Living with incontinence, alone
I was so relieved when I heard this from my physical therapist during our first virtual session, it felt like my name had been called for the finale of a big competition. Finally, I had a real chance at winning this struggle with incontinence. One reason I delayed getting help was that even before I had children, I struggled to do Kegel's exercise correctly, discouraging, when the one exercise that was supposed to solve my problem was one I could never quite manage, even back in PT school.
I can't pinpoint exactly how my incontinence started, maybe my daily green tea, maybe the cold weather. All I know is that I ended up buying myself a female urinal and carrying it with me to work. At the time I was a home health PT with long drives between patients in the remote, scenic areas of southern Vermont, and I'd find myself desperately searching for the nearest gas station to pee. I learned to do timed voiding, which helped, but things got worse after I gave birth. I vividly remember wetting the bed while wincing through the painful early latches of breastfeeding my newborn. As our breastfeeding journey got easier, my leaks improved somewhat, though I'd still have one or two bad episodes, and frequent small drops with a cough, sneeze, laugh, or even excitement.
“It is not all about Kegel's…”, a myth debunked
My physical therapist explained that years of dysmenorrhea, lower abdomen cramps during menstruation caused by a condition called endometriosis, had left my pelvic floor muscles tight, held in a tensed, contracted state even at rest. Because those muscles were already tight, they couldn't contract efficiently when I tried to do Kegel's exercise, leading to the very weakness that was undermining my continence. My more recent pregnancy had also pushed my bladder down onto those muscles, further aggravating my ability to control both urine and gas.
The real goal, it turned out, was to relax and stretch those tight muscles before trying to strengthen them. Working through the home exercise program my PT gave me, I noticed I actually had more difficulty relaxing my pelvic floor muscles than activating them, I had to close my eyes, draw all my attention to those deep muscles, clear my mind, and take a couple of breaths just to feel them start to relax. Only then could I move on to Kegel's, which brought its own challenge: isolating the target muscles so the other surrounding muscles stayed quiet, or at least less active. Whew, what a workout, mentally exhausting more than physically, if I may say.
Tracking progress, with support
Throughout this journey, I decided to keep an exercise diary. It helped me stay motivated even on days I didn't see any changes, and writing down how I felt during each session also helped me communicate effectively with my PT about my response to the program, so she could modify or progress it according to my pace and needs.
That's the beauty of having an expert to help: my program was personal and individualized. I could have just tried to figure this out alone, relying on Google or YouTube, and kept trying and failing on doing Kegel's. But I chose a different path, now I'm not alone in this journey. I made it my own mission to live a quality life: to laugh, sneeze, or cough, and remain dry.
Tribeca Physical Therapy is officially reopened for in-person physical therapy sessions and continues to offer Telehealth PT, or Virtual PT. Call us at (212) 406-8080 or message us to schedule your first session.