Stress Incontinence: Is it "normal"? 

Jill Heath, PT, DPT

This is a common misconception in the mom world - many a meme jokes about it, and books about motherhood write about the “rite of passage” that inevitably happens after baby. And it’s no surprise we think it’s normal - 1 out of 3 moms report stress urinary incontinence (SUI) after having kids. This is leakage of urine with exertion, including sneezing, coughing, laughing, running, jumping, and lifting. It can be a tiny bit, or enough to warrant wearing a pad. Whatever the circumstances, it is inconvenient, awkward, and not something we need to endure.  

SUI is a symptom, just like pain is a symptom, that there is something wrong in the bladder/pelvic floor/core system. Picture your torso as a barrel - the top is the diaphragm, bottom is the pelvic floor, front is the abdominal wall, and back is the back muscles. These muscles all work together to maintain the pressure system in our trunk, or intra-abdominal pressure. This is our core stability! (Core is not just abs…. but that’s a topic for another blog post :-). They must work in balance to be sure one is not outdoing the other, and SUI is a symptom, just like pain is a symptom, that there is something wrong in the bladder/pelvic floor/core system. Picture your torso as a barrel - the top is the diaphragm, bottom is the pelvic floor, front is the abdominal wall, and back is the back muscles. These muscles all work together to maintain the pressure system in our trunk, or intra-abdominal pressure. This is our core stability! (Core is not just abs…. but that’s a topic for another blog post :-). They must work in balance to be sure one is not outdoing the other, and they are maintaining that pressure. Things that can change that balance can include

Overworking the abdominal muscles Lack of diaphragmatic breathing Insufficiency of the pelvic floor due to weakness, pregnancy, postpartum issues, chronic constipation Alignment causing muscle imbalance

These factors combined with increased abdominal pressure and or impact with dynamic activities causes overwhelming pressure on the bladder, urethra, and pelvic floor, and leakage occurs. This is why so many women experience it. So what can be done about it???  

Physical therapy can help identify where the issue lies - too much abs? Pelvic floor not contracting and relaxing at the right time? Overall posture issues? We can teach how to get all of these things working well together so you can stay active without leaking!