So very often in our office, I see women who tell me they diligently are doing their kegels to resolve their sneeze pee issues, without success.  Or, I am starting to see an increasing number of women who have actually heard that kegels alone aren’t the answer, but they don’t know what to do instead.

So what’s a gal to do?  (This is the part where your pelvic PT is enthusiastically raising her hand like Hermione in potions class because she KNOWS the answer!)

What EVERY woman needs FIRST to solve this issue is a thorough evaluation by a skilled pelvic PT.  Because there are no two cases just alike.  Each person has a unique history, body issues, and coordination of their deep core muscles.  And the right solution for each person may be slightly different.  When we skip the cookie cutter solutions, we jump to solving the problem MUCH quicker.  Sounds good right?

Some causes for bladder leakage with stress (cough, sneeze, jump):

• Core and pelvic floor muscles are set too tense.

• There is pelvic floor pain.

• Hip and glute muscles are weak or not firing well.

• Deep core muscles are not coordinating together well (diaphragm, abdominals, and pelvic floor)

• Legitimate pelvic floor and core weakness.

• Body alignment issues/ poor posture.

So yes, most often our patients do need a pelvic floor internal muscle assessment to get all pieces of information from their body so we can solve the puzzle.  We can get a lot of information from everything else externally (body alignment, breath coordination, abdominal assessment, hip strength assessment, etc), but we still may be surprised with what we learn from an internal assessment that we were not expecting.  The tricky part here is that these pelvic floor muscles are hidden from our view and many of our patients don’t have a great grasp of how their pelvic floor muscles are functioning.

Once we get to know the WHY of our patient’s bladder leakage issue (based off of a thorough orthopedic and pelvic floor assessment), we can then focus on the solution!  Some common things that our patients address in PT that lead to less leakage:

• Connecting their deep core muscles with their breathing (inhale= release, exhale= recoil or contract)

• Freeing their pelvis from constantly gripping and tucking their tailbone under them for all squatting and bending movements.

• Regaining hip stability and glute strength.

• Practicing timing with cough or even throat clearing in a position that first works best for them such as on hands and knees.

• Increasing overall core strength.

• Learning the best positioning to sneeze/cough effectively without adding strain to the pelvic floor.

• Improving hip and or ankle mobility.

• Improving thoracic mobility and diaphragm mobility.

So though I wish I could dole out the magic way to “fix” all women’s leakage issues with one blog, I am here to tell you that there is never going to be a cure-all protocol in core and pelvic health.  But there IS a best way to solve YOUR issues based on the information that you and your body give a skilled pelvic PT.

Our patients often come to us after YEARS of symptoms and are able to greatly reduce or resolve their issue within a couple of months!  If you are hesitating to find someone to help you, don’t wait!  Leakage issues don’t usually go away on their own and most often just get worse if we don’t resolve the cause.

Feel free to contact us and we can help guide you on scheduling with us or help you find someone near you.