PELVIC HEALTH PHYSIOTHERAPY & EXERCISE INCONTINENCE
Pelvic Health Physiotherapy is a growing topic and you may want to consider it if during your workout you have ever leaked urine especially when you lift heavy weights, do jumping jacks, or jump rope. Pelvic Health Physiotherapy may also be beneficial for you if you schedule pee breaks before your workout to avoid running to the bathroom or if you have chronic groin or hamstring strains when sprinting.
These are common issues with athletic females especially when returning to fitness postpartum known as exercise incontinence. Pelvic floor dysfunction is an area where most people are not properly educated on & are too embarassed to talk about so they just continue to suffer without receiving any treatment. Also most females believe that incontinence or pelvic pain are a normal part of life, especially after having children.
These issues can have a huge impact on your physical and emotional well being, as well as quality of life.
Your pelvic floor is comprised of many muscles & can be rehabilitated without the need for long term pad use or medications.
It is important to know that pads do not fix the problem, they are just a bandaid solution that leaves your muscles open to further damage if not taken care of with rehabilitation.
1 in 3 women suffer from some kind of incontinence issue, including exercise incontinence, and while this is a problem in and of itself, it can lead to other chronic pain and injuries when you add on athletic activity. It’s time to find out what the pelvic floor is, what it is supposed to do, and what you can do when it doesn’t function properly
WHAT IS THE PELVIC FLOOR AND WHAT DOES IT DO?
The pelvic floor is like a salad bowl keeping all your internal organs supported. The muscles control bowel movement, urine flow, and also sexual and reproductive functions. When these muscles work together they can assist in providing stability and support body posture. In a perfect world, it functions automatically without you thinking about it. In the event that you have some sort of disruption to this automatic function, such as childbirth or injury, these muscle groups may require some retraining to work optimally.
WHY MIGHT INCONTINENCE HAPPEN DURING FITNESS ?
At the end of the day, every part of your body is connected. Your groin, glutes, abdominals, and diaphragm work together with your pelvic floor muscles . If something isn’t working properly, something else will compensate. This is what the body does in any situation. Your neurological system puts function over all else. When something is not working properly, the brain just demands more work of other structures to make sure you can bend, walk, lift, roll, jump, etc. It happens without you knowing until your body starts showing signs like leaking when you laugh.
Example: Jumping : Why do you leak?
What happens during a jump?
The body overcomes the force of gravity and leaves the ground. Upon returning to the ground, the force of your body weight makes contact with the floor. Imagine all those organs in your torso coming down with that force and exerting pressure down onto the pelvic floor. As this occurs, your leg muscles are quickly moving, stressing the pelvic floor where they attach around your groin.
A simple exercise can demand alot on a potentially dysfunctional tissue. So what happens? The pelvic floor could “give” and leakage may occur. The groin muscles may sense the potential for injury and spasm to protect from over-pulling other vulnerable tissue. You may have back or knee pain, because your brain chooses to send the stress to another area in the hopes to prevent further dysfunction in an already weakened area. These other injuries can be a protective mechanism for the weak pelvic floor musculature.
This scenario can lead to overuse. Think of it like this: if your pelvic floor is weak, the groin chooses to compensate to make sure something is stabilizing you. Now the groin is doing 2 jobs – the job of the groin AND the job of the pelvic floor. Eventually, something is going to have to give.
What are kegels and are they good for you?
A kegel is a pelvic floor contraction. If you try to tighten your pelvic floor as if trying to stop the flow of urine, the end result should be a kegel. This is a hot topic as of late, spurring lots of debate as to whether they are the solution or a problem when considering pelvic floor rehab. My answer to the above question is that they need to be prescribed properly to be effective.
Many women who are open enough to discuss their exercise incontinence and pelvic floor problems with their doctors are told, “do kegels.” The amount of reps to do usually comes with s very varied answet which can be very confusing for anybody struggling with exercise incontinence.
A reactive quick kegel will hold against the pressure of a sneeze or laugh to prevent leakage. This kegel comes almost like a reflex – in a healthy pelvic floor it happens without thought or planning and requires appropriate timing to be useful. If a quick kegel happens after you have already urinated a little, your pelvic floor didn’t quite hit the mark.
Kegels may also be used for endurance training, such as holding for 5 or 10 seconds. Unfortunately, if you pelvic floor is already tight, such as in a spasm, further tightening or practice of kegels is not helpful, but in fact can cause more harm. It is also important to note that if you are holding kegels for 10 seconds at a time when your issue is that you pee when you sneeze, you are not retraining the right system.
HOW IS THE PELVIC FLOOR ASSESSED?
First, can you isolate your pelvic floor muscles? Try inserting a clean finger into your vagina and try to perform your kegel. Try squeezing your finger, and then lifting it further into your vagina. A good sign is if you feel a strong squeeze and lift. Next try to hold that contraction for as long as you can until the squeeze dies off. If you can only hold for 3 seconds before you lose tension, you may want to work on holding for 2-3 seconds for a few reps and begin working up to longer holds. As this gets easier, move on to 4 and 5 second holds, or more reps of consistent hold times.
The next step would be to try a quick contraction and relaxation while noting how strong the squeeze is. Now try to see how many reps you get before you feel less power of the squeeze. If you can only do 3 and then feel like the muscles are completely wiped, that would be as if you did 3 squats and your legs became Jell-o. You would want to work on getting the endurance for 4, 5, and 6 kegels in a row, all with the same strong power.
This by no means constitutes a complete assessment, but may inform you whether there is any problems to be addressed by a pelvic health Physiotherapist. If you thought your pelvic floor was weak but you can do the above contractions, there may be weakness in other areas, such as your hips or core. If you can’t isolate these muscles and have issues of exercise incontinence and urinary leakage, there may be good reason for you to come in and visit us for a complete assessment with Marlene Luis or Wenky Ma Pelvic Health Physiotherapists in Vaughan, ON and start addressing the problem.