It’s crushing to see the effect of bladder problems on beloved family members. Read on to find out how you can steer clear of problems…
Every year millions of U.S. women lose their independence when their bladder incontinence reaches the point where family members feel like they cannot adequately care for them anymore.
As a result, women are placed in assisted living facilities and skilled nursing homes to deal with urinary incontinence.
The reality is that women are placed in nursing homes for a common, non-life-threatening problem, but the burden of managing these symptoms simply becomes too much for family members. The consequence is this shocking statistic.
The number one reason women are placed in nursing homes in the U.S. is urinary incontinence!
That’s a staggering number of women losing independence, socialization and the ability to be cared for by family members. These institutionalized settings often lead to depression, isolation, and ultimately a decline in quality of life.
Equally traumatized are families who experience the heartbreak of separation and the added financial burden.
As a pelvic health physical therapist, I often hear ‘I don’t want to have my mother’s bladder problems.’
With good reason, in years past little was known about how to effectively manage bladder issues. Instead, the standard management tool was medication or surgery.
We now know that conservative options like pelvic health physical therapy can be extremely helpful in correcting bladder dysfunctions.
Pelvic floor muscle exercises are a simple way of correcting the loss of strength and coordination that can come on after pregnancy, vaginal deliveries, and hormone-related changes like peri-menopause and menopause.
Exactly how does pelvic floor muscle exercise help?
The muscles of the pelvic floor work with your urethral sphincter muscle to regulate your urinary system. Your urethra is a round donut-shaped muscle that either relaxes and lets the urine flow out or contracts and keeps the urine from coming out.
I like to think of the urethra as a gatekeeper muscle for your urinary system. The urethra’s job is to maintain a ‘closure pressure’.
This closure pressure keeps the urethra shut until you are ready to pee, and is supported by the surrounding pelvic floor muscles.
When your pelvic floor muscles are strong, they are able to help your urethra stay shut and withstand the pressures that come with coughing, sneezing, and exertion exercise. Thus avoiding urinary leakage events.
If your pelvic floor muscles are not strong enough to help the urethra maintain its’ closure pressure, then you get leakage.
It usually starts out with intermittent episodes of leaking, an example is when you get sick or allergy season starts and you experience an increase in coughing or sneezing (high-pressure events).
Eventually, without corrective exercise, you can end up with urinary leakage that is constant. This is a sign that your strength in this area is lacking.
Just like you need good posture to maintain your skeletal health, you need good pelvic floor muscle tone to maintain good bladder health and not leak.
Your pelvic floor muscles are striated skeletal muscles like everywhere else in your body. This means the muscles have the ability to change and improve their function.
This means that the majority of pelvic floor muscle dysfunction is correctable with exercise. Good news!
How do I strengthen my pelvic floor muscles?
If you look at the anatomy of the pelvic floor muscles, there are two primary layers of muscles. The first layer is the most superficial or the closest to the skin.
This layer consists of a triangle that forms between the pelvis’ sit bones and circular muscles surrounding the urinary and anal sphincters. These circular muscles are like the muscles of your mouth, when they contract it closes.
The second layer is the Levator Ani muscles that form a bowl at the bottom of the body. These muscles support our pelvic organs and lift upward toward the center of our body when they activate.
To do a pelvic floor muscle contraction properly you need to activate both layers of muscle, by closing and lifting, in that order.
To get the muscle activation correct, I often suggest visualizing a ‘zipper’.
A zipper on a pair of pants starts at the bottom and zips to the waistline.
This is the movement sequence for the ‘close and lift’ technique. The bottom of the zipper is the closure and the lift is the movement of the zipper upward to the level of the belly button.
How long do I hold it for and how many should I do in a day?
There are two types of exercises for pelvic floor muscles.
The first is a quick muscle contraction, the second is endurance or sustained ten-second hold. Quick muscle contractions utilize the closure and lift technique (zipper), with immediate relaxation afterward.
Second is endurance muscle contractions which involve closure and lift (zipper) technique but with a sustained hold for 10 seconds while you count out loud to ten.
Counting out loud ensures that you are breathing while holding, which is essential because breath-holding can generate pressure in the pelvis and potentially cause leakage.
I recommend doing 15-20 of each type of exercise in various positions during the day. These positions include sitting, standing, and lying down.
As in any exercise program, go slow and if you get tired, stop exercising and resume later. The pelvic floor muscles are small and get tired quickly, so gradually building strength is key!!!
Want even more specifics on pelvic floor exercises? Check out my free printable available here.
Interested in taking a deep dive into women’s bladder health coaching?
Contact me to see if coaching is right for you!
Happy Bladder Wishes!
~ Tami
Tami Lines is a licensed Physical Therapist with certifications in Pelvic Rehabilitation and Women’s Health Coaching. She is the founder of Pelvic-Health-Matters. Tami has over 15 years of experience with expertise in bladder Health, and pelvic floor muscle dysfunction for adolescent and adult women. She is also a mom of two wonderful young adults working their way through college.
References:
Thom DH, Haan MN, Van Den Eeden SK. Medically recognized urinary incontinence and risks of hospitalization, nursing home admission and mortality. Age and ageing. 1997;26(5):367-374. doi:10.1093/ageing/26.5.36
Lukacz, Emily S, Yahir Santiago-Lastra, Michael E Albo, and Linda Brubaker. 2017. “Urinary Incontinence in Women: A Review.” JAMA 318 (16): 1592–1604. doi:10.1001/jama.2017.12137.
Lukacz, E S, C Sampselle, M Gray, S Macdiarmid, M Rosenberg, P Ellsworth, and M H Palmer. 2011. “A Healthy Bladder: A Consensus Statement.” International Journal of Clinical Practice 65 (10): 1026–36. doi:10.1111/j.1742-1241.2011.02763.x.
