Urinary Incontinence, or losing pee (urine) any time you do not choose to, is a common women’s health issue following delivery of a baby, in peri-menopause and in older age. This problem is perceived as messy and inconvenient. Smelly. An embarrassing and unavoidable feature of being female, having babies, aging. Luckily, there are plenty of effective, conservative treatment options available.

The most effective conservative treatment is practicing exercises for your pelvic floor muscles and, lets face it, this requires motivation and good habits.
If you are feeling unmotivated about those exercises, commonly called Kegels, read on for some reasons why putting them at the top of your “incredibly long list of things to do” is worth the investment. I’m talking about features of incontinence that suggest it has a more sinister impact upon a woman’s health, across her lifetime.

Women with incontinence often manage this damp problem by choosing to be more sedentary.
They stop jumping, they stop running, they stop dancing. They suppress their laughter, are afraid to sneeze in mixed company. This behaviour might begin in their 20’s and 30’s with the birth of first children and may carry on, in one fashion or another for their lifetime during which time, they will wear pads, feel shame, and stop moving. This strategy to manage incontinence leaves these women exposed to the health implications of a sedentary lifestyle.

Sedentary Health Issues

The following list is a short list of health problems related to a sedentary lifestyle:

• Obesity
• Heart disease
• Chronic pain
• Osteoporosis
• High Cholesterol
• Diabetes
• Increased risk of colon cancer
• Increased risk of high blood pressure
• Increased risk of depression and anxiety and dementia

Incontinence that stops you from moving is not only a problem of inconvenience. It is not merely a social problem. It is a problem this deep, with pivotal implications for health and wellness through your lifetime. Choosing not to move might be the beginning of all the problems to come, the one thing you need to be vigilant about changing.

Movement is Medicine

Recent movement has revealed exciting results that boil down to those three words; movement is medicine.  It matters not what type of movement it is, any kind you want to do will fit this prescription. It can help prevent, cure and control many of our common complaints, from osteoporosis to joint pain, irritable bowel syndrome, cancer and dementia.

Dementia?

We build new neural networks with better protective coverings when we exercise.  All that newness and diversity of networks leaves us better prepared for our brains to age well. This mean, movement prevents dementia.

Incontinence and Dementia Are Linked

Dementia is the most common reason that elderly people require institutionalized care. Incontinence is the second most common reason.  Our brains are protected from dementia when we live active lives. What of the woman who says no to her child’s invitation to jump and run because she might leak pee? What of the woman who doesn’t join the dancing? Who tells herself that leaking is the normal consequence of being female, having babies, and aging? What if she accepts this in her 20’s and spends a lifetime not choosing movement? Looked at all in the same breath like this, it becomes obvious that more than a passing interest in fixing this incontinence problem is imperative.

Convinced! Next Steps?

There are things that can be done to address urinary incontinence. You can have good bladder habits. You can strengthen the muscles that help control your pee, called Pelvic Floor Muscles. You can insert devices called pessaries to help hold your bladder in a better position allowing you to have control. You can have surgery (last resort!). The most conservative of these approaches is a combination of healthy bladder habits and exercises for the pelvic floor.

Pelvic Floor Strengthening Exercises (aka Kegels)

To strengthen our pelvic floors, we need to learn to use the muscles around our urethra (pee tube), our vagina and our anus (poo tube). These are the muscles that help to control urine and feces. When there has been injury, like in childbirth, to the tissues in this area the muscles can weaken.  Exercises for these muscles are often called Kegels. Kegel exercises work, but only if they are done correctly.

Try This at Home

Use a firm chair, and a towel that you sit on length wise with one sit bone on each side of the towel. Imagine that your pelvis is a tripod with weight distributed between your sit bones and your pubic bone at the front. Your pubic bone is thick and strong. It does not press into the chair like your sit bones do. Instead, your weight needs to be tipped toward it, leaving your tailbone free in the air. Gently rocking your pelvis forward and back, and left and right will help you notice where your pelvis is. Try to find your tripod.

Contract Your Pelvic Floor

With this towel underneath you, while sitting on your balanced tripod, when you engage the muscles of your pelvic floor it will feel like you lift the tissue of your perineum off of the towel. When you relax again, you will feel the tissues settle back down onto the towel.

Try This Pelvic Floor Muscle Exercise

Slowly tighten the muscles that would stop you from peeing. Notice if there is any lift of your tissues off the towel. This is subtle, and if someone were watching you, they would not notice any movement. Keep this feeling and take a breath. Then relax your muscles, allowing your tissues to come to rest on the towel again. Repeat the gentle lift, see if you can keep the tissues lifted for the length of time required for 2 breaths. Relax again. See how many you can do before you become unable to create that gentle lift.

Oops! That’s Not Quite It…

The pelvic floor muscles’ function is to provide boney and organ support, not movement. This means, when you contract your pelvic floor muscles no bones should move. When you contract your muscles if you feel your bones move or your position change you are not doing this exercise correctly. Another thing to notice is if you feel the tissues press harder into the towel when your goal was to contract and lift away. If this happens do not keep practicing as this can make your leaking worse.

Pelvic Floor Help

These muscles are deep and small.  Knowing your pelvic floor muscle contraction is right is challenging. Specially trained physiotherapists (sometimes referred to as a Pelvic Health, Women’s Health or Pelvic Floor Physio) can help you understand if you are using your muscles well, and how to train your muscles to be stronger so that you don

’t leak urine when what you really want to do is dance.

Is your leaking stopping you from moving? Choose to move for lifelong health. Use these links to find a physio to help you get there. www.bcphysio.org   www.physiotherapy.ca

About Gillian McCormick:

Moving Spirit contributor Gillian McCormick is a Pelvic health Physiotherapist with over 20 years experience, passionate about elevating homo-sapiens through rehabilitation, education and love. Find her at www.physiogillian.com. For a Free PDF of Healthy Bladder Habits, send an email with “Bladder Habits” in the subject line to [email protected]