By SMH Physical Therapist Shayna Shefrin
Women: Leaking urine — whether you’ve given birth or not — is not normal, and it is not something you have to learn to live with.
Urinary incontinence in women often results from giving birth, and it can worsen with age. In fact, studies show that it affects somewhere between 19% and 60% of postpartum women. And as a pelvic-floor therapist, I’ve had many patients who’ve said they’d been leaking urine for 30 to 40 years — ever since the birth of their first child. With proper training, in many cases it can resolve, but kegel exercises are not the cure-all.
Recently Post-partum Urinary Incontinence
Most women believe that if they are leaking urine after childbirth, it is because their muscles are weak. This is not necessarily the case.
Often times, the pelvic floor muscles become short and tight during pregnancy because the pelvic floor muscles have to work much harder than normal to handle the increased intra-abdominal pressure. If a muscle is too tight or too short, it will not function well.
Imagine trying to pick up a pencil off of the ground, while keeping your elbow completely bent. It makes an easy task difficult, if not impossible. This is what happens when short, tight pelvic-floor muscles try to stop the flow of urine when women cough, sneeze, or have a strong urge to pee. They can’t do their job, so you end up leaking.
Kegels, or pelvic floor contractions, will only make this problem worse. The muscles first need to let go and release tension before they can become functionally strong.
But how can you know whether you have tight, short pelvic-floor muscles? Visit a pelvic-floor physical therapist for an assessment; these specialists can create a treatment plan tailored to meet your specific needs.
Incontinence that’s Worsened with Age
Most people are familiar with the saying, “If you don’t use it, you lose it.” This is true when it comes to pelvic floor muscles as well.
If you have been leaking urine for many years, it’s likely that your pelvic floor muscles are not doing their job properly. But like any other muscle in the body, with proper training, function and strength can be restored.
A study from 2010 demonstrated that after six months of supervised pelvic floor training with a physical therapist, participants increased their pelvic floor muscle thickness and lifted the resting position of the bladder and rectum. You can regain the function of these muscles, if you know how to use them.
Most people have trouble doing kegels correctly because these muscles are hard to feel and impossible to see. Having a pelvic floor physical therapist guide you through the exercises will help you to accurately use train your pelvic floor muscles. As with any physical therapy, an evaluation will be done first to determine what treatment plan is appropriate for you.
If you have any questions, please reach out to Sarasota Memorial’s Rehabilitation team at 941-724-2620.
Physical Therapist Shayna Shefrin joined SMH’s Outpatient Rehabilitation Center in 2016, after a decade of teaching yoga and practicing massage. With a doctorate in Physical Therapy, she now specializes in treating patients who suffer from pelvic floor dysfunction.