You’re six-weeks postpartum, your OB-GYN just cleared you to exercise (yay!), you went for a run and peed yourself…. WHAT?!
Yes, it happens, and you are not alone!
Running, jumping, laughing too hard… they can all get you in trouble. This is one of a number of topics I will present that falls under the unfortunate assumption of “you’ve had (insert #) children, what do you expect?”… the fortunate part is there IS something you can do about it!
Let’s begin with why this happens:
As your pregnancy progresses and your baby grows, downward pressure is put on your pelvic floor muscles. Think of your pelvic floor muscles as a sling that runs side-to-side between your hips and front-to-back between your tailbone and pubic bone… it essentially keeps everything from falling out the bottom.
That being said, think of a hammock tied up between two trees. Now, think of what happens if you sit in the hammock… it starts to sag. If you sit in the hammock long enough, you may even stress the material to a point that it will stretch and hang lower over time. The same concept applies to your pelvic floor with pregnancy… it’s stretched from the prolonged, downward load (your abdominal wall experiences something similar too – a topic for another day).
The leaking (stress urinary incontinence) occurs because your pelvic floor muscles have been stretched and deconditioned to a point where they do not have the strength to hold everything in anymore.
Now, what can you do about it?:
Symptoms or not, it is extremely important to retrain your pelvic floor muscles after pregnancy. The easiest way to find and activate your pelvic floor muscles is to stop your flow of urine. Once you know how to turn on your pelvic floor, there are numerous ways to retrain your muscles (i.e. Kegel exercises). For example, you can think about your pelvic floor like an elevator… try to squeeze (contract) the muscles a little bit (elevator to floor 2) or a lot (elevator to floor 10). Once you have this concept, try to contract your pelvic floor to a level and hold there (start with a few seconds and work your way up to 10). You can perform these exercises while sitting in your chair at work, sitting in the car or standing at your child’s soccer game. Pelvic floor exercises can and should be done every day!
If you feel like you are unsure about how to retrain your pelvic floor or if you are having continued issues with incontinence, please contact your healthcare professional. Specially trained physical therapists can provide evaluation, treatment and education on how to address your postpartum and incontinence issues. You can find a trained women’s health physical therapist at: http://www.womenshealthapta.org/find-a-physical-therapist/.