Incontinence: Is It Impact or Stress Induced?

Let’s chat incontinence!

Stress incontinence can be defined as bladder leakage caused by moments of physical stress. A moment of stress can be coughing, sneezing, laughing, but a lot of times patients, therapists and even doctors loop in moments of impact such as heavy lifting and/ or jumping. However, lifting and jumping are a different type of load on the body. These are moments of stress, but different than a sneeze, these moments are anticipated.

For example, when moving a heavy box from the floor, we can know before the movement the size of the box, the weight inside of it, where we are moving it to and be able to prepare the body for the amount of impact and load that we are to be lifting.

With a sneeze or coughing fit, we do not usually get this type of luxury. We do not know the position we will be in when we are going to sneeze and the body is responding reactively. Thus, when training the pelvic floor to improve moments of incontinence it is imperative to understand the difference between impact, load and stress and the demands on the body: anticipatory vs reactive.

All of this to say that the way we train to decrease moments of incontinence, stress or otherwise, is to teach a patient how to train the pelvic floor, core, hip stabilizers and back in a functional manner based on the movements that are creating this loss of urine.

You may be wondering, “well why does this happen in general?” and the answer is pretty interesting. A lot of times with incontinence, clients believe their pelvic floor is loose or over stretched when in reality a lot of patients with incontinence have trigger points and heightened tone in the pelvic floor. This means the pelvic floor is actually tight AND weak. Thus, a tightened and weak pelvic floor is already working at its max capacity just going through daily movement. When a moment of high stress presents itself, there is no more strength it has in its threshold and leakage occurs due to an inability to work any harder.

Another reason for incontinence is poor pressure control. When pressure demands increase on the body, the core, pelvic floor, and other related musculature are not sharing the load properly and the pressure is being pushed to the weakest point. Diastasis recti is another condition that is caused by/ creates poor pressure control. The abs are weakened with collagen tissue (linea alba) nut working properly and pressure is escaping through the abdominal wall. In this same way, if pressure from above (the core, ribs, breathing, demands) is pushing pressure straight down onto the pelvic floor, this too can create enough pressure demands to create urinary leakage.

Thus, a specialized therapist will be able to best understand what demands on your body cause this incontinence (impact vs stress vs load), what the body is doing as a result (poor pressure management, tightened pelvic muscles, or a combination of factors) and how to train these exact movements in a functional way to improve your control and help you reach your goals.

At Rooted, we are prenatal and postpartum experts, not just pelvic floor therapists. We have extensive knowledge on how the demands, load and stress of pregnancy change in each trimester and can put strain on the body. We have a unique understanding of birth and birth trauma. We see postpartum patterns in patients whether it be posture from baby care activities or the way the body is healing (C section scars, pelvic bone alignment, perineal scarring) and we are able to dig really deep into these areas to better assist you.

Investing in your pelvic health is an investment in your comfort, performance, and long-term wellbeing. You deserve to feel supported every step of the way!