Say Goodbye to Bladder Leakage: Understanding Causes and Solutions Final Part… Pelvic Floor Hyperactivity

Many times during an initial evaluation, a patient has told me that they have been doing kegels every day but they are still having leakage. I can only imagine how frustrating it would be to feel that something so simple as contracting your pelvic floor like a bicep curl every day wouldn’t be able to ‘fix’ a very sensitive problem.

Sometimes it is just as simple as doing kegels, however, in my experience, there is much more going on than weakness in the pelvic floor that is causing urinary incontinence. Research even shows this as well, especially for my CrossFit ladies!

Our last topic to go over is the hyper-activity of the pelvic floor and surrounding structures. I briefly discussed this in the previous newsletter but I needed to dedicate a whole newsletter to this.

Life is hard and sometimes we tense our pelvic floor without even realizing it as a coping mechanism. Kind of like when you tense your neck or upper back muscles when you are stressed.

People who have an hyper-active pelvic floor should not be performing kegels without learning how to down train first. And in reality, performing kegels even after downtraining may not be the best option for you too. Imagine your pelvic floor is your bicep. If you bicep is hyper-active, your elbow would be fully bent and your arm couldn't function as well. In order for your arm to function better, you would need to downtrain your bicep in order for your elbow to straigthen again.

So why would down training be good for you to reduce leakage?

• It allows the pelvic floor to open which allows the urethra (the hole where you pee out of) to open so you can fully empty your bladder

• It reduces spontaneous spasms and squeezing around your bladder

• It allows your pelvic floor to have full range of motion AND strength so it works more efficiently (think back to the bicep analogy, your arm is functional when your elbow can fully bend and straighten)

People with an hyper-active pelvic floor may also experience pain within the vagina, rectum, abdomen, inner thighs, or low back. Techniques to help reduce overactivity of the pelvic floor are:

• Deep breathing

  • This seems to come up every newsletter 🤪

• Hip opening stretches

  • YouTube has amazing videos out there to help

• Stress management

  • Whatever that looks like to you

• Activity modification

  • This is more to help with body awareness. I'm never going to take away an activity that a patient likes. We may just need to modify the activity in order to reduce tension within the pelvic floor

  • I like to incoporate body scans throughout the day to see if any activity or situation is causing me to clench my pelvic floor subconsciously

• Internal and external manual techniques