How to Fix a Leak
In this month’s newsletter I’m going to spill the tea on the #1 reason why people come to see me at my practice…
They’re tired of leaking when they sneeze, laugh too hard, chase after their toddler, or exercise. Research shows almost half of women suffer (often silently) from leaking, and it gets worse with age. But it doesn't have to.
I’m happy to report there are more effective solutions than the incontinence aisle at your local drug store would like you to believe.
What’s going on when we leak?
The type of leaking we’re talking about today is known as stress urinary incontinence (SUI). It’s when the urethral + pelvic floor muscles that support your bladder become overloaded by a sudden change in intra-abdominal pressure causing a leak of urine.
Think of this pressure system in your abdomen like a balloon made up of different muscles: your diaphragm, abdominals, spinal muscles, and the pelvic floor. When you cough, sneeze, jump, or lift something, the balloon gets squeezed and if the walls of the balloon don't have the strength to handle this change in pressure, then a leak can happen.
But WHY does this happen?
It usually comes down to the muscles in the balloon losing strength and coordination with one another.
This can happen when we:
Are pregnant or recovering postpartum
Have any kind of injury or surgery
Don't strength train regularly as we age
The good news: the muscles of your balloon can adapt and gain back that strength & coordination. And a pelvic floor physical therapist is your best resource to help you get there!
The bad news: most people don't know this, including many medical providers, because education about muscles and strength training isn't widespread knowledge.
Which brings me to my next point..
Leaking ‘solutions’ are garbage
If you’ve ever tried to search for ways to overcome leaking online, or consulted with a doctor about what to do, you might come away thinking:
It’s a UTI , you need antibiotics
It's an overactive bladder, you need botox or surgery
It’s hereditary & there's nothing you can do
It’s normal for your age or after having kids
There is even an article on WebMD (quoting a professor of urology from my alma mater Emory University 😔) telling women to just drink less water and pee more often (see here why you should NOT do this), and if that doesn’t work there are hundreds of surgical procedures to choose from - YIKES!
Even when muscles are acknowledged as playing a role in leaking, you still often get bogus recommendations like 'just do kegels or use vaginal weights'. BUT notice how this doesn't train all the muscles of the balloon.
Just focusing on the pelvic floor alone is NOT going to fix the problem, which is also why surgery alone doesn't have great outcomes either.
So how do you fix a leak? A whole body approach
🌬️ Breathing 🌬️
Your diaphragm is the conductor of your abdominal balloon. How well you’re breathing affects how well the balloon will be able to respond to changes in pressure within your torso.
Patterns like lifting your shoulders to breathe in or holding your breath to jump, lift, or squat tells certain muscles to tense and prevents others from responding like they should, which increases the chances of leaking.
So practice preparing for movements with an expansive inhale through your nose... and then exhaling through the movement like this.
💪 Strength 💪
Ladies, if you’re only doing low impact and body weight exercises (think walking & yoga) that just won’t make up for muscle loss over time. We need you lifting weights.
My patients are always working on controlled, loaded movements that mimic what we have to lift/carry in real life (unlike vaginal weights). This is what builds muscle capacity and bone density to support the WHOLE body!
And my favorite side effect of getting those muscle gainz? The confidence gainz that come with it! Don't know where to start? I got you.
Want a few 10 min routines you can do at home? Start here
Want something more comprehensive? Check out my PELVIC POWER program
💻 Try my self-paced, online programs for stopping leaks, pelvic floor birth prep and returning to exercise postpartum!
Remember, nearly half of your girlfriends are suffering (often silently) from leaking - let’s change that for the better by forwarding this to a friend!
Thanks for Reading! Please forward this newsletter to a friend and help spread the word on pelvic health! Questions, comments, requests for future newsletters? Send an email to info@pelvicsavvy.com.
Your pelvic health matters,
Dr. Chris
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I want you to have the knowledge & tools to make great health choices for yourself. Ideas shared in this blog do not constitute medical advice.
