I often get the question from young moms – some pregnant, some who have young babies or toddlers: “What is up with this pee thing? Why am I wetting my pants now when I cough, and when I have to run after my little one, there is no way I can hold it. What is going on with my body?” The “pee thing” can be a bit alarming, but understanding why it’s all happening always helps.
Visualize our pelvic floor as a very thin, muscular tissue that has the responsibility of controlling the passage of solids, liquids, and air from our body, as well as holding up our bowel, bladder, and uterus. This can help us understand how this muscle can have some difficulty doing all its supposed to do as the weight and size of our uterus increases throughout pregnancy. Incontinence reaches its peak in the third trimester, when the uterus grows most rapidly. So this gives us insight into why we leak during pregnancy, but what about those of us who delivered months or years ago? Why are we still leaking? The answer is that our pelvic floor muscles were stretched beyond their limit, damaging the muscle tissue. When this occurs, there is no guarantee that our muscles will just bounce back on their own and resume normal muscle firing and coordination. Just like after knee surgery, we have to do exercises to ensure that our quadricep muscle will fire again and resume normal strength, we should also exercise our pelvic floors after the trauma of pregnancy and delivery to get our pelvic floor to keep us continent and “supported.” Hopefully that answers the “why” and now I want to give you some direction toward a solution.
I am a mother of three and a physical therapist who feels there are a few missing links of information when it comes to dealing with symptoms of incontinence. First of all, women need to know that they can rehabilitate and strengthen their pelvic floor because, most often, this is a muscular issue! And second, women need to learn howto do it. The bottom line is, you simply have to do more than Kegel exercises to strengthen your pelvic floor.
Did you know that our pelvic floor muscles not only tighten as if to stop the flow of urine, but they also elevate to give better support to our bowel, bladder, and uterus? It is this elevation of our pelvic floor that most women don’t get. In order to achieve optimal pelvic floor contraction, you have to perform bothactions. Beyond these two actions of the pelvic floor, there are also several other muscles that enclose the front, back, and sides of our abdomen, what I refer to as our “abdominal basket”. These muscles work in a coordinated fashion with our pelvic floor muscles to enhance their contraction, so working your entire abdominal basket is the final key to regaining control of that “pee thing.”
Please note that symptoms of incontinence not only follow pregnancy but also commonly appear after menopause. We will save that discussion for next week.