The Best Incontinence Product: Exercise

Before you rip my head off, I understand urinary incontinence (UI) pads and liners have there place and time. We do need these products however, when I watch these commercials claiming that these pads and liners are the answers to your prayers and the only answer, I get upset. And the more I learn and talk with patients I observed this is something many women sweep under the rug and don't address because it is "normal". You are suppose to have urinary incontinence post-partum, it is part of the process and part of being a mom. NO!

Some fun facts:

• 17% of women have urinary incontinence pre-pregnancy (I am one of these women) Wesnes et al 2007

• During Pregnancy 46-66.6% of women have urinary incontinence Wesnes et al 2007 - which is predictive of UI later in life Abrams et al 2013

• 1/3 women experience incontinence in the first 3 months post partum Thom & Rortveit 2010 - of these women 92% of them with still have UI 5 years later

The prevalence of women having UI is astonishing. No wonder its believed to be normal. But, did you know that by dedicating some time to yourself you can retrain your body and decrease the risk UI later in life? Notice how I said body and not just pelvic floor. The pelvic floor and Kegel are important but only part of the equation. Maybe your pelvic floor is too tight and Kegel exercises are just making the issue worse, or perhaps you are not performing a Kegel correctly. However, in addition to Kegels and the pelvic floor we need to look at our entire core. This includes pelvic stability and thoracic spine function. We need to actually train our bodies again.

Now, here is the kicker - 20% of women reduce their exercise level due to UI - salvatore S et al 2009. When in actuality these women need to start moving. They need to start training the abdominal wall. Motor control, strength and endurance of the abdominal wall is recommended for individuals with UI. However, this is where the water gets muddy because there is not one right way to restore function to the abdominal wall. The strategies used need to be individualized and task specific.

When you seek out a therapist to help you restore pelvic and abdominal health make sure they are not just giving you a cookie cutter treatment by handing you a piece of paper and sending you on your way.

Make sure they

• assess your posture,

• all 3 levels of your transverse abdominals,

• all 3 layers of your abdominal wall,

• determine if you are able to generate tension in your abdominals

• Ensure that they also look at your pelvic floor (internal or external dependent on their qualifications),

• sacroiliac joint function

• That your entire assessment is not done laying down, they should be assessing you in standing and how you move

On top of a proper assessment your therapist should be taking the time to ensure you are performing the exercises correctly. They should be coaching and cueing you through every exercise. Doing the exercise and doing it properly and feeling it work are two very different things.

Hopefully this short blog has given you a little insight into UI and if you decide to seek treatment that it helps you find the right therapist who is willing to put in the proper time and effort that you deserve. If you have any questions, I am always here to answer.