Why am I Leaking?

I had the incredible opportunity to interview Deborah Goldman on The Body Pod about pelvic floor dysfunctions. Deb is a pelvic floor physical therapist and, in my opinion, one of the best! Stay tuned for this episode to be released soon. In the meantime, Deb has shared some information on why we might be leaking.  

- Hailey

Many women in their 40s who I see in my pelvic floor physical therapy practice complain that since having children, they experience bladder leakage with exercise. If they’re in a gym, they make sure they empty their bladder before class starts even though they might have emptied 20 mins before. 

Or when the jumping starts, there’s a mad dash to empty again before the leaking starts. 

Yet, when they are lifting weights or on a bike they can delay those bathroom trips. 

Let’s break down what’s happening. 

When we sneeze, cough, laugh, jump, there is a sudden increase in our intra-abdominal pressure. The abdominal wall pressure increases and that pushes down on our bladder and urethra. At the same time the breathing diaphragm and pelvic floor are pushing down as well. 

If the bladder is filled and the urethral sphincters can’t override that pressure, you will leak. There are 3 potential issues in the pelvic floor that could be causing that to happen. It could be weak deep pelvic floor muscles, damaged pelvic fascia or weakness of the urethral sphincter muscles. 

Understanding the true cause will lead to greater success and cure, but starting pelvic floor therapy is the most evidence based conservative treatment. 

So why can some women do all the things but as soon as they jump on a trampoline, leak? 

A trampoline is very different from jumping off the floor. The floor exerts an equal and opposite reaction force that allows you to push off the ground and accelerate. When you jump on the trampoline, the springs move downward and store potential energy. As you jump, that’s kinetic energy. It requires a high level of pelvic floor activation not to leak. For some women, it exceeds their threshold for urethral sphincter recruitment. 

But as with all the leakage issues described here, pelvic floor physical therapy can help you effectively strengthen and restore normal bladder function.