Guest post: Stress incontinence - 'Fallen fanjos are a feminist issue'
Did you know that one in three women aged 35-55 wet themselves? Stress incontinence is very common, and yet we're often too embarrassed to talk about it. Physiotherapist Elaine Miller (AKA gussiegrips) is determined to remove the taboo and encourage all women to do their pelvic floor exercises. In this guest post, she explains why it matters.
Posted on: Wed 21-May-14 10:55:17
(259 comments )
Doorstep piddling wasn't unusual for me - you know how you're okay right up until you get the key in your lock? Well, my poor neighbour caught me as I was wresting small kids and shopping with a post-coffee-bladder. She chatted away as I tried to disguise that I was bursting (standing on your tip toes works by the way, for a time).
Our relationship was mostly based on exchanging gardening tips and accepting parcels for each other. So, washing her down the driveway in a giant tsunami of my steaming piss was a bit, y'know, socially awkward.
And I had no excuse. I knew exactly what pelvic floor exercises were, how to do them, and why I should bother because <hangs head in shame> I'm a physiotherapist.
No excuse, but, there was a good reason – I was awfully tired. I lived with hundreds of tiny kids who were always trying to maim themselves, and each other, in ever-more inventive ways. I could barely remember my children's names, let alone remember to clench my nether regions.
But the great Dribbly Doorstep Disaster was the motivation I needed.
"Make it a habit" is the advice, so, I did them every time I shouted at my kids' (effective), every time I craved a glass of wine (remarkably effective) and every single time I thought an evil thought about my husband (dry in three months).
Here's the sciencey bit:
One in three women aged 35-55 wet themselves, and, about 50% of women over 55.
70-80% of stress incontinence can be cured with pelvic floor exercises within four months.
Read that again. At least a THIRD of your peers use pads, and MOST of them can be cured.
The exercises are cheap to teach, free to do and don't have any side effects. Unless you count toe curling, panting, blaspheming orgasms as a side effect (ask me how I know).
And it bloody MATTERS. Incontinence quietly disempowers women by interfering with every single thing they do, and yet, few complain. It matters because wetting yourself in the front row of Zumba, means you are unlikely to go back to Zumba (again, erm, ask me how I know), and we know that diseases of inactivity kill people. It matters because being "a bit leaky" is a big deal that can have a huge impact on your long-term well-being.
It bloody MATTERS. Incontinence quietly disempowers women by interfering with every single thing they do, and yet, few complain. It matters because wetting yourself in the front row of Zumba, means you are unlikely to go back to Zumba (ask me how I know), and we know that diseases of inactivity kill people.
We silence ourselves. It’s as if we are so ashamed of having less bladder control than our toddler that we'd rather continue to suffer in silence than seek help. I suggest we try being angry and vocal instead, because that’s how taboos change.
Even more silent are the one in ten people who leak poo, or the 50% of women over the age of 50 who have vaginal prolapses. Some wait until they are practically dragging their cervix behind them before seeking help.
It's common to be a bit disengaged with your "down below" because, well, you can't see it. We know that many women find the exercises difficult to do correctly, and that energetic eyebrow wiggling is not an effective alternative.
So, set the scene: You're in a tiny lift with your boss, your MIL and someone you've got a massive crush on. Imagine you can feel a fart brewing. A really nasty one. You know that bum-ole squeezing you do to hold in the mortifying toot? That's you working your pelvic floor. Hold it for a count of 10. When you let go you should feel a "drop" down into your pants. Or you could do 10 quick flicks and relaxes in a row - try doing them in time to the beat of music.
The important thing is to keep breathing and to relax your muscles in between the exercises. Do these three times a day, every day for four months, and then, once a day, every day, until you die. If you get pain, stop and take your bits to a GP or pelvic physio.
And, I'll even remind you via twitter - when I tweet, you twitch your twinkle. Midwives and physios are collaborating with #squeezeandlift. If you see it, do it!
Basic lifestyle changes – like reducing caffeine, citrus and alcohol (so, at least cut out the 'slice' from your rum and coke), controlling hayfever or asthma coughs and (even small amounts of) weight loss can make a huge difference to the amount of leaking you experience.
As with all things, the best place to start is with good information – there are brilliant blogs out there, like Evidently Cochrane, and lots of useful stuff from the CSP and the Bladder and Bowel Foundation. Or, you could even watch me, on a really bad hair day, doing stand-up comedy about pelvic floors.
The bottom line is that any leaking at all is abnormal. It is not an inevitable consequence of ageing or parenthood, and you don't need to put up with it.
Watch Elaine's alter ego Gussie Grips take the Edinburgh Festival by storm over on the Mumsnet YouTube channel - and don't forget to subscribe - lots more brilliant videos coming very soon.
By Elaine Miller
Yup, I'll be there! Boggles at audience participation - synchronised squishing?
Synchronised Squishing it is.
Do come and say "hi" if you come along. I'm always a wee bit surprised that there are real people behind the screen, gives mea wee warm and fuzzy.
Gussiegrips, I'm not sure of the specifics of when they will pay. Just that when I called they asked if it was pregnancy related and when I said yes (as I was referred at my post natal 6 week check) they refused to pay as my policy doesn't cover pregnancy or related issues. Seems a bit Horst sighted to me....
Interesting blog post for you Gussie - to me makes perfect sense but I am not a physio.
Basically says that pelvic floor issues are a function of poor posture and tucking pelvis (caused by high heels/tight muscles etc) and that to fix maintain PF we should do squats and not kegels (as doing kegels weakens PF)
I would be really interested to hear your take on this article/post.
And follow up post to link above...
It's, I am familiar with the article, and I respect Kathryn bowman. But, I disagree with many of her assertions. The sacrum simply doesn,t move as she says. The pelvis is a fixed structure, there,s a few mms of movement at best. And, the pf is a dynamic structure that rises nod falls as you breathe and move. I do agree with her saying keels aren't,t the whole answer, but, neither are squats. Indeed, if you have a prolapse and start doing deep squats you,re risking worsening the prolapse. Any one size fits all approach is going to be flawed. There is no substitution for assessment, and that goes for my rumblings too! So, yep, she,s got some good points, but I,d caution against squatting and doing nothing else. Training is specific, if you want a pf that coordinates itself and resists the forces you subject it to, well, squatting isn,t going to mimic that at all. Sorry for the typos, a, away from computer and on bloke,s stupid I pad.
I realise that I may be too late to this discussion?
I was wondering if you had come across urinary incontinence caused by adhesions/ soft tissue issues (rather than pelvic floor weakness). A few people (e.g. cranio-sacral osteopath) have mentioned this to me, so I am keen to canvas other thoughts on this.
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Hi all your ladies I am 65 yrs old with two adult children, both were quite large children and my first was a forceps delivery. I now find myself with a quite bad continence problem. I did see my GP who referred me to a specialist pysio, but after six months of doing PF exercises I did not have any improvement so I stopped going. I have tried electronic stimulators but they seemed to make me worse, I continue to do manual PF exercises but do not seem to get any better and wear a pad most days. have any of you had the vaginal tape repair and how did it work for you, answers appreciated please many thanks
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