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  • Writer's pictureDr. Crystal Worth

Does Weak = Leak???

Updated: Oct 16, 2023

Stress urinary incontinence: a leakage of urine during moments of physical activity that increases abdominal pressure, such as coughing, sneezing, laughing, or exercise.

Stress urinary incontinence is the most prevalent form of incontinence among women, affecting an estimated 15 million adult women in the U.S.

Did you know that 50% of elite female athletes that have not had children, experience Stress urinary incontinence?

This research is revealing to us that leaking urine during exercise, laughing, jumping and coughing are not just symptoms of the pregnant and postpartum female and the elderly. It is also evident in our strongest women, the elite female athletes.

But isn’t incontinence the result of weakness?

Let's dive in.

Woman Holding her hands over her pants trying to not pee her pants

Women are complicated…literally. Taking into account the ever-changing cycles, dynamic movements and complex physical, chemical, hormonal, and mental aspects of the female human body. We are not simple creatures, however for clarity we can look at things in a simple way.

Stress urinary incontinence reveals that this issue is not just about weakness or aging, but rather the complexity of the female body.

Just Another Muscle

Pelvic floor muscles are just like any other muscle, with the same types of muscle fibers, some allowing for quick contractions and speed, some for endurance and long sustained contractions. Hypothetically, If you were to have symptoms of dysfunction in your hand such as accidentally dropping things, obviously indicating weakness. Your solution would hopefully consist of more than “you must be weak, squeeze this grip thing and good luck, also purchase extra coffee cups for when you drop more”. For women suffering from urinary incontinence, the last thing we want to be told is to do more kegels, buy more pads and the gym girls group text: “don’t forget to wear black, double-unders today”

Coordinated Firing

Back to the hand; A clinician will likely look at the function of joints above, the joints below, neural involvement possibly stemming from other places in the body, differential diagnosis, a thorough history and review of systems, Range of motion and of course strength taking into consideration age, bone health and other comorbidities, before hands on palpation and special testing to identify a root cause.

The approach to pelvic floor physical therapy is not much different. This muscle group

collectively known as Levator Ani, is set apart in that it houses important organs that the human body utilizes for daily function. Pelvic floor muscles are the foundation of our core, located in the bowl of our pelvis, opposing the ever important diaphragm (both of which surround and house new life, are life giving, and the gateway for new life. Oxygen, Babies ya, no big deal) I digress. The pelvic floor SHOULD work in coordination with our diaphragm and co-contracts with glutes, deep abdominals and

inner thigh muscles.

"The human body is the best work of art." - Jess C. Scott

Do you have full range of motion of your Pelvic Floor?

In order for the PF to function properly, it will need access to its full range of motion. On cue your pelvic floor should be able to fully lengthen and fully contract as well as maintain a steady resting state. Aside from Considering age, hormones, state of the nervous system, diet, and other pelvic organ functions, some key indicators that can lead to SUI that are not just weakness are as follows; Lack of full hip Range of motion/mobility, core-breathing dis-coordination, poorly managing intra-abdominal

pressure, low back and abdominal weakness and/or tension, neural impingement, rib to pelvic posture deviations and scar tissue, just to name a few.

Does Weak Equal Leak?

Does Weak equal Leak? Yes….also, very much NO!

Sometimes the pelvic floor IS weak, the bigger question is why? Regardless of the reason, my hope for all of us is that the solution is more than just “Do your kegels.” Understanding how to correctly contract and relax your pelvic floor, for YOUR body, and in a variety of ways and positions that your body spends time in is imperative.

Let's Wrap it up

For a better understanding of why you are experiencing urinary incontinence or other pelvic floor dysfunction symptoms, please don’t hesitate to find a Pelvic floor therapist to guide you on the right path to improved function.

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