Healthy Weight + Exercise = Happy Pelvic Floor & Bladder

By Melissa Nassaney, PT, MS, DPT

Women’s Health & Pelvic Rehab Specialist, Performance Physical Therapy, Warwick, RI

When it comes to bladder health and controlling urinary leakage, there is more to staying dry than just doing Kegels. Albeit, Kegels are probably one of the simplest ways to curb incontinence. Kegels are pelvic floor muscle contractions that, when done correctly, can slow or stop the flow of urine during urination (try this once to find the right muscles but avoid practicing Kegels while urinating). Kegels are the first line of treatment recommended by the American College of Physicians.

One of the most common types of urinary leakage is called stress incontinence. This is related to the inability of your urethra's support muscles to effectively close it off during instances of increased inner abdominal forces that come from us laughing, coughing, sneezing, lifting or jumping. Your pelvic floor muscles (the layers of muscles you sit on that line the bottom of your pelvis from front to back) and your urethral muscles need to be strong enough to counteract this sudden and downward force. Amazingly this happens automatically, most of the time. Thus, we can prevent the leakage. Pelvic floor muscles can become weakened for a variety of reasons such as straining during bowel movements, pregnancy, giving birth, or chronic coughing. What some women may not realize is that carrying around extra weight can put additional strain on these muscles whether it is due pregnancy weight gain or generally being overweight. Overweight women have a greater risk of being incontinent than women with an ideal body weight.

The good news is, studies have shown that significantly overweight women with incontinence who lose excess weight can actually reduce episodes of unwanted urine loss. One study (by a leading urogynecologist in RI!) demonstrated that obese women who exercised and lost about 10% of their body weight reduced their leakage by half and maintained these results for six months. Maintaining a healthy body weight by following a nutritional plan that is best for you and making exercise a part of your daily routine may decrease your risk for incontinence. Incorporating exercise into your day can strengthen your core and pelvic floor muscles, leading to even greater protection from leaks. Strength training can help control weight by improving metabolism as muscle burns calories. Muscle strengthening of the pelvic floor can decrease or even eliminate incontinent episodes.

6 Tips for a Happy Pelvic Floor & Happy Bladder

1. Maintain an ideal weight ~ what's your BMI? Find out at NIH.gov

2. Avoid smoking ~ smoker's cough wreaks havoc on the bladder and your pelvic floor muscles.

3. Perform Kegels daily to several times a week until you can stop your urine stream during urination (remember just as a self test/re-retest)

4. Avoid or minimize bladder irritants ~ remember, not all irritants will cause YOU bladder irritation

5. Maintain good water intake of at least 6-8 glasses of water daily or amounts specified by your doctor.

6. Perform the knack ~ squeezing your pelvic floor muscles right before you sneeze or cough (This takes practice!) KEGEL, KEGEL, KEGEL... Breathe... Life is better with Kegels!