How to Stop Urine Leakage When Coughing
Stress urinary incontinence is a common but treatable condition in which the pelvic floor cannot manage the pressure created by activities like coughing, sneezing, lifting, or running. It develops when the pelvic floor is weak, tense, or poorly coordinated, and it is not a normal or inevitable part of aging or having children.
The core functions as a pressurized system made up of the diaphragm, abdominal muscles, low back muscles, and pelvic floor. When this system loses coordination through habits like breath holding, straining, or power peeing, the pelvic floor becomes less able to absorb and rebound from physical stress.
Pelvic floor physical therapy addresses urinary leakage through individualized evaluation, core and hip strengthening, pelvic floor tension release, and breathing retraining. Understanding the root cause of leakage is the first step toward resolving it.
I am so glad that pelvic floor physical therapy is becoming more mainstream and even trending on social media platforms! So many women think that they have to just live with urinary leakage. Society has historically taught women that leaking is just part of having a baby or aging… Not true!
Let me tell you more about how you can help stop or prevent urinary leakage when coughing.
Why Coughing Causes Leaking
When you cough, pressure in your core increases.
The core is all of the muscles in your abdomen including your diaphragm (your breathing muscle), multiple layers of abdominal muscles, multiple layers of lumbar muscles (low back muscles), and the pelvic floor. These muscles work together to support you through activities that put more stress on your body.
Coughing adds stress just like lifting weights adds stress to your body.
When you leak while coughing, that indicates that there is some sort of pelvic floor dysfunction happening. There can be tension in the pelvic floor that isn’t allowing for full muscle activation throughout the full length of the pelvic floor, weakness of the pelvic floor muscles, and/or coordination problems with the pelvic floor.
A coordination problem can be compensated for by the body to get the task at hand done- the body always likes to work smarter, not harder, so it will use the muscles that are already strong.
Another coordination problem can be holding your breath and/or straining during activity or when going to the bathroom putting more load on the pelvic floor.
What is Stress Urinary Incontinence?
Stress urinary incontinence occurs when the pelvic floor cannot support the pressure being placed on it, causing unwanted leaking of urine.
Pressure in the body increases with coughing, sneezing, and laughing naturally because of the way our breathing is connected to the core by the diaphragm.
Doing exercise and lifting weights increases pressure to our body literally by increasing the body’s load through weight and/or duration of load. Running and jumping also increase pressure in the body by way of physics and the way the load of our body increases as we increase velocity.
How the Pelvic Floor Manages Pressure
The body manages pressure by dispersing the load across the whole core system (diaphragm, low back muscles, abdominal muscles, and the pelvic floor). The pelvic floor’s role in pressure management is to “shock absorb” the load by controlled lengthening as it receives the pressure, then rebounding up shortening the pelvic floor muscles to hold bowel and bladder contents in.
The Role of Breathing and Core Coordination
As I have mentioned a couple of times in this blog already, breathing is connected to the core by the diaphragm. I like to think of the core like a soda can.
It has a top, the diaphragm, a bottom, the pelvic floor, and the sides are all the layers of lumbar and abdominal muscles. This system works together to maintain pressurization to give us support and stability to move off of.
Think of the core like our foundation. In order to stay pressurized, the core has to keep the load it receives disbursed evenly throughout the whole system.
Think about taking that soda can out of the fridge- when it is sealed it is strong when you squeeze the sides because the load is evenly shared. When we lose pressurization by doing things like holding our breath, straining, or only breathing into our belly/the front of the core, it's like we have popped that soda can open and now it is easy to crush the sides. Our core loses stability and support when we lose pressurization.
That is why learning proper diaphragmatic breathing techniques are so important for exercise and life!
Common Habits That Make Leaking Worse
Habits that can put you at risk for stress urinary incontinence are things like hovering over the toilet seat, power peeing, and straining to have a bowel movement.
What do all of these habits have in common? They all put stress on the pelvic floor to let contents out to void while it is in a contracted state.
This weakens the pelvic floor and teaches it that it is okay to let things out when it is contracted, because our pelvic floor is supposed to be relaxed to open sphincter muscles when we are going to the bathroom and letting things out.
What Pelvic Floor PT Can Do For You
Learning about your pelvic floor and making habit changes is the first line of defense in treating urinary incontinence. Beyond that, a pelvic floor physical therapist can do an evaluation to determine your specific needs.
Common treatment techniques in pelvic floor PT include overall strengthening to the core, pelvic floor, and hips, addressing pelvic floor tension with stretching and soft tissue work like trigger point release, teaching diaphragmatic breathing, and working on pelvic floor muscle coordination.
Where to Find Pelvic Floor PT if You Want to Stop Leaking When You Cough
If you are local to the Lakes Region of New Hampshire and need help with incontinence, book a discovery call with me to get started!
I would love to be a part of your pelvic health journey!
My office is conveniently located in downtown Meredith, and I offer individualized pelvic therapy for women who are looking for a trauma-informed, gentle, and caring approach.
To get started, feel free to book online. If you have questions before you begin, feel free to contact me or book your free discovery call.
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Disclaimer: The information provided on this blog is intended for general wellness education purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physical therapist, physician, or other qualified health provider with any questions you may have regarding a medical condition.