Ladies, ladies, ladies….. Let’s be real for a minute. Stress urinary incontinence (SUI) is a thing. You may know this thing as “I pee a little when I sneeze”, “I pee when I run”, “I pee when I skip rope” “I pee on the trampoline” “I pee when I quickly lift up my 48lbs child or 100lbs barbell”.  And you know what?  You’re not alone. You’ve probably even had a giggle with your girlfriends who’ve gone through the same thing. You admit that you only buy black leggings because any other colour would be too obvious if there was a “leak”. You may be running again but you go to the bathroom 3 extra times before you go out, just to make sure all the pee is gone.  Skipping rope is a thing of the past…a mere grade school activity.  Trampolines are a no-go zone unless getting your child off of one, but you make sure to have one foot planted on the outer ring and definitely no jumping.

We justify these lifestyle changes because our circle of friends tells us “it’s normal after childbirth” or “oh that happens when you get into intense weightlifting or CrossFit”.

No, no, no with a side of absolutely not.  

PEEING YOUR PANTS IS COMMON, not NORMAL.

Let’s be clear.  SUI is COMMON, but it is not NORMAL.  This would be like spraining or breaking your ankle and limping for 6 weeks but telling people it’s “normal” when you’re still limping 6 months or even years later.  Sure, a panty liner is back-up, a just in-case plan but how is that any different than using a cane for that ankle injury one year later.  Just like there is no shame in spraining your ankle, there is no shame in getting help for SUI. Independence from any external device post-injury should always be the goal of treatment.  Accident-free living is the goal of pelvic physiotherapy.

WHAT CAUSES STRESS URINARY INCONTINENCE?

SUI is the most common occurring form of incontinence in women under the age of 60 and accounts for more than half of the cases.  It is defined as the involuntary loss of urine when there is an increase in intra-abdominal pressure.  Several health factors put you at risk as well as life events.  They include nerve and muscle damage from birthing or surgical trauma, loss of pelvic muscle tone (often seen with aging), hysterectomy, obesity, menopause, chronic coughing due to smoking or lung disease and even heavy lifting or high impact sports in younger female athletes.

SO WHY IS MY PELVIC FLOOR TO BLAME?

Pelvic floor muscles (PFM) act as a sling to provide support for our internal pelvic organs (bladder, rectum, uterus).  When an increase in pressure from our abdominal cavity pushes down, our PFM act to keep everything in…. pee included.  For many of us, our PFMs have become dysfunctional due to trauma or repeated changes in our behavior (heavy lifting) such that they have adapted to a new normal.  PFMs can be too weak but, surprisingly, they can also be dysfunctional if they are too tight.  How many times does your physiotherapist tell you that your quads or calves are too tight and to stretch or roll them out?  Sometimes, our PFMs need to relax so they work efficiently too.

KEGELS?  THROW THEM OUT OR DO 4000 OF THEM?

It depends on your internal pelvic assessment.  Yes. Internal.  Evidence repeatedly supports that women who see a physiotherapist and have an internal pelvic assessment and treatment have much higher success rates in managing SUI and other PFM-related symptoms.  But your physiotherapist cannot determine if you should be doing 4000 Kegels (pelvic floor contractions) or 0 Kegels unless they can feel the integrity of the tissue and how it contracts.  We were all led down the single solution road of Kegels from our mothers, our GPs and even our OB/GYNs.  What if this is making it worse? 

THE GOOD NEWS WITH ALL THIS PEE….

Pelvic Floor Physiotherapy is gaining awareness and IHI is very excited to have Kate Roddy join our team to help you skip, run, laugh, sneeze and wear red, pink and even baby blue leggings to work out in again.  Kate can help guide you back to an accident-free normal.  It’s common to be dry as well.

Kate has been a physiotherapist for 14 years at one of the top sport medicine clinics in Toronto.  After the birth of her two very large babies, she became a busy, athletic mom with all the “common but not normal” post-partum incontinence symptoms.  She has since become a certified pelvic health therapist and a Studio Lagree Pilates instructor.  Her extensive background in all these areas lets her be uniquely suited to restoring pelvic floor function and overall functional movement in women and men trying to be active and accident-free.