I saw a saying on a billboard
somewhere that said, “I laughed so hard I wet my plants.” Although it was meant
in a humourous way, individuals whom experience incontinence do not find it to
be a laughing matter in most cases. Why is incontinence not a laughing matter?
Because incontinence is the involuntary loss of urine, meaning you had no
control.
In Canada based on the Canadian
Continence Foundation numbers, approximately 3.3 million Canadians have
incontinence (1). I’ve read estimates in various studies saying 1 in 3 or 1 in
4 women will experience incontinence in their lifetime and 1 in 9 men. If it is
so common, why aren’t more people talking about it and most importantly seeking
treatment for it?
I believe it is because media and
even some healthcare providers have normalized incontinence as normal after
giving birth and something that comes with age. Just because something is
common, does not mean it is normal. There is a shift happening currently where
more celebrities and healthcare providers are working really hard to spread the
word about pelvic health. I am just one of those people trying to educate
others.
Okay so, what’s this about 3
different ways I can lose urine?
Well, there are 3 types of
incontinence that are the most common, stress incontinence, urge incontinence
and mixed incontinence.
Stress
incontinence: the loss of urine associated with increases in abdominal
pressure, such as coughing, sneezing, laughing, lifting, running and high
impact exercises.
Urge incontinence: is when you get
the sudden urge to go pee and you rush to the bathroom but don’t make it.
Mixed Incontinence is a combination
of stress and urge incontinence.
What can I do about it?
Very good question. Most women are
familiar with the term “kegels” which are basically pelvic floor contractions.
But are they enough? And are they right? I want to take the time now to clear
up a few things.
Yes Kegels can be helpful if they
are performed correctly. Many women “think” they are performing them correctly
but I often see in my practice that they are also contracting compensatory
muscles such as the abs, inner thighs or buttock. I also see clients whom are contracting
more strongly around the anus, which is great for keeping control of stool but
are under-utilizing the muscles around the urethra where the urine comes out. So
if you are thinking about trying kegels at home, I strongly encourage you to
find a pelvic health physiotherapist near you to ensure kegels are right for
you and that you are performing them correctly.
Now, its important for me to note
that “kegels” are not for everyone! In some cases can make your symptoms worse.
I see more often than not pelvic floor tightness that leads to weakness. In
these cases learning to relax the pelvic floor muscles helps to optimize
strength because the muscles can actually move through their full range of
motion. So if you are performing kegels and are not getting better it can be
because a) you’re not doing them correctly b) you actually have tightness in
the pelvic floor or c) lack of coordination with other muscles.
Lastly I wanted to clear up that
incontinence is not just something pregnant women get. Several studies have
been conducted showing young female athletes get incontinence too. One study
found the highest percentage of incontinence among young women is in gymnastics
and track and field (2, 3). This is another discussion that healthcare
providers are trying to educate coaches, parents and athletes about,
incontinence in sports. It is more common than previously thought and again
common but not normal.
Other risk factors aside from
pregnancy for developing incontinence are obesity, surgery, strenuous work or
exercise, constipation, straining with bowel movements, chronic coughing and
older age (4).
What about age? A large study of
34,815 women out of Norway found, 10% of women had incontinence between the
ages 20-24, 14% 25-29, 18% 30-34, 21% 35-39, 24% 40-44, 28% 45-49 and 30% 50-54
years old (5). Although the percentage of women experiencing incontinence does
increase with age, younger women experience it too.
I hope you found this article
informative about incontinence and that it cleared up some misconceptions. So
ladies and gentleman if you have incontinence, please find a therapist whom is
trained in pelvic health and can perform internal exams so that they can help
you. To find a therapist close to you, visit www.pelvichealthsolutions.ca
Don't forget to follow me on Facebook.
The Pelvic Health Lady
References:
1.
Canadian
Continence Foundation, accessed n Feb 4, 2017 from http://www.canadiancontinence.ca/EN/what-is-urinary-incontinence.php
2.
Nygaard
et al. 1994. Urinary incontinence in elite nulliparous athletes. Obstet Gynecol
84: 183-187.
3.
Nygaard,
IE. Does prolonged high-impact activity contribute to later urinary
incontinence? A retrospective cohort study of female Olympians. Obstet Gynecol
90: 718-722.
4.
Bø, Kari. 2004. Urinary Incontinence,
pelvic floor dysfunction, exercise and sport. Sports Med 34(7): 451-464.
5.
Hannestad
et al. 2000. A community based epidemiological survey of female urinary
incontinence: The Norwegian EPINCONT Study. Jorunal of Clinical Epidemiology
53: 1150-1157.
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