As moms, it has become normal to joke about peeing our pants. I get it. We use humor when talking about difficult topics.
While incontinence may be common in postpartum women, it is not normal. In fact, leaking is a sign of dysfunction in the core/pelvic floor system.
Today I’ve got two tips to share for those of you struggling with leaking. These are actions you can take right now to work on improving this.
Tip #1: Find Pelvic Floor Balance
First, a little anatomy. Your pelvic floor is a huge set of muscles that connect from the pubic bone at the front of your pelvis, to the tailbone at the back of your pelvis. We should be able to engage the entire set of muscles. But, often, women who leak are instructed to “do more kegels” by just squeezing the muscles that shut off the flow of urine. That cue engages only a small portion of the pelvic floor muscles.
You want to make sure you are engaging the entirety of your pelvic floor – both the front and back. We do this by playing with our pelvis positioning.
To test out your balance, try this. Sit on a chair with your feet flat on the ground.
1. First, engage the muscles at the front of the pelvic floor.
a) Tilt your hip bones forward to move your pelvis into an anterior pelvic tilt position.
b) Then engage your pelvic floor by squeezing the muscles that shut off the flow of urine.
c) Try to hold that engagement for 10 seconds and observe what happens.
2. Then engage the muscles at the back of the pelvic floor.
a) Tilt your hip bones back and tuck your pelvis under you (Posterior Pelvic Tilt Position).
b) Now engage the back of your pelvic floor by squeezing the muscles that shut off the flow of gas.
c) Again try and hold that engagement for 10 seconds.
3. Now engage the entire pelvic floor.
a) Bring your pelvis back to a neutral position (sitting on your sit bones)
b)Now engage the entire pelvic floor by engaging the muscles that shut off the flow of urine AND the muscles that shut off the flow of gas.
c) Now you have all your pelvic floor muscles firing. What happens when you try to hold for 10 seconds?
While doing this, ask yourself: how is your balance? Does one part feel stronger or weaker? If so, you would benefit from creating balance in those muscles.
You might be asking…but what does this have to do with leaking?
The muscles that are responsible for holding urine are in the front of your pelvis.
By positioning your upper body in a slightly forward position, you encourage the muscles at the front of the pelvic floor to engage more readily…which helps prevent leaking! (Watch the video above for a clear visual of how this works!)
Tip #2: Work the Fast and Slow Twitch Muscles
So now that we’ve got the body positioned to help these muscles fire more efficiently, the second step is to work both muscle types. Your pelvic floor has two types of muscles, fast-twitch and slow-twitch.
The slow-twitch muscles help hold your internal organs in. They are designed for holding a low level of engagement over a long period of time. When you hold a kegel for 10 seconds, you are engaging your slow-twitch muscles. If they are weak, you may find them getting shaky as you hold them. However, these are NOT the muscles that stop the flow of urine.
Fast twitch muscles turn on with sudden demand (like when you sneeze or hit the ground in a jumping jack). These are the primary muscles that help you prevent leaking. These muscles engage quickly, for just a moment, and then they relax.
For this reason, it’s important that your pelvic floor training works both types of muscles. You want to engage your pelvic floor with long holds (e.g. 10 seconds) and multiple reps of quick pulses (squeeze, release, squeeze, release). This will train your pelvic floor to respond to the demands of daily life and those sudden moments of intense pressure (like a sneeze).
The unpleasant leaking that many moms experience does not have to be a fact of life. Body positioning AND training both fast- and slow-twitch muscles can help reduce leaking once and for all.