Exercise to Support Bladder Health
Do you struggle with exercise for fear of not being in control of your bladder? Or have you been told that it is "normal" and there is nothing you can do about it? The truth is that urinary issues are NOT NORMAL at any age and can be prevented with the right exercise and breath control. The same exercises that help urinary dysfunction also help other problems such as back pain and pelvic girdle dysfunction.
Common bladder issues include:
- stopping at every bathroom (urinary frequency)
- the sudden and incontrollable need to urinate (urgency),
- incomplete bladder emptying (urinary retention)
- involuntary loss of urine (urinary incontinence)
- waking in the middle of the night to void (nocturia).
- pelvic organ prolapse (organ descent of urethra, bladder, vagina or rectum)j.
There is evidence that doing Kegels, or pelvic floor exercises, can lower the risk of stress incontinence, which is the involuntary loss of urine with coughing, sneezing or exercise (Cochrane Review). However, exercise for the pelvic floor muscles should incorporate both lengthening and strengthening. Often the pelvic floor is tight and needs to attain its proper length before it can contract. To ensure the pelvic floor moves through its entire range of motion, therapeutic exercise that incorporates proper breathing along with deep core and hip strengthening is essential.
Lengthening of the pelvic floor occurs on the inhale as the pelvic floor descends like a hammock. Strengthening or contracting the pelvic floor occurs on the exhale as the diaphragm pulls the pelvic floor back inside the pelvis, making the pelvic floor hammock taut, like a trampoline (see diagram below). Breath holding due to stress or habit does not allow the pelvic floor to move or function as it should. Adhesions from surgery, trauma/ falls or gut inflammtion further disrupts pelvic floor function when the diaphragm is not able to move appropriately.
In addition, tension in the hips can disrupt pelvic floor function. The pelvic floor muscles are like a hammock that attach from the tailbone to the pubic bone and to the obturator internus/ hip rotator muscles on each side (see photo below). Imagine pulling a hammock from both ends to lift the hammock. This is the same function that the hip rotators provide for the pelvic floor; to create a fascial lift from the sides. However, if one hip is tighter, the pelvic floor cannot contract properly and becomes dysfunctional. One of the first goals in treatment of urinary dysfunction at Healthy Core is full hip range of motion to provide a fascial lift of the pelvic floor. Mobilizing tight structures and instructing in exercise to improve hip mobility is essential for a healthy pelvic floor.
Incorporating our TOP THREE EXERCISES into your daily routine can address abnormal tension in the pelvic floor and hips, while retraining the correct deep core muscles to stabilize your spine and pelvis:
1. REVERSE KEGEL on the inhale with KEGEL on the exhale
2. PELVIC BALANCING
3. PILATES POSTURE OF POWER
In addition to exercises that address pelvic floor and hip tension, there is evidence that general moderate exercise may lower the risk for urinary incontinence, possibly as a result of decreased weight on the pelvic floor. Skip the crunches, Insanity workouts and Boot Camps until you have restored the core to function. See our BLOG on why you should avoid crunches and sit-ups. You cannot put the cart before the horse and expect to get results.
If you or someone you know is struggling with bladder issues, request our FREE GUIDE, Three Steps to a Healthy Core by clicking here. Become empowered and stop covering up the problem with expensive pads and medications that come with unpleasant side effects. Strengthen your core, lose your belly pouch and do not celebrate that "pee happens" but rather kick incontinence to the curb!
Cochrane Data Syst. Review (2010), CD005654.
B. Engl J Med (2009). 360: 481.