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Understanding Stress Incontinence: Leaking When You Sneeze!

Why is it called “stress” urinary incontinence if I’m not feeling stressed out? I mean when I leak urine it’s stressing me out, so am I making it worse because I’m stressed out about leaking when I sneeze?

Stress urinary incontinence refers to the “stress” or “pressure” that goes through our body during a particular activity. So, it doesn’t refer to a “mental stress”, however leaking urine with certain activities does tend to stress us out!

Now if you haven’t read my previous blog post “What is the Pelvic Floor”, do yourself a favour and go back and have a quick read, otherwise the rest of this post might not make a whole lot of sense.

So, what causes us to leak with certain activities (like coughing, sneezing, jumping, skipping, lifting weights, lifting babies, lifting grandbabies, carrying groceries, getting out of our chair – ANYTHING!)

It can be one of two things (or a combination!). There’s either something going on with our muscles, or with our fascia (but it doesn’t mean we’re only going to look at the pelvic floor – I’ll explain later).

Recap on the pelvic organs, muscles & fascia

Stress-Related incontinence can be caused by one of two things (or a combination!). There’s either something going on with our muscles, or with our fascia.

So, what can go wrong with the muscles – like any other muscle in the body they can be weak, slow, have poor holding capacity (endurance) or have poor coordination. The good thing is, we can change muscles and by WE I actually mean YOU. With my guidance. Because the only way to change our muscles is to exercise them and learn to integrate them back into the general functioning of our other body systems.

The next thing in our pelvic floor that can lead to leaking urine is if we have damage to our fascia. This can cause Urethral Hypermobility. Imagine that we have a muscle that wraps from our pubic bone, all the way around the back to the tailbone, and then back around to the other side of the pubic bone (deep pelvic floor). These muscles are attached to all the organs they pass with fascia. The facia then wraps between the organs as well. So, we have a thin wall behind the urethra and in front of the vagina and we have fascia behind the vagina and in front of the rectum and anal canal. If the tissue supporting the urethra (wrapping it on to the pubic bone so it doesn’t flop around), gets damaged, all of a sudden it’s a little easier for the urethra to get knocked about by a pressure, rather than holding fast up against the pubic bone to absorb the pressure.

Explore the Difference of Stress-Related Incontinence Anatomically

Notice the difference in urethral support available in your pelvis – and how this may impact your body’s ability to respond to different pressures

Another (easier!) way to think about this is imagining our urethra is like a hose pipe. If we turn on the hose, water will come out. If we then lay that hose across the cement driveway and park the wheel of our car directly over the hose, the water will stop. Because the cement is a really firm backing for the hose, and the pressure of the car causes it to close off. If we then moved the hose on to a trampoline and did the same thing by parking the car on top, the water probably wouldn’t completely stop. Because instead of getting blocked by the cement, the hose would just push into the springy surface and the hose wouldn’t be able to close off.

If our fascia is damaged, we still have lots of treatment options to help you achieve your goal of performing whatever activity it is, without leaking! It all depends on what we find in our assessment,

and what the rest of your body is doing from a “pressure” perspective as well. We might use pelvic floor exercise, breath training, full body strengthening or perhaps fit you with a pessary device.

If you are suffering from leaking, don’t feel hopeless, Pelvic Floor Physio’s are here to help!

Book in to see one today.

Feeling like you need an expert on your side?

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