The Luxury of Dryness (Getting your Bladder to Behave)

. July 1, 2016.

by Karen Liberi MS, MPT, WCS

What do sex, pee and poop all have in common? It sounds like the beginning of a bad joke. The reality is that when the common factor for all three of these important vital functions, pelvic floor muscles, don’t not work properly, the results are no laughing matter.

The pelvic floor muscles, also known as your “kegel” muscles (named after Dr Arnold Kegel who “invented” an exercise back in the the late 1940’s, are literally the “FLOOR” of our body giving support to our organs (bowel, bladder and uterus) as well as our spine.

When our pelvic floor is healthy and functioning well, it helps us stay dry when we cough, sneeze and laugh. Proper functioning muscles “down below” also allow for sex without pain.

Issues that Affect Us

Our healthcare system does little to address pelvic floor health. Childbirth is typically the start of the downfall of pelvic floor stability, with a domino effect through life. Vaginal deliveries and chronic constipation place added stress to the already compromised pelvic floor muscles. Coughing related to smoking or bronchitis, or a job or hobby that requires heavy lifting add to the demise of vaginal and rectal muscles.   

Another influencing factor can be scar tissue from surgery. If the scar tissue is not addressed, it can restrict the normal function of your abdominal muscles and pelvic floor muscles.

“Cures” for Incontinence

If you are experiencing incontinence (can’t make it to the bathroom on time when you have a strong urge to go, or leak with coughing/sneezing/laughing) there are MANY strategies that you can learn in a VERY SHORT period of time to help you experience the luxury of dryness.   

These strategies can be learned through evaluation and treatment by a women’s health Physical Therapist. 

The appointment comprises about 30 minutes for education about the anatomy and physiology of the pelvic floor muscles, and then discussion about your individual story. “Every member of the neighborhood” effects each other and it is important to know how your organs and pelvic floor muscles co-exist to be sure that a game plan tailored for you will allow for the best outcomes . . . improving your quality of life.

Biofeedback (think EKG for your heart) places pads on the outside of your pelvic floor to allow the therapist to “see” the activity of your pelvic floor muscles when you kegel. It is important to understand the coordination of your muscles as well as the endurance of your pelvic floor. Both of these types of muscle fibers can be trained with therapy.  It is important that both “fast” and “slow” kegels are practiced depending on the type of incontinence you have. 

Using the pelvic floor muscles to decrease ‘stress incontinence’ (with coughing, sneezing, laughing, lifting) and urge incontinence (gotta go) is discussed. An example, when you cough, don’t just stand, hunch forward and cross your legs . . . to support the dropping of your bladder when you create strong pressure “from above” with your cough. Instead, counteract that downward drop of your bladder by “hugging” it with your deep abdominals and pelvic floor at the time of your cough. This will help you to stay dry. 

When you have a strong urge to go, your bladder is essentially “spasming” giving you the sensation that you have to go NOW. If you send your bladder an “SOS” signal in the form of 5 quick kegels in a row, this will suppress your urge allowing you time to make it to the bathroom without leakage. 

There is help and hope for improved bladder control. If you or friends or loved ones also suffer from trouble “down below” (bladder, bowels, abdominal pain or pain with intercourse) there are ways that a women’s health physical therapist can help. 

NWO Center for Pelvic Rehabilitation and Wellness 419-893-7134 |


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