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How to stop leaking when you cough

Updated: Sep 22, 2020

Help I'm leaking!

You cringe when your fitness instructor calls out "jumping jacks!"

You wear a pad when you go for a run.

And coughing fits mean full outfit changes.

Sound familiar?

Stress urinary incontinence is common.  In fact studies show about 1 in 3 women experience stress urinary incontinence.

Think you have an "overactive bladder"?

Think this is normal because you've had kids?  

Think this is "just the way it is"??

Think again.

Yes, this can happen after pregnancy and having kids.

But this can even happen to elite athletes who have never had kids.

And there's a long-term cost to accepting this as "just how it is."

What happens down the line, years from now when you're 70-something, if you don't act to intervene now...??

As it stands, too many of us are accepting our new realities.   Only about 3-5% of women struggling with SUI actually seek help.

That's so sad.  Because, really, it's so simple to fix!

Why do we leak?

Quick anatomy lesson - your pelvic floor is a group of muscles that work together to support your pelvic organs, joints, hips and spine.

pelvic floor anatomy

However, in life many things can go wrong.

Pregnancy is a common way the pelvic floor becomes weakened.  

In a difficult delivery, tearing, or scar tissue and it can take a while before full function comes back.

But we also do other things that have nothing to do with being pregnant that can impair the function of the pelvic floor.

Forward head posture has been shown to be correlated with pelvic floor weakness.

Backwards breathing patterns, which can be cause by pregnancy, chronic stress, or other surgical interventions, actually cause us to place too much pressure down on the pelvic floor.

And sometimes over-gripping our abs or glutes can create a pelvic floor that is too tight, and therefore weak.

Any one of these situations can create a pelvic floor that is ineffective in carrying out its task of holding things in.

So when things are "normal" you don't have to think about how to contract your pelvic floor.

But when things go hay-wire, they need to be re-trained.

Do I need do more kegels?

Yes and no.

According to pelvic health expert Diane Lee, up to 65% of people who think they are doing a pelvic floor contraction are doing it wrong.

Here's the thing - you don't necessarily need to do more, you need to make sure you are doing them right!

A healthy pelvic floor contracts both concentrically (meaning shortens - think of showing off your bulging biceps, that's a concentric contraction) and eccentrically (this is the lengthening phase). 

A healthy core system works together in a coordinated manner, meaning your pelvic floor and deep transverse abdominals actually respond to each other, as well as the diaphragm, and one cannot function without the other. 

You will want to train your pelvic floor and core muscles for strength in both directions, duration, and the ability to quickly contract and relax against pressure (think jumping jacks!)

How do I know if I'm doing a kegel correctly?

The best way to know if your pelvic floor is performing correctly is to get evaluated by a pelvic health Physical Therapist.

The right PT will help you understand the right kinds  of exercises to do for your body and your situation, so you can stop worrying about peeing in your pants when you sneeze.

Most of you do not need to go to a physician first, as most states have what is called Direct Access to Physical Therapy.  A quick google search will tell you if that's the case in your state.

If you're in Wisconsin you're good to go, and I'd love to help or direct you to a provider near you.  Contact me if you'd like more information on working together.

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