To mark World Continence Week, Megan Bergman, our physio working with Women’s and Men’s Health brings you 3 great tips on a subject that affects a huge number of the population, from elite teenage athletes to the more mature members of our community.
Top Tip 1: Healthy Bladder Habits
These are some easy habits to practice that help to avoid issues with continence throughout your life.
- Drink enough water. 1 to 1.5L per day and more if you are exercising
- Eat well. Good bowel function goes hand in hand with healthy bladder and avoiding too many processed foods keeps the bladder happy
- Sit on the toilet in the correct position ensuring your tummy completely relaxes and never strain to empty
- Avoid just in case wees... Void volumes should predominantly be between 350 to 500mL for most wees.
- Exercise regularly to maintain ideal body weight
And finally ….
- Do pelvic floor exercises regularly to keep the muscle strong and active
TopTip 2: Pelvic floor
We know that pelvic floor exercises are important in helping maintain continence, particularly as we age…. but how do we do them, when do we do them and how many and for how long??
The key is to start gently. You are trying to ensure you are getting an isolated contraction of the pelvic floor muscles.
Some visualisations for women include
- ·Imagine stopping the flow of urine or wind
- ·Imagine lifting a tampon up into the pelvis
Some visualisations for men
- ·Imagine trying to shorten the penis
- ·Imagine trying to stop the flow of urine or wind
The Continence Foundation of Australia recommends starting with one set of 10 contractions. Hold each squeeze/lift for 5 seconds and try to build up to 10 second holds.
You should also remember to lift your pelvic floor when doing activities that increase your tummy pressure such as coughing, bending or lifting. It seems simple but research shows that pelvic floor exercises are an important factor in helping prevent incontinence.
Top Tip 3: Intra-abdominal pressure and exercise
Is how I breathe during exercise important??
Many people are aware that they don't breathe well or much when they are exercising, particularly doing activities such as lifting, or abdominal strength work.
Breathing helps to control intra-abdominal pressure and is important in helping prevent downward strain on the pelvic floor and pelvic organs which can lead to leaking with exercise or pelvic organ prolapse.
Think of your abdomen like a cylinder with the diaphragm at the top, pelvic floor at the bottom and tummy muscles wrapped around the middle.
Breathe in or hold your breath and the diaphragm moves down
Imagine the diaphragm moving down and then drawing in or squeezing through your tummy…there is only one way for the pressure to go and that is DOWN!
Your poor pelvic floor will struggle to lift up against the downward pressure generated by these two strong muscles….
However if you breathe out on the effort of the movement the diaphragm will move up, giving the pelvic floor a chance to lift and close the sphincters preventing leakage, and also to lift and support the organs.
When you are exercising spend some time focussing on your breathing to train this important habit. (Sometimes it can help to purse your lips a little so you feel the breath and don’t forget to breathe!)
Megan is a committee member of the APA Women's Mens's and Pelvic Health Physiotherapy Special interest group in the APA and a member of the Continence Foundation of Australia.