Sitting on the sidelines because of the fear of losing bladder control may actually be making your leakage worse in the long run. It's a simple case of muscle de-conditioning. In the physical therapy clinic, we often talk to patients about the "viscous pain cycle". The pain cycle goes like this - pain leads to decreased activity, which leads to muscle de-conditioning, which leads to increased pain with use, which leads to greater limitations of activity and so on.
Incontinence issues can fall into this same cycle. Even though it may not cause pain, you can substitute embarrassment, apprehension, or inconvenience as the cause for decreased activity. By limiting our activities because of involuntary leakage, we will see increased weakness of our pelvic floor muscles and the supportive musculature of our abdomen and pelvis. This will lead to even less bladder control over time as we continue to limit more and more of our activities.
How can we break the cycle? We can do it by writing down those activities that we love and make a point to do them 1x, 2x, or 5x a week. Initially this may feel uncomfortable. We may have to wear a sanitary pad or bring an extra change of clothes, but we are pushing ourselves out of the dangerous zone of inactivity and limitations. By continuing the walking, the dancing, the running, the hiking, etc., we ensure that we are keeping our muscles conditioned. With a goal of participating in these activities symptom free, we can choose to devote 30 min/day to specific pelvic floor strengthening exercises and postural retraining. You can learn these exercises from a women's health physical therapist in your area or by finding a physical therapist guided "at home" program on a dvd or within a book.
Your commitment to continue the activities you love while actively strengthening your pelvic floor muscles and the muscles of your abdomen and pelvis that support your pelvic floor will set you on the path to complete bladder control. It takes a commitment to learn how to effectively perform a Kegel contraction and to elevate your pelvic floor muscles. A commitment to learn how to find and how to hold neutral spine posture throughout your daily activities to give your pelvic floor optimal support. A commitment to strengthening the transversus abdominus, the multifidi muscles, your deep hip rotators, and your inner thigh muscles to enhance the contractile strength of your pelvic floor. All of this, while committing to continue with those activities you love!
Tasha Mulligan MPT, ATC, CSCS
Creator: Hab It: Pelvic Floor dvd
Published On: February 10, 2010