Why too much tension may be causing your incontinence

Did your doctor tell you to do kegels to fix your bladder incontinence? Did it fail to work or even make things worse? This is a super common thing I hear from my patients. Urinary incontinence is complex, and it goes beyond just your pelvic floor. It's important to look at how your whole system is working together. This means your posture, your ribcage mobility, your abdomen, your hips, feet AND your pelvic floor. I love working with women on this issue, it really is a puzzle that we can solve together by looking at the whole body, and is usually multi-factorial and complex. And it almost always requires more than just kegels to fix!

For this post, I want to talk about how too much tension might be the cause of your incontinence, more specifically in the case of stress incontinence. Read on to learn more!

Like any muscle in your body, it is important to have both flexibility AND strength. For a muscle to be able to function effectively, it has to be able to move through a full range of motion (flexibility), as well as be able to tolerate a lot of load placed on it. Load can come in the form of lifting a weight, but also can be from simply your own body weight, a cough or sneeze, a fetus during pregnancy, or a fast acceleration such as running or jumping. Your pelvic floor muscles are no exception. In order to work effectively (i.e hold in your pee), they have to be able to lengthen AND shorten, as well as be able to tolerate a load

When it comes to managing pressure, I like to use the analogy of a trampoline. You pelvic floor muscles should function similarily to a trampoline. Imagine what happens when you drop a bowling ball on a trampoline. The elasticity of the trampoline can absorb the force of the bowling ball without breaking, and then lift it to keep it suspended. Similarily with your pelvic floor, when you introduce a load or pressure to those muscles, they should be able to STRETCH to absorb that force and also lift against that force. If your pelvic floor muscles are too tense, it's like dropping a bowling ball on a concrete floor. That floor is going to crack, right? In your case, this may mean you leak pee.

Strengthening your pelvic floor muscles with kegels and other exercises is not going to be effective if you can't first lengthen those muscles. If tension is your underlying issue, you MUST address that first. There are so many strategies to help relax and lengthen your pelvic floor muscles, let's talk about a few!

1. Internal Muscle Release

You can work with a trained pelvic floor PT to do internal muscle releases for the pelvic floor muscles. This is typically done intravaginally. They can be extremely effective!

2. Breathwork

Your pelvic floor naturally follows the movement of your diaphragm. When you take a deep inhale, your diaphragm drops and so does your pelvic floor. Doing some deep breathwork to tap into that downwards movement of your pelvic floor is a great way to start releasing tension.

3. Stretching

Your pelvic floor has connections to your hips, so focusing on hip stretching can help improve the flexibility of your pelvic floor. Stretching with long holds and deep breathing also elicits a relaxation response. Stretches such as happy baby, childs pose and pigeon stretch are a few good ones!