What if I told you that the next time you have an urge to urinate that is so powerful you’re almost certain you’ll leak if you make one wrong move, you should simply consider relaxing everything. This advice is almost insulting. I know what you’re thinking; “Great, another provider telling me I just need to relax. It’s all in my head. Does she really think I wouldn’t relax if I could?”
I can’t attach an exact percentage to it for you, but more often than not, when I am working with a patient to manage their urge urinary incontinence, I actually have to gear their treatment towards something we call “pelvic floor down training”. Pelvic floor down training involves lengthening (or relaxing) the pelvic floor muscles.
Let’s get specific; urge urinary incontinence is when someone leaks urine with just an urge as opposed to a specific movement or action such as running, squatting, jumping, sneezing. Urge urinary incontinence frequently manifests itself in the moments where you’re fiddling with your keys at the front door or unbuckling your belt before you sit on the toilet. In those moments you may have thought to yourself “How was I able to hold it that long just to leak right as I’m about to sit down?” Okay, I’ll stop predicting your thoughts now.
Your pelvic floor is like a hammock for your pelvic organs. Your bladder is considered a pelvic organ that sits nicely in that hammock. If when it’s full, you’re squeezing everything around the organ such as your abs, your gluts, inner thighs and your pelvic floor in an attempt to avoid a leak, you’re simply taking up the space your bladder could use to relax into. Practice relaxing your abs by taking a deep, beautiful breath into your belly. Practice relaxing your gluts and inner thighs by uncrossing your legs and letting them separate a bit. If you’re unsure how to relax your pelvic floor, you can begin by contracting it as if you are trying to hold back some gas, then fully letting that go. I essentially just told you to let your belly hang, man spread, and let one out— advice I am certain no one has ever given to you before. Consider trying this in the comfort of your own home first before taking it out for a spin in public.
This is just what’s happening physically, let’s talk about what’s happening on a psychosomatic level that can also support you leaking less next time we meet.
***As with everything I post, I’m a pelvic floor physical therapist, but I am not your pelvic floor physical therapist (yet!?). This approach is to be used with discernment and at the very end of the day, everyone deserves to sit down with a provider who can tell you what is going on with your body and what treatment approach you would best benefit from. My whole schtick is that I really want women to raise the standard for themselves by no longer accepting these “small” inconveniences that snowball into bigger life inconveniences as we age. If you mention issues such as this one to your physician and they aren’t able to support your healing, consider advocating for yourself by requesting a pelvic floor physical therapy referral. If you’re a candidate for pelvic floor PT, they ought to consider writing you a referral and if they don’t know whether you are or not— time for a new physician!
Synaptic Physical Therapy 