Peeing when you cough, laugh, sneeze, run, or jump is common as you get older or after having a baby. But that doesn't make it inevitable.
Stress incontinence is the unintentional release of urine due to increased pressure on the pelvic floor and bladder. This pressure increase occurs with activities such as running, laughing, coughing, sneezing, lifting heavy objects, and having sex. While stress incontinence is much more common in women, men can also develop this condition.
If you are someone familiar with these symptoms, you are probably also familiar with the feelings of embarrassment and lack of control that can accompany involuntary leaking. You are probably also familiar with the sometimes life-limiting steps taken to avoid peeing at inopportune moments. Measures like avoiding sex, laughter, and picking up your kids; constantly wearing liners or pads; discontinuing exercises and activities you love; making knowing where the restrooms are in any new place your first priority.
Talking about this issue can be difficult. So much so it sometimes feels easier to just deal with it. After all, the leaking might not happen all the time. Or if you have felt comfortable enough to talk to a friend or family member, you were likely told, “Welcome to life after having a baby!” or, “That's just what happens as you get older.” Obviously, “dealing with it” is less than ideal otherwise you would not be reading this. It's also important to know “that's just the way it is” is an unfortunate cultural myth.
There are many options for healing stress incontinence. You doctor can discuss all of these with you in detail. (If your doctor is not willing to discuss several options and find the one that is best for you, please do not be afraid to find a new doctor.) The two (best in my opinion) pathways toward healing are pelvic floor physical therapy and abdominal massage.
A large component of stress incontinence is your pelvic floor’s ability to adapt under changing pressure to ensure your urethral sphincter remains closed so you can retain urine until you choose otherwise. When your pelvic floor is taxed and maladaptive, leaking happens.
(Side note: many health professionals will talk about weakness in the pelvic floor as the reason the sphincter opens involuntarily. However, pelvic floors that are Hulking out can also be prone to leakage as their muscle fibers are so tight they cannot contract further to adequately hold position. This type of hypertonicity is much more common than true muscular inhibition. We must also remember that since it is the pelvic floor’s job to respond accordingly to changing pressures to maintain function - i.e. resist downward pressure when jumping and to relax with downward pressure for elimination, to simply say that it is weak (or even overly active) does not always account for the entire picture. To acknowledge this need for flexibility, I will refer to healthy function as "adaptable" as we continue this article.)
Both physical therapy and massage focus on supporting your pelvic floor, helping it to be as adaptable as it needs to support healthy function.
Both massage and physical therapy for the pelvic floor are performed by therapists who have chosen to specialize and seek further education for working with this complex body area. Without getting bogged down in the training and licensure elements of these professions, one of the major differences between the two types of therapies is that pelvic floor PTs are able to work internally (intravaginal and intraanal) whereas pelvic massage specialists will usually work entirely externally via the abdomen and pelvic girdle. You will work with your chosen professional to create a treatment plan that meets your needs, learning self care (such as self massage and stretches, meditation and breathwork techniques), and lifestyle modifications under their guidance. And of course you will also receive the necessary bodywork to help balance the contributing musculoskeletal structures. Combining the work of these professionals can catapult your results to near miracle status! Find a pelvic floor physical therapist here. Find a pelvic massage specialist here.
Who have you consulted about your stress incontinence? What strategies have you used to manage? Have you worked with a pelvic PT or pelvic MT before? What was your experience? Let me know in the comments!
And remember to share :-D
This article is intended for educational purposes only. Please seek the advise of a doctor for medical concerns.
_________________________________________________ Rhiannon Flores-Drennen
LMBT & Founder of Philosopher's Stone Therapeutic Massage
Serving Haddonfield, NJ and Surrounding Areas
Rhiannon loves helping you solve your pain puzzles! A chronic pain specialist with a sub-specialty in pelvic dysfunction, she understands the huge impact pain can have on your life and is dedicated to helping you reach your health goals so you can enjoy your life fully and whole. Though her style can sometimes be described as "therapeutic fluff," she is not the therapist to see for a "just to treat myself" massage.
Augmenting her initial massage training with multiple courses and certifications including SMRT, ATMAT, and IHPS she has the skills to create effective and lasting change for you. But don't go on blind faith - check out her amazing reviews!
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