To think that pelvic floor exercises are not the complete answer

[Blipbipbeep]

to stress incontinence?

TMI alert

I have an excellent pelvic floor. I have been doing the exercises religiously for 15 or more years and, trust me, its awesome

But I still get stress incontinence. I can't sneeze more than three times in a row and I wont get on the trampoline.

I have two DC and both were natural births with no tearing or stitches. Come to think of it I had stress incontinence long before I ever got pregnant which is why I have been doing the darn exercises for so ruddy long.

So please does anyone have any better ideas?

I don't mean to hijack this but as its here can anyone answer this question.

Ive no kids, only 21, but lateky I'm sure I'm having some bladder problems.

I'll have a wee before I get in bed, lie there for ten mins, need a wee. Every night. I wake up about 2-3 times needing a week. During the day I'll have regular wee's but sometimes feel a little bit trickle out every now and again

And I don't even know how to do bloody pelvic floors! Surely it should be fine anyway?

My pelvic floor is ok...I can do jumping jacks till the cows come home.

However, a violent cough or a few seated drops on DS's trampoline is another matter

The pissing shame of it

Anyone else find incontinence much worse after ovulation. I'm generally fine after my period for a couple of weeks then I ovulate and have much worse control until my next period. It really is a massive difference but I've no idea why this should be.

That's normal, left angle.
Something with the effect of oestrogen on the tissues.

After 3 rather large baby whale sized DC and 12 years since I last gave birth, I had been doing the PF exercises but still had a bit of a problem until......
Earlier this year I took up kettlebell exercising concentrating mostly on the core work.

I'm not joking after 2/3 months I could sneeze, cough, trampoline, physically stand and try to force wee out :) urghh sorry TMI but for testing purposes....and NADA, nothing, zero wee leaked. If I also mention "grip" "tightness" and "intensity" then you ladies will know exactly what else is better
It's also repaired the small Diastatsis recti, that I was left with from pregnancy, just under my tummy button.
What I will say if you are going to take this up is, it MUST be done correctly, better you go to some classes to learn how to execute the movements but it is possible to find training vids on youtube too.

Dondon - glad to hear it. Improved grip and whatnot are fairly good motivators...

Leftangle - coffee's right. The hormonal changes make your collagen a bit stretchier than normal, so the ligaments supporting your bits stretch and the stress on your pelvic muscles increases - and, oops.

Betty - do the quick flicks. Twitch away to the beat of the music, every step you take (actual steps, not advocating Sting. Other musicians are available) the windscreen wipers - whatever. 10 in a row, rest, do another set, rest, repeat. Aim for at least 3 a day.

Goldship - might be an idea to see your GP to rule out an infection, or something else medical-ish. Do that first, then get your people to call my people and we'll tawk. Or, rather, send a PM.

I had pelvic floor physio at hospital after a 3b tear with DD - my awesome therapist recommended the free DVD from Tena (you can find it on the website) she said it was all the exercises she did with her private patients - it's free! Worth a look :-)

And I would second Nancy on a campaign re this, incontinence is utterly crippling, destroys confidence, makes people prisoners in their own home - people are SO ashamed - but very common and mostly a female problem. Very little research or solutions given despite how widespread the problem is. Definitely needs bringing into the light.

Great, Nux.

I was chatting to a drug rep this morning - and she pointed out that GP's are paid for QOF issues GP's get paid more for prevention and management of killer conditions

Continence isn't on the list of incentivised conditions to manage...

And yet, there's a paper published that shows that women don't get the help they need when they do present themselves to GP...can't help but think that the two are linked...

And yet, this is a condition that is associated with mental health issues, surgical interventions and significant lifestyle changes to a large percentage of our population. Never mind factoring in the personal and financial costs of little old ladies breaking their hips in the night when they fall en route to the loo.

What are the figures for the secondary costs of continence problems?

More mulling. And, a bit of foot stamping.

Who is telling the GP's about how to manage continence? Drug companies? Who is telling them the scale of the issue, because the patients certainly aren't, they are just buying job-lots of pads online.

Doyerblardyexercises, right now! Squeeze 10, 10 flicks, up three floors and back down again.

Or, I'll make you look at pictures of a prolapse - I will, I'm proper mean when I'm all political.

I'm not great in that department, thought I'd got a lot better recently but this week has not been good so I'm interested to see the theory about oestrogen levels as it is also 8 weeks since my last period. (& I'm deffo not pregnant did a test yesterday just to be sure) so I guess I'm getting peri menopausal which is even more bad news for my pelvic floor isn't it?
We live on a hill and I hate trying to walk down it in high heels (we usually get a taxi from the bottom of the road) as it is nigh on impossible to stay dry to the bottom which is a really bad start to a night out

Sadly, yep, menopause increases your risk.

Menopause is guff for your collagen (that's a technical term) So, you get wrinkly skin and your ligaments aren't as strong as they used to be.

Crummy ligaments means increased stress on joints - that contributes to arthritic problems associated with old age...but, it also means the network of ligaments you have supporting your pelvic organs get slacker.

So, they sag onto your pelvic floor muscles. Which also has guff collagen. And the whole thing lands up rather like a burst balloon.

However. An aged muscle can be strengthened. Indeed, there's new research suggesting that older people have a better response to exercise than others. Not only do they gain strength quicker than we thought, when you compare them with their peers who are not active and therefore losing strength - they have much better health outcomes as a direct result. So, fewer falls, less memory problems etc etc etc.

A peri-menopausal precious place will still be helped by the exercises. The downhill in high heels issue is helped by the peculiar "imagine you've got a lift in your la-la" exercise. Especially the going from the third floor down - it's just because a muscle working eccentrically (against gravity) has to work harder than concentrically (in the direction it's designed to work)

Still, bet your high heels just faaaaabulous! Well, if you've not dampened their shine by now?

There are also lots of types on incontinence.... overactive bladder (needing to go urgently), latchkey incontinence ( fine until you put key indoor type of thing)

I had botox a couple of years ago on my bladder, after taking pills ( which were awful) having physio ( pelvic floor was fine but worked on delaying and 'mind control' activities) and it was absolutely transformational!.

Unfortunately it does wear off after 12 months and whilst mine is much better than it was I can't get a repeat on my private healthcare and as it is seen as a last resprt on the NHS ( and to be fair it is expensive) I have to go through the whole shebang of pill/physio again before they would even consider me as a botox candidate...

So physio and pelvic floors isnt all its about and consulting a physio as a specialist in this area would be my first point of contact .....

king why do you have to go back to being symptomatic and trialling treatments that didn't work for you before having the botox repeated?

You've had investigations, physio and found an effective treatment, so there's a cost-saving element for the NHS to sticking with what has been proven to work.

Have you asked your GP to refer you on the NHS? Sadly, in my experience, when it comes to continence, it's the people who ask who get...

Right, I've got a request:

I'm now involved in a small capacity with APOPS mahvellus, you must read their stuff

We see a need for a directory of physios, nurses and GP's with an interest in continence and pelvic organ prolapse.

APOPS UK is hoping to get a directory together and be able to put people in touch with professionals in their area. Details wouldn't be published, it'll be a private resource held by APOPS - but it would mean that desperate women can get help faster than at present.

I'd be really grateful if you'd consider PMing me the name/geographical area/contact details of anyone you have had help from.

I'll speak to them and see whether they'd be happy to be included - no one will be put on the register without their consent!

Also - have a look at APOPS facebook website. There are some really talented specialists giving advice and help for free on here

facebook APOPS

We are looking for case studies to publicise the massive problem of continence and how it blights lives. Next step - Dept of Health, Dept of Education, Parliament and Infinity and Beyond....