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Why it's Not Normal to pee yourself and other Pelvic Floor Advice


If you had a sore calf during multiple training sessions, you’d probably decide to see a physiotherapist for advice on strengthening it. If you were feeling dizzy every time you ran, you’d likely book in with your GP to find out what was wrong. But what if you were… peeing yourself during your runs? Would you know what to do? Who to seek advice from? Would you think this was an issue at all, or would you laugh this off as one of those unavoidable ‘runner problems’? As much as this may be one of those ‘icky’ topics women avoid discussing, this is such an important health issue that should be addressed by the appropriate health professional.

Around 41 – 43 per cent of elite female athletes experience what is called ‘Stress Urinary Incontinence’, defined as leaking small amounts of urine during activities that cause physical stress, including coughing, sneezing, or exercise. While some think this is all just a normal part of high-level exercise, it truly is not!

What is the Pelvic Floor?

Your pelvic floor is a group of muscles that cover the underside of your pelvic opening and work as the support structure for the organs held within your pelvis – including your bladder, uterus and bowel. The pelvic floor functions as both a very important support for these muscles, as well as the voluntary muscle control that allows us to start, or stop, urinating and defecating.

The reason it is so important to address any weakness in the pelvic floor early is that a lack of support from the pelvic floor muscles results in increased pressure and tension on the ligaments and fibres attached to your pelvic organs. Increased stress through these fibres can lead to stretching, that is unfortunately irreversible, and over time increases the risk of incontinence and prolapse.

What to look out for?

If you do a full marathon, keep yourself hydrated throughout and don’t stop for the toilet at all, you might end up ‘overflowing’ a little. If this happens a couple of times, there might not be anything wrong. But, if you experience a few of the symptoms listed below, it might be important for you to seek assistance from a health professional.

  • Incontinence (also known as ‘peeing yourself’).

  • Feeling a need to rush to the toilet, but not making it in time.

  • Leakage when coughing, sneezing, jumping or any other impact activities.

  • Difficulty emptying the bladder or bowel, including a feeling of incomplete emptying.

  • A ‘bulging’ or heaviness feeling around the vaginal opening.

  • Pain in the pelvic area, including during sex.

Women who have given birth or reached menopause are at a higher risk of pelvic floor dysfunction, however, these issues can affect women of all ages. Other risk factors include being overweight, a history of constipation, a chronic cough, back pain and previous injury to the pelvic area.

What can you do?

Firstly, you can contact the National Continence Helpline on 1800 33 00 66 to discuss your concerns and symptoms with a continence nurse. They may offer you advice, education and resources to follow up.

Pelvic floor exercises, as provided by a qualified health professional, have an extremely strong evidence base in treating and preventing further pelvic floor dysfunction. While there is plenty of information online about how to complete pelvic floor exercises, sometimes known as ‘Kegels’, there is a small risk that you may not be addressing your specific problem. For example, some women have pelvic floor dysfunction related to over-activity of the muscles and by completing these ‘squeezes’ the problem can become worse.

In order to ensure the exercise program you complete is specific to you, and therefore most effective, you should see a health professional with expertise in this area.

Who Should You See?

Qualified women’s health physiotherapists are trained in pelvic floor assessment and would be the ideal professional to seek out if you are concerned about the health of your pelvic floor. A fantastic resource is cfaphysios.com.au where you can search for post-graduate qualified physiotherapists in your local area. Alternatively, all qualified physiotherapists working in a private practice should be able to provide basic education and a starting point for addressing your pelvic floor issues.

Finally, your GP would be a suitable resource to explain your symptoms, discuss further treatment options and provide appropriate resources. Just be aware that ‘conservative’ management (for example, exercises and education) are strongly recommended before thinking about ‘invasive’ treatments such as surgical treatment.

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