by Magdalen Link
I remember in college when I was competitively cheerleading it was a joke among my friends that sometimes we peed a little when we tumbled. A roundoff backhandspring on a hard basketball court puts a lot of pressure on the pelvic floor–but little did I know back then. I have seen this same joke play out in different ways–moms crossing their legs when they sneeze, looking at their kids saying “you did this to me!” And clinically I see it time and time again. “Do you leak when you cough sneeze or jump” I ask. “Oh yes, but I’ve had 3 kids so…
Stress urinary incontinence is leaking (a little or a lot) of urine with any activity that increases the pressure in your abdominal cavity such as sneezing, coughing, laughing, jumping, running ect. It is very common–up to 30% of women experience stress urinary incontinence–but it is not normal. There are many factors that can contribute to the development of symptoms. Some include poor coordination, strength or relaxation of pelvic floor muscles, damage to the pubocervical connective tissue, urethral hypermobility, ect. During pregnancy your pelvic floor has not only the job of holding all your internal organs but also holding a baby. This is hard work and can lead to stretching of pelvic fascia and weakness of the pelvic floor muscles. Childbirth, particularly where forceps are needed can lead to stress urinary incontinence from damage to the pelvic floor. Chronic coughing, straining when having a bowel movement, or excessive weight gain can also lead to SUI.
What to do about it?
The good news is–most of the time it is treatable! First line of treatment is conservative management which includes lifestyle changes, pelvic floor physical therapy and/or pessaries. In pelvic floor physical therapy, treatment may include pelvic floor muscle strengthening, relaxation, coordination training, optimizing your body’s ability to manage pressure, and strengthening surrounding musculature. Sometimes the pelvic floor needs a bit of internal support in the form of a pessary. A pessary is a small device that fits into the vagina to help support a prolapse of the uterus, bladder and/or rectum. If all else fails, surgery may be an option for you.
It is important to normalize talking about pelvic floor health so the high percentage of people who have pelvic floor dysfunction can get the treatment they deserve. So the next time you hear someone joking about their stress urinary incontinence tell them a pelvic PT can help!
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