Incontinence is a difficulty unto itself; having to plan regular bathroom trips, pack extra pads, underwear, worrying about jumping, running, and if you live in North Carolina, it also means accounting for pollen season.
Unfortunately, incontinence is also a yellow flag that more injuries are down the road. To understand why, we’re going to need a foundation for anatomy and how our body works!
The pelvic floor is the group of muscles at the bottom of our pelvis. They control our ‘ins and outs,’ as I say, and they’re also deeply interwoven with some of our deep hip rotators. The pelvic floor isn’t an inert group of muscles just sitting around waiting to kick on when you have to go to the bathroom. They are in fact the foundation of your core.
Our core is a lot like a soda can, actually; a bunch of liquid contained by rigid walls. The top of the can is our respiratory diaphragm, the walls are our obliques, and the bottom is our pelvic floor. Something important about the can analogy is that it’s a pressure system. Our body has to manage all the fluid on the inside.
When we inhale, our diaphragm actually descends to create a vacuum, which is what draws in air for us to breathe. If we come back to the can analogy, that means the top of the can is descending, and it’s pushing against the fluid mass and contents of our abdomen (IE, our organs). If nothing changed, this would pressurize our abdomen, pop the walls of the can outward, and squish our organs.
Because our body is brilliant, our pelvic floor muscles actually move with our diaphragm. As our diaphragm descends, our pelvic floor muscles lengthen, and “drop down.” If the top goes down, the bottom needs to go down too, to maintain the pressure.
How does this whole pressure system play a role in incontinence, and why does it leave us vulnerable to injury?
Incontinence is a huge neon sign pointing towards pelvic floor dysfunction; like I said earlier, it controls the ins and outs of our pelvis. If the pelvic floor isn’t functioning well, incontinence is one of the most common effects.
And if our pelvic floor isn’t working well, then we no longer have a strong foundation for our abdominals to work from, or a functioning partner for our diaphragm. Trying to maintain a strong core with a weak pelvic floor is like trying to build a house on a water bed; it simply isn’t going to be stable.
And if we don’t have a strong core, our limbs cannot exert force as efficiently. What happens instead is that we start pulling for stability from elsewhere, like our hips, our knees, our ankles or shoulders even. We start putting more load on other joints because they no longer have a place to anchor to. Which is why I often see people 2-3 years after pregnancy with injuries in a number of joints; their pelvic floor was changed by their pregnancy, they heard that incontinence was “just part of having kids,” and carried on with their life.
That’s why I always want to address incontinence sooner rather than later, because 1) it’s definitely not something you have to live with, and 2) it’s a sign of mechanical inefficiency that leaves you at risk for more injury.
So if you’re dealing with incontinence, a strongly recommend seeing a pelvic floor physical therapist. Give us a call so we can get you scheduled, and resolve this for good!
