Your bladder control isn't what it used to be?
September 02, 2020

Your bladder control isn't what it used to be?

By Natalie Hobbs

Do you dread doing star jumps at the gym because you are worried you are going to have small ‘leak’? Do you cross your legs when you cough? Every time you open the front door you need to go to the toilet?

Ally Collishaw Optimal Therapy If so, you aren’t alone. Whist it’s a topic of conversation that’s rarely had, one in three women are reported to have some form of incontinence in their lifetime. Incontinence can develop after childbirth, from being overweight, from repeated heavy lifting, as we get closer to menopause, or even just by getting older.  

To learn more about incontinence and most importantly what can be done about it, read what physiotherapist Ally Collishaw, part of the optimalMums team at optimalTherapy has to say.

Ally is a mum who specialises in women’s health, and knows a thing or two about pelvic floors and exercise having completed the London Marathon and several triathlons. 

Incontinence is a common problem in women who have had a baby or are perimenopausal. Incontinence can be faecal the (inability to control bowel movements), urinary or both. Urinary incontinence is separated into stress, urge or mixed incontinence (stress and urge together).













Stress Incontinence

Stress incontinence is when there is some leaking when you cough or sneeze, jump up and down or lift something.  This is due to an increase in the pressure in the tummy which puts pressure down on an ineffective pelvic floor. You may notice it becomes worse when your period is due, as your estrogen levels decrease, weakening the pelvic floor.

When the pelvic floor is working properly, the pelvic floor creates a pressure around the urethra (the tube you wee out of) closing the tube stopping it from opening. But when the pelvic floor is not functioning well (either because it’s too weak or is over active) and there is increased pressure around the pelvis and bladder – ie when we cough or jump – then leaking of urine can occur.  


Urge Incontinence

Urge incontinence/overactive Bladder syndrome occurs due to an irritation in the bladder lining causing women to feel like they need to go to the toilet even when there is only a little bit of urine in the bladder.  This can start to occur after recurrent urine infections, the onset of autoimmune conditions, constipation or a change in toileting habits which can occur if you have stress incontinence and start going to the toilet ‘just in case’.  Over time the bladder trains itself to think it is full when it is not, thus giving your brain the message ‘it is time to run to the bathroom’.  This feeling is the urge.  Simple daily actions such running a bath or putting the key in a lock can trigger this urge to urinate and many ladies just can’t get to the toilet on time. 


Mixed incontinence

If you have symptoms of both stress incontinence and urge incontinence, you likely have mixed incontinence, a combination of both types.


The impact

There are varying degrees of incontinence but whatever the level, it can have a detrimental effect on women’s lives.  Many women can remember an embarrassing episode where they leaked in public – perhaps during a gym class, when carrying something heavy, going for a run, during a coughing fit, even from laughing. For some they’ll stop wanting to go out to places they don’t know; stop their exercise class; restrict their fluid intake; or frequently panic about where the nearest toilet is.

Whilst these experiences are common, they are by no means normal and no-one should live like this. Incontinence can quite often be resolved with the right advice and support – and a bit of hard work.


Can I strengthen my pelvic floor so I don’t need to worry about leaks anymore

Yes! Not only can you, but you should. As you get older the risk of a prolapse increases if you have a weak pelvic floor. A prolapse is when the pelvic organs drop lower in the pelvis, creating a bulge in the vagina.

If you are concerned about your pelvic floor, light bladder leaks or incontinence, talk to a women’s health physiotherapist. They are experts in incontinence and the function of the pelvic floor.  They can help improve the incontinence symptoms by working on the pelvic floor muscles and the cognitive control of the pelvic floor. 

When you have had an issue like incontinence, it gradually effects your whole body. A good therapist will not only work on the muscle function, but also the way your brain is reacting to signals from your bladder and the way your limbic system (emotional system) is involved.

Doing the right pelvic floor exercises, the right way, and frequently, will mean you can do those star jumps at the gym, you can go for a run (whether it’s around the block or a marathon), and you won’t need to worry about a cough, a sneeze or a laugh.

Suffering from incontinence isn’t something you need to accept. And it’s not a life sentence.


Whilst you are working on your pelvic floor

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