1. Urinary incontinence is normal: This is not true. It is very common, but it is not normal. A similar example would be considering a twisted ankle “ normal” in a soccer player. Though ankle injuries may be common in this group of people, the ankle is meant to strong and stable, not lax and painful. Yes, there are factors, such as age and gender, that cannot be modified and may increase the risk of incontinence. But, not all women over the age of 45 experience incontinence. This means that there are other factors, modifiable factors, at play that may determine whether or not you experience bladder leakage, namely: your pelvic health. Pelvic health, or the state much of bladder, bowel, and reproductive organs, is perhaps the most modifiable factor concerning urinary incontinence (as well as sexual dysfunction, pelvic pain, and pelvic organ prolapse). Pelvic health is determined by factors such as weight, smoking, inactivity, pregnancy and perhaps most importantly: the function of the muscles and tissues of your lower pelvic, also known as your pelvic floor.
2. All bladder leaks are caused by “weak” pelvic floor muscles that needs to be “tightened up”. In fact, many times the muscles of the pelvic floor are too tight. Though they have an underlying weakness, they may first need to be stretched and relaxed before they can be strengthened. A muscle needs to be able to move through full range of motion to provide optimal strength. If it is “stuck” in place, it will not be able to contract enough to stop leaking when you exercise, or provide you with support.
3. Kegels will cause all of my troubles to go away. Kegels, or “squeezing” your pelvic floor, can be an important part of pelvic rehabilitation, but they will not benefit those individuals with tight pelvic musculature. A similar comparison would be like strengthen a bicep muscle with bicep curls if your biceps is “stuck” in a bent position. You would probably want to stretch your arm out first, and then progress to the bicep curls once your arm is able to move more. Furthermore; back, hip, abdominal, and breathing problems can play a big role in pelvic pain and dysfunction. In such a case, performing kegals may only be addressing one piece of a very dynamic and complex puzzle.