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Over 25 million adult Americans experience this symptom, yet no one's really talking about it… adult urinary incontinence. It's more common than you know; and not just amongst prenatal, postpartum or menopausal women - but also among athletes and regular folk. It is nothing to be embarrassed about and it can be helped!
Understanding the different types of urinary incontinence (UI) and ways to manage them can make a big difference in your daily life. Let’s dive in.
Are These Perspectives Relatable?
“At first, it was just a few drops when I laughed too hard or sneezed, but over time, it got worse. I remember one particularly embarrassing moment at the gym. I was deadlifting, mid-rep, when I suddenly felt that dreaded leak. I had to rush to the bathroom. It was mortifying.”
“Living with urinary incontinence has impacted my quality of life in more ways than I anticipated. I used to love going for long walks and exercising, but now I'm always worried about having an accident. I avoid drinking too much water when I’m out and about, especially traveling, and I am always looking for a bathroom, just in case.”
Types of Urinary Incontinence
There are two main types of urinary incontinence (UI): stress urinary incontinence and urge urinary incontinence.
- Stress Urinary Incontinence happens when physical activity or exertion, like coughing, sneezing, or exercising, puts pressure on your bladder. This pressure can cause a small amount of urine to leak out.
- Urge Urinary Incontinence is when you suddenly feel a strong need to urinate and can't hold it in long enough to get to the bathroom. It's often described as the “gotta-go” feeling and doesn’t seem to be brought about by exercise.
Pregnancy and Postpartum Implications
For women, pregnancy and childbirth are significant factors that can contribute to urinary incontinence. The weight of the baby and the pressure it puts on the bladder, along with the function/control of the pelvic floor before/during/after childbirth, can lead to both stress and urge urinary incontinence. Postpartum, these issues can persist as your body recovers and adjusts.
This is one of the many reasons that LVLTN’s pre & post-natal coaches program pelvic floor strengthening and relaxation techniques into our clients’ prenatal and postpartum training plans.
Menopause Considerations
Did you know that menopause can also impact urinary incontinence (UI)? Are you within the perimenopause or menopause age range and noticing you have to pee more in the middle of the night?
During menopause, the decrease in estrogen levels can cause the tissues of the bladder and urethra to become thinner and less elastic. The weakening of the pelvic floor muscles can contribute to both stress and urge urinary incontinence. Hormonal changes can also affect the frequency of urination and the urgency to go.
How to Manage
First of all, when you have to go, go! But things like bladder training and working on pelvic floor and core function with a qualified coach or physical therapist would be helpful next steps in managing UI.
Frequent UTIs and Their Impact
Frequent urinary tract infections (UTIs) can also lead to incontinence patterns. UTIs irritate the bladder, making it more sensitive and causing the urge to urinate more frequently. If you're prone to UTIs, managing them effectively with proper hydration, hygiene, and sometimes medication as directed by your healthcare provider can help reduce the impact on your bladder control.
So What Can You Do?
Training Your Bladder for Urge Urinary Incontinence
If you’re dealing with urge urinary incontinence, bladder training can be very helpful. This involves learning to delay urination after you get the urge to go. Start with short delays and gradually increase the time between bathroom trips. The goal is to lengthen the interval between urination and regain control over your bladder.
I encourage documenting your bladder trips. Keep a note in your phone or a notepad in your bathroom. Note how many times you go per day, how long you’re going between wees, how many seconds the stream is, and it might be helpful to note your fluid intake daily as well.
You Can Also Practice the Stop-Pee Test
(One time, not every time you pee please)
While you are on the toilet, stop your pee mid-stream by contracting the pelvic floor. You may notice:
- Your flow will stop as intended, which indicates your pelvic floor control is in good standing.
- The pelvic floor contraction will slow down the stream, but doesn’t stop completely. This means you have some work to do on coordination and strength.
- Nothing happens, the wee keeps weeing. You may need some help recognizing and strengthening these muscles with professional help.
What Else Can We Do About It?
- First, don’t try to self-diagnose and treat. You’re too busy for that!
- Use your health team: your physical therapist, or a pelvic health physiotherapist, your OB/GYN, your coach/trainer, and possibly other professionals such as a urologist.
Relax and Strengthen Your Pelvic Floor
- Learn to both relax and contract your pelvic floor muscles.
- Learn to engage your “deep core” or transverse abdominis (TVA).
- Coordinate your breath with pelvic floor contractions to manage intra-abdominal pressure (IAP).
Integrate Functional Movements
- Start with daily bodyweight squats, practicing pelvic floor relaxation on inhale and contraction on exhale.
- Apply this pattern to activities like lifting children or heavy bags.
- Consistent training and proper technique can improve strength within weeks.
Strengthen Your Glutes
- Strong glutes are crucial for pelvic stability.
- Women who stand with a tucked pelvis (flat butt) often have weak glutes.
Stretch and Improve Mobility
- Stretch your hamstrings, calves, and adductors.
- Relax these muscles and focus on pelvic floor activation to reduce tension and improve function.
Train Without a Belt
- Avoid using a belt for heavy lifting, as it can increase intra-abdominal pressure that the pelvic floor may struggle to handle.
- Train without a belt to fully integrate your deep stability system.
Prioritize Form and Function
- Let your pelvic floor guide your training limits.
- Don’t lift heavier than you can manage without leaking.
- Focus on perfect form and gradually increase the load as your strength and stability improve.
Urinary incontinence is more common than you might think, and understanding the types, causes, and management strategies can empower you to handle it better. If you're experiencing symptoms, it’s always a good idea to talk to your healthcare provider and a qualified physical therapist or trainer/coach! There are so many effective solutions that could significantly improve your quality of life.
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