Put simply, your kidneys produce urine, which is constantly trickling into your bladder. When your bladder is needs emptying and you go to the toilet, it contracts and your pelvic floor relaxes allowing urine to pass through your urethra. Stress incontinence is unwanted leaks in between toilet visits when the pressure on the bladder has increased (perhaps due to a sudden movement or a sneeze) and the pelvic floor muscles are not strong enough to keep the urethra closed. This can become embarrassing, and also limits what activities you feel comfortable doing, or what clothing you feel at ease wearing.
In extreme cases surgery may be necessary, but most of the time pelvic floor strengthening exercises will do a fantastic job of reducing episodes by improving body awareness and re-educating the mind body connection.
Why me?
For women, most commonly stress incontinence occurs after child birth, during the menopause, as we age, throughout obesity or after prolonged high impact exercise. For Men, pelvic floor issues commonly arise after Cancer treatment, usually for prostate or bowel Cancer. So that’s a huge portion of society who can be affected. This is so unbelievably common, yet people don’t want to seek help because they are too embarrassed.
What shall I do?
Pelvic floor exercises are key when trying to limit or prevent stress incontinence. Pelvic floor muscles can be squeezed in any position. You don’t need to be laying a certain way. Once you have the ability to squeeze and control them, you can do it anywhere and no-one will know.
Why will this help?
Pelvic floor muscles can be held at a constant rate (we usually say 30% in Pilates). This strengthens their endurance fibres and allows the muscles to work harder throughout each day for you. They can also be squeezed maximally quickly. This strengthens their strength fibres and encourages them to react quickly when needed, like when you sneeze. The combination of these, along with some homework (10 fast squeezes each time you use your phone / stop at a red traffic light) should see an improvement in your pelvic floor function.
How do I squeeze it?
‘Squeeze as if you need to go to the toilet, but you’re not quite in the bathroom yet’. Everyone can relate to this, and it works for both sexes. Once you have the basic understanding of how to squeeze it, you just need to remember to do it. In a Pilates class, the instructor is on hand to remind you, but after that, you are trusted to try and make it part of your day. Apps are now available to remind you to activate your pelvic floor at various intervals throughout the day. Your phone will beep and you can tick off that they have done it.
If your symptoms are quite severe, you may need medical intervention. If you are in any doubt, see a medical practitioner. They may need a scan to assess your situation accurately.
In Pilates we engage our pelvic floor muscles throughout every exercise we do meaning you are constantly reminded. This is because it is so important. For some, it is the most important part of the session. There is no specific exercises that are more effective or provide a quicker road to recovery. Little and often is the main focus. Don’t worry. You are not alone. Pilates can make a difference and will give you back your confidence.
