01 Apr Let’s talk about Leaking
By: Karin Salzman, Registered Physiotherapist & Pelvic Health Physiotherapist
As a pelvic floor physiotherapist, one of the most common symptom clients talk to me about is urinary leaking, also known as urinary incontinence. There are a number of different types of incontinence. Some clients experience leaking with a sneeze, cough or laugh, while jumping on the trampoline or even standing up after finishing to pee. This kind of leaking is called stress urinary incontinence. Some people experience a strong urge to pee and leak prior to making it to the bathroom or once they arrive in the bathroom but before sitting comfortable on the toilet. This type of leaking is called urge urinary incontinence. Leaking is a very common issue impacting over 3.3 million Canadians (1). This includes men of all ages, young ladies who have never had kids, mamas postpartum and ladies in their golden years. Urinary incontinence is very common, but as my colleagues and I say, “Common, but NOT normal!”
Why does leaking happen?
When the pelvic floor muscles are functioning as part of a well coordinated and efficient muscular system, they provide closure around the urethra and keep us continent when we are going about our activities. (To learn more about the pelvic floor, see our previous blog post for a lesson of the pelvic floor and how it functions). Prior to a sneeze, cough or any increase in intra-abdominal pressure- like a jump, these muscles should be able to provide a little extra closure around the urethra to ensure that we stay dry. Leaking is a sign that the pelvic floor muscles aren’t able to do their job effectively. This can be due to the muscles being overactive (working to long and hard without a break) or under-active (unable to work hard or strong enough). It is my job as a pelvic floor physiotherapist to figure out the nature of the muscle dysfunction. In either scenario- treatment involves rehabilitating the pelvic floor and surrounding core muscles by ensuring they are at their optimal length and then re-educating them to function as part of an efficient and well-coordinated pelvic floor and core system.
You should know that pelvic floor physiotherapy, including pelvic floor muscle training, has been recommended as first-line conservative management to improve and cure any type of incontinence (2). So stop your leaking and come in to chat with your local pelvic floor physiotherapist!
In the meantime, if you are experiencing leaking as you go about your day some important things to ask yourself include:
- Am I adequately hydrated? This will vary from person to person and depend on your overall diet but a good general rule is eight 8 oz cups per day or the 8×8 rule, easy to remember. Turns out that adequate hydration is super important in treating incontinence.
- Am I regular with my bowels? This means not only are going regularly (this could vary from person to person) but also, ensuring that you pass bowel movements with ease so that they do not require you to strain and leave you feeling completely emptied. Straining on the toilet to have a bowel movement, even a little bit, can prevent the pelvic floor muscles from functioning properly. If you are straining, assess your diet for adequate fiber, hydration levels and positioning on the toilet. Ideal position on the toilet is feet elevated on a stool. This allows the pelvic floor muscles to relax and the rectum to empty fully and easily.
- Take note of the following: When do you leak? Does it happen throughout the day? Later in the day? Which activities cause you to leak? Take notes! This information will shed light on when your pelvic floor muscles are not coping well. Take this info to your physiotherapist, it’s valuable.
Lastly, know that urinary incontinence is NOT a symptom you have to live with. Don’t just assume that it’s a common part of pregnancy, aging etc… you CAN have you life back and live in a world with no leaking.
Want to know more? Contact us with your questions! We would love to continue the conversation!
(1) The Canadian Continence Foundation (2018). What is Urinary Incontinence? [website]. Retrieved from http://www.canadiancontinence.ca/EN/what-is-urinary-incontinence.php
(2) Dumoulin C, Hay-Smith EJC, Mac Habée-Séguin G. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews 2014, Issue 5. Art. No.: CD005654. DOI:10.1002/14651858.CD005654.pub3.