Most people fear urinary incontinence and excessive urgency to age. We are getting older, things are not working, we are getting up to sleep. Wax jokes on adult diapers and invest in the future of "depends". It's not completely out of place. Aging matters. There is just more than that. Like other aspects of "aging", incontinence and unreasonable urgency do not just happen. Aging can accelerate or accompany decline, but it is by no means inevitable, inevitable, or flawless.

There are surgical treatments, many of which involve the implantation of balloons and slings, rings and hammocks. These are beyond the scope of this article, which will focus on exercises and other less invasive interventions and preventive measures.

What is the problem with urinary incontinence?

The most known type is stress incontinence . When you do something intense enough to create pressure, such as a sneeze, a particularly boisterous laugh, a trampoline session, a force cleaning or a jump in the box, the pressure escapes through the the weakest point of your body, your loose pelvic floor muscles that support and activate bladder function. This results in an inadvertent leak.

The most common type is urgency incontinence . That's when you'll have enough control over your bladder, but you'll feel like you're going to go more often than you want. This can disturb sleep and put you in uncomfortable situations.

There is also urinary incontinence related to the prostate . If men suffer from incontinence, it is usually because of prostate problems or an operation of the prostate that impairs the normal flow and function of their urinary tract. Today's post will not explicitly address this issue, although most of the exercises I will discuss that help women treat incontinence can also help men treat prostate-related incontinence. For more information on this, check out my post on prostate health from a few weeks ago.

Stress incontinence and urgency incontinence generally have the same cause: pelvic floor dysfunction. The pelvic floor acts as a supple and supple sling of muscle and connective tissue between the pelvis and sacrum that supports the pelvic apparatus, including organs, joints, sexual organs, bladders, intestines and various sphincters. We use it to control our urination, our bowel movements and even our sexual functions. Its very important.

What's wrong?

It becomes weak and tight and pulls the sacrum inward (the tail is pulled towards the front of the body), interfering with urination and urinary control.

What are the causes of pelvic floor dysfunction?

Childbirth is one of the possible causes, but it is not inevitable. Women who deliver vaginally are more likely to experience more pelvic floor dysfunction than women who have a caesarean section, while a more recent study found that vaginal delivery assisted by tool and episiotomy were the main risk factors for incontinence associated with vaginal delivery, not vaginal delivery alone. . Allowing a passive descent to the second stage of work, rather than actively pushing from the start, could also reduce the association.

Muscle atrophy of the pelvic floor muscles. The basin is where magic happens. This is where we generate energy, walk, run, procreate, dance and move. To keep it happy, healthy and strong, we have to move. And then keep going. Through the different ranges of space and time and possible permutations of limbs and joints. That's what all our muscles expect from the environment. That's what they need. When this does not happen, they atrophy like other muscles.

Who develops incontinence?

Stress incontinence is more common in women than in men. And most women with stress incontinence are elderly, although childbirth may increase the incidence.

Signs of poor pelvic floor function

In addition to urinary incontinence and urgency incontinence – that it is quite difficult to miss – what are the warning signs of pelvic floor dysfunction?

Activity of the gluteal weak to nil during the march . According to expert Katy Bowman, glutes play a crucial role in pelvic floor function and in the prevention of incontinence.

Absence of curvature in the lower back . This suggests that your pelvis is being pulled inward due to poor gluteal activity and / or overly tight pelvic floor musculature.

Muscular atrophy elsewhere . If the muscle disappears from your arms and legs, what do you think is happening elsewhere?

What can you do?

Work on your squat

If you can not sit down completely, with the shins rather upright and the heels on the ground, you have to work your form.

I suggest reading this old article by Kelly Starrett describing the optimal shape of the squat. It focuses on performance and strength training, but the technique also applies to squat basic body weight for pelvic floor health.

One thing to note: Go as low as you can without reaching the "wink" threshold. The boost is when the pelvis starts to turn back under the body. If you slap your eyes everywhere, you shorten your glutes and prevent them from balancing the pelvic floor situation. Stop before the wink.

Squat a Lot

You do not have to load the bar, although this is a great way to strengthen the strength of the buttocks. In fact, I would refrain from squatting heavily if you presently have urinary incontinence because the stress exerted on this area of ​​the body during a heavy squat can aggravate the problem and cause leaks.

I mainly talk about squatting everyday: playing with the kids, picking up dog shit, unloading the dishwasher, brushing your teeth, cleaning the house, gardening. If you can incorporate crouching movements when using the bathroom, perhaps with a Squatty pot or a similar product, it's even better. Katy Bowman recommends crouching women to pee in the shower as part of her treatment for pelvic floor disorders.

Squatting to use the toilet (or at least getting up)

Almost ten years ago, I wrote an entire article on the virtues of the squat. Not only does this improve the symptoms in hemorrhoidal patients, it reduces tension and relieves constipation, but squatting against the poop is found to relieve a lot of excessive pressure on the pelvic floor musculature .

Not everyone is ready to climb over the toilet, stand on a stack of big books, or do everything possible to build a Southeast Asian-style Turkish toilet in her room. bathroom, nor even to pick up his jar. That's probably the best way to do it – and it's certainly the most consistent way in terms of evolution – but it's not entirely necessary. What matters most is to lift your feet and knees above your hips. If you can do this by placing your feet on a stool (not that kind of stool) while you sit on the toilet, this should do the trick.

Stroll and Feel Up

The next time you walk, put your palms on the upper swell of your buttocks. Every time you enter, you should feel your glutes contract. If they contract, great. You unconsciously use your glutes to propel you forward. If this is not the case, you will have to train them to contract when you walk.

Do it by walking for at least ten minutes each day while feeling your glutes. Consciously devote them enough and feel strong enough and the resulting biofeedback will make the gluteal activation a passive behavior, such as breathing. Finally, you'll start doing it without thinking about it. It is the objective.

Are the Kegels Different

Conventional treatment of pelvic floor disorders involves training the pelvic floor muscles directly with kegels. This is the muscle that you contract to keep you from peeing in the middle of the stream. "Making kegels" means contracting and releasing that muscle for scenes and reps. A common recommendation is to hold for ten seconds, release for ten seconds, repeat throughout the day. Stand in line? Kegels. Having dinner? Make kegels. Do you remember that last week's DMV man who was hugging himself and starting to sweat while you waited for your number? He was probably doing kegels.

That's certainly part of the story – studies show that kegels work for men, women and the elderly – but that's not enough.

Consider Katy Bowman's opinion on the subject. She thinks that kegels aggravate the problem by creating a narrow but ultimately weak pelvic floor muscle that pulls the sacrum further inward. Combine this with weak or sub-active glutes that should balance the anterior traction on the sacrum but do not worry and you end up with pelvic floor dysfunction and increased incontinence. She recommends squatting kegels to make sure that the glutes are well engaged and that all other contributing muscles are in balance.

Do more than kegels

The bad news is that we do not have controlled trials of Katy Bowman's protocols with deep squats, frequent daily movements and barefoot on various surfaces and squatting toilets. We mainly have "pelvic floor exercises", which usually means "kegels". The good news is that even these suboptimal exercise therapies seem to work in any person suffering from incontinence, whether it comes from a pregnancy or a birthday at the same time. 39, age 70 , or a prostate procedure. Young, old, middle-aged men, men, women – physical exercises.

In fact, we have a small study that suggests that kegels will work much better if you balance them with exercises that target the glutes and hips. In the study, women with urinary incontinence were divided into two treatment groups. One group did exercises for the pelvic floor muscles (cegels). The other group did exercises for pelvic floor muscles, as well as exercises to strengthen the adductors of the hip, gluteus maximus and gluteus maximus. Both groups improved the symptoms, but the group that did the combined exercises had better results.

For hip adduction, you can use this hip adduction machine where you ride the chair with your legs apart and bring your knees closer to the resistance. Another option is to use resistance bands. Attach one end of the bracelet to a secure structure and the other to your ankle. Stand with your legs apart, then bring your ringed leg inward towards the un-banded leg; you should feel it in your inner thigh. Do this for both legs.

For glutes, you have a lot of options. Gluteal bridges, hip thrusts, squats, deadlifts, clefts, slits of resistance bands.

If you want to go deeper into this subject and really learn the optimal exercises in case of pelvic floor dysfunction, I would like to take a copy of Katy's Down There For Women.

Be strong and stay strong

One of the main predictors of urinary incontinence is physical frailty. The more fragile men are – weak, frail, prone to falling, unable to hold the stairs, unstable – the man or the woman, the more likely they are to suffer from urinary incontinence. This mainly comes down to muscle atrophy; frail people usually have low muscle mass, including the pelvic floor.

Studies show that strength training improves urinary control in men and women during prostate procedures.

The best option is to never become fragile in the first place. If you are younger and fit, continue your training and move. Do not lose it. If you are young and you tend to be fragile, take a training and move. Do not waste the time you have. It goes quickly. If you are old and fragile, you must start today. It does not happen overnight. Being fragile makes it harder for you to become strong, but that does not relieve you of responsibility.

The bottom line

None of this is a guarantee against incontinence. Guarantees do not really exist in life. But I would argue no doubt that anyone who uses all of the tips and tricks listed in today's post will be better able to maintain bladder control than his doppelganger in a parallel universe that never tries anything – the most early will be best.

If you have experience with urinary incontinence, let us know in the comments below. What worked? What did not happen? What worked for a while, then stopped?

Thank you for reading and sharing here. Happy Halloween to everyone.

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References:

Bernstein IT. Pelvic floor muscles: muscle thickness in healthy women and those with urinary incontinence is measured by perineal ultrasound in reference to the effect of pelvic floor training . Estrogen receptor study. Neurourol Urodyn. 1997; 16 (4): 237-75.

CC De Araujo, Coelho SA, Stahlschmidt P, Juliato CRT. Does vaginal delivery cause more pelvic floor damage than caesarean section, as determined by 3D ultrasound? A systematic review. Int Urogynecol J. 2018; 29 (5): 639-645

Kokabi R, Yazdanpanah D. Effects of childbirth and sociodemographic factors on urinary incontinence in postpartum stress in primiparous women: a prospective cohort study. J Chin Med Assoc. 2017

Handa VL, TA Harris, Ostergard DR. Protect the pelvic floor: obstetric management to prevent incontinence and pelvic organ prolapse. Obstet Gynecol. 1996; 88 (3): 470-8.

O Dokuzlar, Soysal P, Isik AT. Association between serum vitamin B12 and frailty in the elderly. North Clin Istanb. 2017 4 (1): 22-28.

The Urinary Urine and Incontinence Message: Why is not it just age that first appeared on Mark's Daily Apple?

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