“I laughed so hard I nearly peed myself!” Why is it when we tell accounts of a funny incident, we equate the comedic value of it with our tendency to almost soil ourselves? Do you know who was the first person to utter these words? To be honest, I have no idea (and neither does Google). However, I imagine the author as someone who found a great way to attribute bladder leakage and pelvic floor dysfunction to an external source (ie. funny stories). Genius right? But what if we took this quote and rephrased it to describe what could be going on internally? The quote might sound more like this: “My bladder and pelvic floor are not performing as they should, so I leak urine when I laugh”. Not so catchy. Let’s try another. Have you ever experienced some leakage at the gym and thought to yourself “I went so hardcore I peed”? What happens if we rephrase this to “my pelvic floor muscles may be tight and/or weak so they are unable to withstand the stress of my demanding workout”? Definitely not catchy, but this is a better description of what may actually be occurring in your body. Peeing when you laugh, sneeze, or exercise is a symptom of stress urinary incontinence and pelvic floor dysfunction. And it should not be ignored.
The Role of the Pelvic Floor
One of the functions of the pelvic floor (layers of muscles lining the bottom of the pelvis) is urinary continence. As your bladder fills, your pelvic floor muscles and internal urinary sphincter contract to prevent leaking of urine. As you empty your bladder, your pelvic floor muscles and sphincter relax to allow urine to exit your body. Stress Urinary Incontinence (SUI) is the loss of urine with physical exertion. With SUI, the body cannot withstand increased intra-abdominal pressure (as what happens when we sneeze, laugh, cough, or exercise). As a result, urine leaks from the bladder. Anyone can experience SUI: men, women, teens, and children. According to the Urology Care Foundation, 1 in 3 women experience SUI. Since this is a sensitive topic for some women, many do not seek medical advice or simply think its normal, especially after giving birth. SUI is common, but it is NOT normal!
If you discover you have Stress Urinary Incontinence, what should you do?
Seek help. Consult with your doctor to rule out other causes of incontinence, and find a trained Pelvic Physical Therapist. A Pelvic PT will perform a thorough assessment of your posture and movement, which will include an examination of your pelvic floor muscles. A Pelvic PT can determine if your abdominal muscles, respiratory diaphragm, and pelvic floor are working in a coordinated fashion. Our pelvic floor muscles do not work in isolation so just doing constant kegels will not suffice. Your treatment should be tailored to meet your specific needs and goals with a whole body approach. Remember, SUI is no laughing matter and there is help!