Yes, I said incontinence. Come on- I wrote a blog about how Pilates will make your sex life better, you think I’m too embarrassed to write about this? Nope! I’m actually writing about this topic because more than one of my clients has disclosed that this is an issue for them- and Pilates has HELPED! So- it’s time to talk about incontinence. There are 2 main types: stress and urge. Stress incontinence is when you sneeze, or cough or laugh or jump up and down, and urine leaks out. Urge incontinence happens when you have a sudden and intense urge to urinate- even if you went a few minutes prior. There are several other classifications- but these are the 2 main ones that most people experience. But does it really matter what we call it? The bigger issue is that you’re peeing when you don’t want to and you want to know how to fix it, right?
The 2 most common things that cause stress incontinence in women are pregnancy- pre and post partum, and menopause. In both cases there is a hormonal shift that encourages relaxation of the pelvic girdle and the added trauma to the pelvic floor muscles that occurs during a natural birth can create a significant weakness in this muscle group that results in the need for, well, diapers. There was a twitter post by model Chrissy Teigan that went viral recently. She said “no one told me that I would be coming home in diapers too”. It’s real… whether we talk about it or not. So lets talk about it. And by the way- men have issues with incontinence too. Weak bladder muscles, weak pelvic floor muscles and certain prostate and nerve conditions can all be factors.
That brings me to the pelvic floor musculature once again. This group of muscles creates a basket at the base of your pelvis that holds everything in and can assist in maintaining a pressure gradient that prevents the unwanted flow of urine. The ability to engage the pelvic floor during the movements that often cause leakage can significantly decrease the amount of urine lost and save incredible amounts of embarrassment and stress. Engaging these muscles has also been shown to help during episodes of urgency to buy you time until you can scurry into the nearest bathroom.
So- How do you engage these magical muscles that not only make your sex life better (check out my blog on Pilates and Sex here: https://pilatesinthegrove.com/get-in-bed-with-pilates/ but also help manage issues of incontinence?
- Identify where they are! Your pelvic floor is made up of a group of muscles that create a sling along the bottom of your pelvis. The anal canal, the vaginal canal in women and the urethra all exit the body through this “sling”.
- Learn how to engage these muscles! Have you every heard of a Kegel? This is the standard exercise to engage this muscle group. I want you to image that you are in a situation where you have to pass gas. We’ve all been there- during an intimate dinner, a job interview, front row of a wedding… regardless of where or when- we’ve all been there. Now- try to “hold it in” and not let the gas out. Lift up and draw the muscles in towards your belly button. Hold this contraction for 10 sec (if you can- if not start at 3 and work up to 10) and then relax. Make sure that your glutes and abs DO NOT CONTRACT! Work up to the point where you can engage these muscles and maintain a contraction for 10 sec (while breathing) in laying, sitting and standing.
- Make functional! Now, you’ve learned how to turn on your pelvic floor muscles when you are being still. But how will that help if your issue is that you pee when you are moving? Jumping? Trying to scurry to the bathroom? Most people don’t have issues with incontinence when they are sitting still. So now the trick is to work on maintaining this contraction while you are moving. Start lying in bed and working on sliding one heel in to your hips, then the other. Once you’ve mastered that work on standing marching while maintaining the contraction. Then start trying to add it in to your day to day activities; walking, picking up the laundry basket, going up and down stairs and during your PILATES practice. It’s this step of being able to maintain the contraction during functional movements that will make the greatest difference in your life.
The great news is, if you’re reading this blog you either already come to Pilates in Grove, or are at least thinking about Pilates. There is mounting peer reviewed evidence and tons of anecdotal reports of Pilates making a tremendous difference for men and women who suffer from incontinence. So I encourage you to talk to your instructor about any issues you might be having. Set up a private session with one of us and let’s work together to get you out of the diaper and pad aisle of the drugstore and back to running, jumping and laughing without fear!
Stephanie Sprout DPT
(Until Pilates makes the difference you’re looking for, check out this amazing product to help keep you dry and feeling confident: Icon Pee-Proof Underwear www.iconundies.com)