Don’t make me laugh…
Updated: Oct 5, 2021
Hands up if you’ve ever peed a little when you’ve coughed or sneezed, maybe you’ve laughed so hard you’ve felt like you were going to wet yourself, perhaps taking on skips or double unders at the gym leaves you cross-legged, or you’ve lifted that little bit heavier and oopsie, you’re now worried you’ve got a visible wet patch in your tights!
It’s not often talked about, yet is surprisingly common and so often it is believed that it is just something you have to put up with. We blame it on getting older, or on having had children…. Well ladies we don’t have to live with it. There are things you can do to help yourself.
I’ll be honest, not so long ago I went much heavier than usual in a kettlebell goblet squat, the first few reps were good but I got to the 5th, I squatted quite deep, and as I went to push back up to standing I felt a little give and then the worry that I’d peed myself. Thankfully nothing notable, but it made me wonder who else might be experiencing the same thing and what I could do to start the conversation.
As a personal trainer we have these conversations with clients and modifications are easily made, as a group fitness instructor – not so much. But I want to put it out there that you shouldn’t be afraid to talk to your instructor, people modify their workouts for all sorts of reasons and injuries, and I would prefer they take responsibility for their health. We openly talk pelvic floors in our Mum’s exercise classes, yet I’ve never heard it mentioned in a regular class. There are always those that just don’t want to go heavier with lifting, some ladies steer well clear of the skipping rope or any higher impact activities, and some require mid-class trips to the bathroom, IF this is because of fear of a little wee, I want to reassure you and give you my tips for a less stressful gym experience.
If any of this sounds familiar, there’s a good chance that you’re dealing with stress incontinence, and you’re not alone, research shows that….
About 1 in 3 women have stress urinary incontinence at some point.
Muscles can weaken when you give birth, particularly if it’s a vaginal delivery and symptoms can occur right after childbirth or not until several years later.
Muscles can also be weakened by surgery, heavy lifting, being overweight, constipation, chronic coughing or menopause.
You’re more likely to develop stress incontinence as you age, but it’s not inevitable, nor does it have to be permanent. (please note that “stress” refers to physical strain and has nothing to do with psychological stress.)
My first piece of advice would be to go and see a Pelvic Health Physiotherapist. They are little known about works of wonder that, in my opinion, all women should have access to post birth. They will help you rehabilitate your pelvic floor muscles. As a pelvic floor safe trainer, my advice is always to seek professional specialist help first. It's my role as your trainer to provide you with pelvic floor safe exercises and correct your form to ensure you are protecting your pelvic floor. I encourage you to practise engaging your pelvic floor using this simple technique. The video below shows you a simple way to work on engaging your core and pelvic floor, at first you may only be able to hold the squeeze for 1–2 seconds, but if you keep practising, you should find you are able to hold the squeeze for longer.
At home… an easy one to do while you are brushing your teeth/food prepping/washing the dishes or simply sitting watching TV.
Squeeze and draw in your back passage as if you’re stopping a fart.
Squeeze and tighten your vagina like you’re holding a tampon, and your bladder as if you’re stopping your urine flow.
Keep breathing normally while you do these exercises.
Hold the squeeze for a few seconds – at first you may only be able to hold the squeeze for 1–2 seconds until your muscles get stronger. Later, try to count to 10.
Relax, pause, and then repeat a few times.
Make sure that you don’t pull in your stomach or squeeze your glute muscles when you squeeze – you will be using the wrong muscles if you do this.
Aim to do these squeezes a few times per day.
In the gym…
You need to learn how to use your pelvic floor and protect it. Make sure you are using correct lifting technique, including switching on your pelvic floor and core as you lift. If you are unsure of how to do this, ask a Pelvic Floor Safe trainer or book a one to one session where you can focus on this vital skill. It’s your body and your workout, so own it and always remember to put your pelvic floor first.
My top tips for pelvic floor safe weighted workouts are:
Breathe. It’s common to hold the breath when lifting a heavy weight or during periods of concentration. But try to focus on exhaling when lifting a weight (remembering to lift and engage your pelvic floor) and inhaling when lowering a weight.
Maintain good posture. Maintain the normal inward curve in your lower back during every lift/lower/push/pull exercise you do, regardless of whether you are sitting, standing or lying on your back. This will promote the protective activity of your supportive deep abdominal and pelvic floor muscles and discourage the activity of your strong outer abdominal muscles.
Use a narrower stance for squats (no wider than shoulder distance apart) and avoid deep squats and lunges. Avoid squatting as deep/low. You will find it easier to activate your pelvic floor muscles when your feet are close together.
Reduce the weight carried as extra weight increases intra-abdominal pressure.
Avoid jumping movements e.g.jumping lunges/box jumps, low-impact alternatives are safer options.
Modify overhead work. Exercises performed overhead place considerably more pressure on the pelvic floor. Reduce the weight or perform alternatives.
Remember that the more weight you lift, the more intrabdominal pressure you create and the more prone you are to stress incontinence. Try dropping the kg’s and find a weight you are comfortable lifting that is not at the expense of your pelvic floor. It’s not just weights at the gym you need to be careful about – think about your pelvic floor when you pick up your child, lift a buggy, carry in shopping bags etc.
As a parting thought, and quite a confronting one.... continence will be your independence when you are in your later years so it really is worth getting on top of any issues early and for the very best care for your pelvic health, it really is worth visiting a Pelvic Health Physiotherapist, they can test your pelvic floor and give you appropriate strengthening exercises, and having met a few, they aren't in the least bit scary!
So on that note....
Health and Happiness