*Disclaimer - I may earn a small commission for purchases of recommended products made through the links within this post. Your purchase helps support my work in bringing you real information about exercise, prenatal and postpartum health.*
I experienced urinary incontinence shorty after the birth of my first son. I noticed that I was leaking when I was in forward flexion type positions - think bending forward to wash my face at the bathroom sink or to pick up my baby out of the bassinet. In these early days postpartum I did expect there to be some leaking as my pelvic floor and surrounding tissues healed, but it got old REALLY fast.
I went to see a pelvic healthy physiotherapist around 4-5 weeks postpartum to have an assessment and discuss some of the pelvic health challenges I was experiencing. I recommend that ALL of my postpartum clients see a pelvic health physiotherapist/physical therapist early postpartum - ideally around the 5-8 week mark - to have an assessment done. At this appointment, they will determine baseline strength/weaknesses and check for muscle imbalances as well as discuss any other factors that have impacted their recovery such as healing of incisions or tearing, pelvic pain, pelvic organ prolapse and you guessed it - incontinence.
Urinary incontinence is very common postpartum but that does not mean that it's normal.
Urinary incontinence is the unintentional loss of urine or the inability to hold urine in the bladder due to loss of voluntary control over the urinary sphincters resulting in the involuntary passage of urine. Urinary incontinence is very common postpartum but that does not mean that it's normal. That's right, you heard me. It's common to pee a little bit when you sneeze, cough or jump but it's not the way your body is supposed to function.
There are 2 main types of urinary incontinence:
Stress Urinary Incontinence - Urine leaks out while coughing, laughing, or doing some activity, such as running or jumping
Urge Urinary Incontinence - There is a sudden and intense urge to urinate, and urine leaks at the same time or just after. This is also known as reflex incontinence or “overactive bladder,” and is the second most common type of urinary incontinence. There is a sudden, involuntary contraction of the muscular wall of the bladder that causes an urge to urinate that cannot be stopped.
And then there's another super fun thing that we can also experience called bladder irritation. Bladder irritation was something I only recently learned about as I worked with my pelvic health physiotherapist after my second son was born. Some days I'd find myself heading to the bathroom every 20-30min all morning or going out for a run only to have to pee AGAIN within a few minutes of starting (FYI I started running around 5 months postpartum). We discussed what time of day this generally occurred (usually mornings for me) and what irritants I might be consuming prior to the pee marathon starting (*ahem* ALL THE COFFEE).
Coffee, tea and carbonated drinks, even without caffeine
Alcohol
Certain acidic fruits — oranges, grapefruits, lemons and limes — and fruit juices
Spicy foods
Tomato-based products
Carbonated drinks
Chocolate
So my morning coffee + caffeinated pre-workout drink + a dehydrated morning bladder = bladder irritation. The best solution for me included 2 major points - matching each cup of coffee/caffeinated beverage with a cup of water and re-training my bladder to wait longer in-between bathroom trips. I KNOW that adding MORE liquid seems counterintuitive but it actually helps balance out the irritant of caffeine. And teaching my bladder to wait longer in between bathroom trips re-trains the nervous system to wait until my bladder is actually full to signal the brain rather than when it's only partially full.
Experiencing leaking during exercise isn't just a pelvic floor strength issue. It's more of a body positioning and pelvic floor coordination issue. Adjusting my position during day to day activities was a key factor in managing my early incontinence after my first birth - this gave me the confidence to begin adding exercise into the mix and going into forward flexion positions like a bentover row or deadlift that previously caused leaking.
Here are my top 3 strategies to manage leakage during day-to-day activities and exercise:
If your body is in a position that puts pressure on your bladder, once you add impact into the equation there's a greater chance of leakage. This can often be adjusted by adding a slight lean forward with walking/running/jumping to stack rib cage over hips and also by untucking/unclenching the bum
If your breath throughout the impact movement is not coordinated with the contraction/relaxation with your pelvic floor you may also experience leakage. For this scenario think about focusing on the EXHALE breath as you land and absorb the impact. This will help your pelvic floor lift and support your bladder at the point of impact.
Using strength training exercises to support the muscles around the pelvic floor can also help decrease leakage with impact. These muscles include the transverse abdomens (deep core muscles), rectus abdomens (6-pack muscles), obliques and glutei (aka your booty).
Below are FOUR fantastic exercises that can be done quite early postpartum (or basically anytime) to work on activation and strengthening of the supporting muscles of the pelvic floor.
Seated Pelvic Floor Ball Squeeze
Sit up tall on a sturdy chair or bench with your gaze looking straight forward, your chin parallel to the ground and shoulders stacked above your hips. Place a mini-ball (or a firm pillow if you don't have one) between your thighs. Exhale slowly, lift through the pelvic floor and squeeze the ball and hold for 5-10 seconds. Inhale and release the pelvic floor and pressure on the ball. Repeat 10 times.
If you want to add this mini-ball to your home gym here's one I recommend.
Seated Pelvic Floor Activators with Mini-Band
Sitting up tall on a sturdy chair, place a mini-band around your thighs about 2-3 finger lengths above your knee with your feet together. Exhale and lift your pelvic floor as you press your knees apart and then bring them back together in control as you relax your pelf floor. Think about activating your glute muscles throughout the range of motion. Repeat for 10-15 reps.
If you want to add these mini-bands to your home gym here's some I recommend.
Heel Slides
Begin laying on your back with knees bent and feet flat on the floor. Engage core with slight pelvic tilt to press low back to floor. Inhale slide the heel along the floor until your leg is extended and then exhale as you slide your heel back to the start position. Avoid letting the low back lift or arch off of the floor throughout the motion. Alternate sides and repeat for 10-15 reps/side.
Heel Scoops
Begin laying on your back and bring your legs up off of the floor so shins are parallel to floor (in table top position). Engage core with slight pelvic tilt to press low back to floor. Inhale as you drop one heel to floor and slide the heel along the floor until your leg is extended, then exhale as you raise foot and bend knee as you bring your leg back to start position (think of it like a backwards bicycle pedal motion). Repeat all 10-15 reps on one leg and then switch sides.
If urinary incontinence is holding you back from returning to some of the activities you love, try out these positioning, coordination and strengthening tips and see how your body responds!
PLEASE let me know if any of these suggestions helped you by leaving a comment below or sending me a DM on Instagram. Here's to no more pee-sneezing!
Comments