Your Health: A condition not to stress about...

editorial image

Stress incontinence affects about nine million females in the UK and basically means involuntary leakage of urine during physical activity.

The ‘stress’ part however isn’t an emotional one, the pelvic floor muscles and supporting structures of the bladder have become weakened after having babies and aren’t keeping the bladder outlet closed when you are bouncing up and down or sneezing.

It can cause urine to leak in any positions where there is stress or pressure on the bladder and is the most common form of incontinence.

What’s happening ‘down there?’

The pelvic floor muscles lie at the base of the pelvis attaching like a sling from the pubic bone at the front, tailbone (coccyx) at the back and the ‘sit bones’ at each side.

This forms a hammock supporting the bladder, womb, bowel and vagina. Clenching the muscle has a close and lift effect on the bladder and bowel openings, preventing leakage.

If you can stop your pee mid flow - well done it works. For some it resolves spontaneously, but for many the problem lingers requiring treatment.

Stress Incontinence is common in pregnancy and especially after vaginal deliveries simply because of the weight the poor pelvic floor/vagina has carried and the amount of stretch that happens pushing the baby out. Damage to the muscle or nerve supply makes it sluggish and slow to respond during activities, causing leakage.

Current NICE guidelines recommend at least three months guided pelvic floor Rehabilitation before considering other treatment options for stress incontinence (medication, surgery), making physiotherapy the first line treatment.

If you’ve had big babies, constipation, a chronic cough, are overweight, smoke or are menopausal you are more likely to develop Stress Incontinence and men can get it too especially after prostate surgery. Heavy lifting jobs and impact sports are also culprits.

How can physio help?

A physiotherapist with specialist Pelvic Floor/Continence training will take a full confidential history of your symptoms, and find out what is bothering you most.

You may be asked to do a bladder diary to establish a pattern if you are experiencing urgency and rushing to the loo often.

With your permission the physio may carry out a vaginal examination to get information about the strength and endurance of your pelvic floor and check for prolapse, skin conditions and general vaginal health.

The assessment is extremely beneficial, especially when 50per cent of women who think they are contracting their Pelvic Floor Muscles correctly are actually doing the opposite movement.


The main goal of treatment of course is to reduce/stop leakage and improve quality of life and to be able to play with your kids on the trampoline again. The physio may use some of the following to help.

Muscle training and core strength

The physio can tell you the best regime to train the muscles effectively, which usually involves exercising the core/abdominal muscles.

The muscles have to learn to contract quickly and slowly to function properly and exercising the pelvic floor three to four times a day is advisable, progressing to different positions and activities.


The use of biofeedback involves a small electrode placed inside the vagina.

The electrode traces the muscle activity (EMG) and you can see it on a computer screen.

This helps you ‘find the muscle’ and train it in different positions to work better, it also helps to monitor your progress.

Muscle stimulation

If the muscle is very weak, a gentle electrical current can be delivered to the muscle helping it to contract (a tingly sensation).

This can sort of ‘jump start’ the muscle until you gain better control yourself. You can rent or buy machines to do this at home and the physio will advise you about this.

Cones (a bit like tampons with weights)

A weighted cone in place when doing everyday tasks can stimulate the pelvic floor to work harder and strengthen.

How do I find out more?

If you want to learn more there is a special Women’s Health event on Saturday, March 5 from 3pm to pm at Physio and Therapies in Todmorden.

If you would like to book an appointment with Katy Winters, or for more information about the event, call 01706 819464 or go along to the website at