Our women’s health physiotherapist, Maritza Lue, can answer them here.
Q: I have 2 kids, 12 years old and 10 years old. They were both naturally delivered. In the past year, I have been training for running competitions, and I have noticed that I leak in the first 15 minutes of running. I have been doing Kegel’s exercise for 3 months now, but why is it that it is not helping?
A: First of all, are you doing the Kegel’s exercise properly? You need to consult a physiotherapist who specialize in women’s health to assess your performance.
Second, you might have abdominal separation from the previous pregnancies. The core muscles include the transverse abdominal and multifidus. It holds your trunk like a corset, lessening the intra-abdominal pressure, thus putting less pressure on the bladder and pelvic floor.
If you have abdominal separation, all the pressure goes down onto the pelvic floor and so you leak when you run.
It would be best to see a women’s health physiotherapist and mend the abdominal separation and assess your pelvic floor strength.
It is very important to mend the abdominal separation because if you only strengthen the pelvic floor, the leaking would subside but will always reoccur since you have not treated the root cause of the problem.
Q: I just had a baby 6 months ago. I noticed some incontinence when I lift, cough and run. I am planning to have a second child. Should I wait until I am done giving birth to my second child and then address the incontinence, or should I see a women’s health physio now?
A: It is best to address the incontinence now because by doing so, you will address the weak pelvic floor muscles, the weak core muscles and the abdominal separation.
It will solve the embarrassment of incontinence, prevent back pain, provide you with better quality of life, better sex life, improve post-natal body recovery and prevent any complications when you carry the second child.
Most moms state that the second pregnancy was tougher on the body. The reason could be because their abdominal muscles were already separated after the first pregnancy, thus causing an array of symptoms such as: back pain, pelvis pain, hip pain, incontinence and so.
In France, the government provides 10 pelvic floor strengthening physiotherapy sessions for all women who have given birth, after each birth.
It is encouraged to do 10 sessions after each birth, even though they are planning to have more children.
They have noticed that the body recovers faster with treatment after each birth.
Q: I am 60 years old, never had any kids but I am a bit overweight. In the past 5 years, I have put on 20 pounds around my waist. I am trying to lose weight by going hiking but every time I go down slope, I leak.
I want to continue hiking but the incontinence is making me very embarrassed!
Can you fix the incontinence even though I am 60 years old?
A: Yes, incontinence can be fixed no matter what age you are. Since you never had kids, it is unlikely that you have abdominal separation. But, because you have put on 20 pounds around your waist, that extra weight is pushing down on your pelvic floor and it might have also overstretched your core muscles. When your core muscles are weak, it cannot reduce the intra-abdominal pressure, thus the pelvic floor cannot hold the urine whenever you go down slope.
The pelvic floor muscle is like any other muscle in your body. It can regain its strength if you perform the appropriate strengthening exercise. If you want to strengthen your biceps, you do biceps curl. If you want to strengthen your pelvic floor, you do Kegel exercise.
Just make sure you are doing it correctly.
Q: I am 5 months pregnant and my belly is bigger than normal pregnant women. I noticed that my big belly is pushing down on my bladder, so I leak before I reach the toilet in time. I used to run 3 times a week. Now, because of my incontinence, I cannot walk, nor run without leaking. Since I am pregnant, can the physio still work on the pelvic floor?
A: Yes, the physiotherapist can help even if you are pregnant.
Normally, the women’s health physio would check the pelvic floor externally and internally. But because you are pregnant, it is most likely that the physio will only check externally and make sure that you know how to engage the pelvic floor.
However, it seems like the big belly might be the cause of your incontinence.
You might have abdominal separation causing extra pressure onto the bladder.
There is different severity of abdominal separation, the more severe it is, the harder you have to work in order to mend it back.
Right now, is the best time to start mending back your abdominal separation!
Specific Reformer Pilates and home exercise would be prescribed according to your abdominal separation.
When your core muscles become stronger, there would be less pressure on the bladder and consequently less leaking.