift of the pelvic floor. Hold the contraction for 10 seconds and repeat 10 times. Then complete 10 short sharp pull-ins as hard as you can and quickly let go. Avoid gripping the abdominal muscles, holding your breath, or squeezing your bum and inner thigh muscles. You should repeat this 5 times per week.

Unfortunately, up to 70% of people complete their pelvic floor exercises incorrectly, so it’s always advisable to see a Pelvic Health Physiotherapist to check your technique and adapt the exercises to suit your individual needs. This is even more important if you are experiencing symptoms, as weak pelvic floors are often more difficult to activate and strengthen. Every pelvic floor is different, so exercises must be tailored to suit your individual strength, endurance and exercise tolerance.

Strengthening the pelvic floor muscles works the same way as any strength programme. You need to complete the exercises regularly in order to reap the benefits, and if you stop your exercises you will start to lose strength within 4-6 weeks. To remain consistent with your programme, it’s important to integrate the pelvic floor exercises into your daily routine so they become second nature. If you don’t use it, you’ll lose it, as the saying goes.

It is equally important to strengthen the core and gluteal muscles that work in conjunction with the pelvic floor. These muscles work together to stabilise your pelvic when you walk, sit and move and are often overlooked when treating pelvic floor issues. Strengthening the pelvic muscles ensures the pelvic floor doesn’t absorb additional load and endure undue stress throughout the day. This is particularly important if you notice your symptoms are worse at the end of the day or after exercise.

Pilates – and particularly Dynamic Reformer Pilates is a great way of strengthening the pelvic muscles using a combination of low impact resistance, balance and stability training, as well as postural control. Pelvic strengthening should always be done alongside any pelvic floor rehabilitation programme for maximum benefit.

If you’d like to speak to one of our specialist Pelvic Health Physiotherapists, please complete the following enquiry form and we’ll contact you to arrange a convenient time.

Self-paid pelvic health consultations can also be booked online.

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