Mythbusters: Resisting the Urge to Urinate

Incontinence starting to feel like an inconvenience during your workouts? Here’s why it’s happening and how to fix it, explained by Angela Dobinsky, PT, DPT of Sullivan Physical Therapy.



Myth #1

It’s the result of a weak bladder.
It’s actually the pelvic floor that needs strengthening, not the bladder. Anytime there is an increase in abdominal pressure, it pushes down on the pelvic floor and can create leakage, which is the cause of stress incontinence. Some of examples of activities that can result in it include coughing, laughing, bending over, and jumping. It’s different from urge incontinence, where you have that sudden feeling that you have to go to the bathroom and just can’t hold it.
Any type of weight lifting can cause it. We know that it’s best to stabilize with our deep abdominal muscles, but it’s also important to stabilize with the pelvic floor. I tell my patients to contract their abs and pelvic floor during their reps—together, that creates a pelvic brace and it’s the ultimate support. People also tend to hold their breath when they workout, which creates a downward push and creates extra pressure on the pelvic floor.

 

Myth #2

It only happens post-childbirth.
Although pregnancy and childbirth can weaken the pelvic floor muscles and lead to incontinence, there are so many other things that could also lead to it, such as weakened pelvic floor muscles from certain surgeries, hormonal changes, certain medical conditions and/or medications, and increased weight.

 

Myth #3

It only happens to women.
It can happen to men, women, and children. A lot of the men we see for stress incontinence have had prostate surgery. The two most common side-effects of prostate surgery are stress incontinence and erectile dysfunction. We will see them before and after the surgery to strengthen their pelvic floor.

 

Myth #4

It’s an inevitable part of aging.
Not at all. If you take care of your body and pelvic floor, as well as make any necessary lifestyle modifications, you can avoid incontinence for your whole life. Some examples of lifestyle modifications include dietary changes (such as decreasing bladder irritants and increasing water), weight control, and not waiting longer than four hours between voids. The main bladder irritants are: anything acidic, carbonated beverages, caffeinated beverages, alcoholic beverages, and spicy foods. 

 

Myth #5

Once you begin experiencing stress incontinence, it only gets worse with time.
Patients with incontinence do really well with physical therapy, but it doesn’t get fixed overnight. If they want to see improvement, they have to work at it and they have to work hard. For example, if you work really hard to tone a certain part of your body, you can’t just go to the gym everyday until you get that body part the way you want it, and then just stop. The same goes for the pelvic floor. Usually it takes about a month of doing Kegel exercises to see some improvements, and then it takes about three months for patients to see complete or close to complete resolution. After reaching 100 percent, a maintenance program is often suggested.

 

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