‘If you’re leaking, just do Kegels!’ — sounds familiar?
If you are leaking, even a little bit, it is a PROBLEM! Leaking is common but not normal, and it can be treated with conservative care without medication, injections, or surgery… But treating a Leaky Bladder is NOT all just about doing Kegels.
Before we even start talking about the treatment itself, let’s take a closer look at what actually a leaky bladder is.
So what are we exactly talking about?
About having accidents — when you’re trying to work out or maybe even just go out shopping. I know that many women wear a sanitary pad as a precaution because they are afraid of having an accident. My patients tell me that they have started to limit what they do when they work out, eg. when they are jumping or running because they are simply worried they could ‘wet in their pants in public’. Pretty scary thought, ugh?
But what causes a Leaky Bladder?
Changes to the pelvic floor muscles, pelvic bony structure, bladder tissues, or the anal sphincter muscles can happen during pregnancy and labor/delivery which can cause a Leaky Bladder or in medical terms Urinary Incontinence.
There are 2 main types of a Leaky Bladder (otherwise Urinary Incontinence):
- Type – Stress Incontinence happens when physical movement or activity puts pressure on your bladder, eg. when you exercise. But this can sometimes happen even when you just cough or sneeze.
- Type of Incontinence is called Urge Incontinence (or Overactive Bladder) when you have a sudden urge to ‘go to the restroom’ and you simply have to ‘drop everything and go’.
Watch my short video here where I talk about these two main types a little bit more (1:10 onwards):
A Leaky Bladder can also occur during the aging process but is treatable without medication by physical therapy regardless of age. Oftentimes women put up with leakage for years before it gets “problematic” and they bring it up to their healthcare provider.
One of the reasons why it may take my patients to go and try a physical therapy treatment for their Leaky Bladder can be a simple fact that they are worried about the process of evaluation or assessment before any treatment can be considered. Does that sound like you?
Let’s talk about how we assess for Urinary Incontinence and what the treatment entails.
The treatment at the Healing Spot has 3 phases:
Phase 1: Assessments
Step #1: We conduct a Phone Consultation
Yes, before we even start into looking at anything and doing any evaluation, we want to talk to you so we can understand your problem fully and make sure that we can actually help you.
Step #2: We offer you a Discovery Session
After that phone consultation, if you qualify for it, we may offer you a discovery session where you sit down, face-to-face with us and we’ll go a little bit deeper: you’ll tell us a little bit more about you, your past, etc. See, we at the Healing Spot look at our patients as whole people so we really want to know what’s going on with you. We look far beyond just your diagnosis of incontinence. What you might not think is related to your incontinence we as pelvic floor specialists may be able to see as part of the bigger picture, and we will help guide you and offer you a customized treatment.
Step #3: No cookie-cutter approach, please!
Absolutely, we couldn’t agree more. Don’t expect any fits-for-all approaches, we pride ourselves to treat everybody as an individual and so their treatment is fully custom made to FIT your individual needs.
Enough Justine, I can hear you saying, I get it, but what I really want to know is: ‘Am I gonna have to be naked? Do I have to take all my clothes off? What am I to wear?
We usually start our first session with a standing assessment when we look at your posture. At that point, I recommend you’d be wearing a pair of shorts and either a tank top or a sports bra. To observe your posture is very important. It will tell us a lot of information about you: about where your body is pulled out of alignment, where those restrictions or those so-called sticky spots in your body might be that may be contributing to your Leaky Bladder.
What else are we looking for?
We don’t just look at what’s the strength of your pelvic floor. If you’re being told: “Hey, if you’re leaking just do Kegels, beware! That’s not what everybody needs because some people already have a strong core and strong pelvic floor muscles, but they may have many other issues that can be more complex than it can seem at the first glance.
I talk about those in my video here (watch from 3:15 to 7:50):
As you know, our women’s bodies are a little bit more complicated, especially if they’ve gone through a birth/delivery, so we look out for implications like: Diastasis Recti, Open Birth Pattern or Pelvic Organ Prolapse or any pelvic floor imbalances. These all can contribute to a Leaky Bladder or be a part of the problem.
Is that all? How about an Internal Assessment?
As women’s health physical therapists, it’s within our scope of practice to test the integrity of the pelvic floor muscles internally. We would talk to you about the Internal Assessment ahead of time, educate you, get your permission, of course, we’re in agreement for this we would check your pelvic muscles internally. I describe the process in my video here (watch from 7:53).
That doesn’t all happen on day one, depending on whether you’re ready for this and the customized treatment we offered to you.
Phase 2: Alignment, Mobility, and Inner Core Strength
We don’t see people for one or two sessions only, because we know it takes longer than that to get back the alignment and mobility in the pelvic area. Once these are back then we can start to build the Inner Core Strength. It’s a little bit like building a house. We’ve got to build that foundation first. We have to bring awareness to what the Inner Core muscles are and how to engage them. And maybe even do some Kegels if appropriate. 🙂
In Phase 3 we’ll be working on functional things
What are your goals? Do you want to run, do you want to work out? Specifically, do you want to run a half a marathon…? Do you want to take care of your kids? Do you want to push a stroller or do you want to have your baby on your back? Or maybe if you’re an older lady you might be thinking: ‘I just wanna make sure that I don’t pee my pants when I go shopping…’ So Phase 3 really is looking at those overall long-term goals and preventing re-occurrence. You want to make sure that we don’t stop too soon and things don’t regress.
Talking about a Leaky Bladder and Exercise…
Stress Incontinence can cause leaking with running, HIIT workouts, Cross-Fit, lifting weights, jumping…even with just laughing or sneezing! Check out my 3 simple tips if you wear a pad “just in case” when you exercise, if you’ve ever had an embarrassing accident, or if you’ve stopped certain parts of your favorite workouts due to Stress Incontinence.
This is a fair amount of information on the topic of a Leaky Bladder and how to heal it. Everybody’s needs are unique, so how many sessions you need, how many assessments, what exercises, etc will be custom made and as unique as you are.