Continence

Millions of women suffer with urinary incontinence (bladder leakage) at some point in their lives. A common misconception is that experiencing a few drops or a stream whilst exercising, laughing, coughing or sneezing is normal. The truth is it is not a normal part life and you don’t have to live in fear of an embarrassing leak.

Urinary incontinence (UI) can affect everyday quality of life causing embarrassment and stress to the sufferer.

What is the Pelvic Floor?

The Pelvic Floor is made up of the muscles, ligaments, nerves and tissue that sit at the base of the pelvis. It attaches to the pubic bone at the front all the way through to the tailbone at the back. It is often described as acting like a sheath or sling to support the pelvic organs – the bladder, bowels and reproductive organs but also assists in bladder, bowel, sexual function as well as trunk stability and mobility.

Which Factors Contribute to UI?

In women, physical changes resulting from childbirth, menopause, ageing or lifestyle factors often contribute to the pelvic floor becoming weaker. When the pelvic floor weakens the bladder can shift downwards and the muscles that ordinarily force the urethra shut cannot squeeze as tightly as they should. This results in urine leakage during moments of physical stress such as laughing, running or jumping.

How do you Strengthen Your Pelvic Floor?

Strengthening the pelvic floor can often cure stress urinary incontinence; it is recommended as a first line treatment for women with stress urinary incontinence.

Studies have shown up to a 70% improvement in symptoms of stress incontinence across all age groups following appropriately performed pelvic floor exercises.

Sometimes referred to as “kegal” exercises contracting and relaxing the correct muscles strengthen and tone the pelvic floor and support and hold up the bladder. A Pelvic Health Physiotherapist can help identify if you are performing your pelvic floor exercises correctly and support you with a rehabilitation programme.

Good Bowel Habits

As we know the pelvic floor is involved in both bladder and bowel continence. Relating to bowel function, in order to maintain continence and not feel any urgency or leakage, the focus is on the rings of muscle (anal sphincters) around the lower end of the back passage. The outermost sphincter muscle is part of the pelvic floor, looping around the lower end of the bowel and can be strengthened with pelvic floor exercises to increase our control and reduce the likelihood of these problems occurring.

Once the stool has reached the lower end of the bowel and is ready to make its final passage out, the bowel contracts to push it down like toothpaste through a tube. In response to this, the pelvic floor must relax to allow the stool to pass without any effort. In some cases the pelvic floor struggles to relax and can indeed work to oppose this movement. This results in the person unable to pass the stool without a great deal of straining which is going to cause further damage and must be avoided.

There are some good bowel habits that can ensure you are looking after your pelvic floor including:

• Don’t rush, take your time and try to relax
• Sit on the loo fully (don’t hover)
• Lean forwards from your hips
• Rest your feet on a stool 
• Rest your arms on your thighs
• Breathe into your belly so it bulges out
• Gently bear down without straining
• If after a few minutes this does not result in success, leave the loo and try again later
• NEVER FORCE ONE OUT even if you have passed a small amount and feel the job is not done but no sign of being able to pass more
• Try later it doesn’t matter