Everyone knows that sports and exercise can be really good for your health, boosting benefits such as decreasing your risk of major illness by up to 30%1. In fact, it’s recommended that you do a mixture of strengthening exercises and moderate-intensity activity four to five times a week2. Yet, if you experience incontinence, participating in sports can be daunting. Some studies even show that up to 20% of women have reported quitting exercise due to the fear of leaks3. But, playing sport is possible with bladder weakness, and there are even some forms of exercise that can improve your symptoms!
Incontinence is defined as the unintentional passing of urine, and it can be categorised into the following types:
In terms of how incontinence can affect sports, stress incontinence is the most common issue as it can cause you to leak urine when you exercise. However, there are still plenty of sports you can play while experiencing incontinence.
Firstly, there are certain sports that can cause you to experience incontinence more frequently, especially stress incontinence. For example, high-impact exercise, such as sit-ups and aerobics, can put extra strain on your bladder and therefore potentially cause leaks5. Other forms of exercise to avoid include any sports that involve skipping, jumping and excessive weights and core training.6 Nonetheless, there are still plenty physical activities you can enjoy with an overactive bladder.
While some sports can make symptoms of urinary incontinence (UI) worse, there are many bladder-friendly exercises you can enjoy. Activities that strengthen your pelvic floor are ideal if you experience bladder weakness. These include:
As these don’t apply pressure to the pelvic floor,9 you are less likely to leak urine. They can also improve your pelvic floor muscles, thus lessening your incontinence symptoms10. Plus, getting active can help you to lose weight11, which, in turn, can make leakages less frequent. This is because carrying extra weight can put more pressure on your bladder, making UI symptoms worse12. We highly recommend that you speak to your doctor before you take up a new exercise regime.
Finally, there are other things you can do to lessen the chance of experiencing incontinence while playing sports. In addition to focusing on bladder-friendly sports, we suggest:
We hope this article has shown you that it’s possible, and even beneficial, to continue to play sports when you have incontinence!
1 “Benefits of exercise”, NHS, 4 August 2021, Source: https://www.nhs.uk/live-well/exercise/exercise-health-benefits/
2 “Physical activity guidelines for adults aged 19 to 64”, NHS, 4 August 2021, Source: https://www.nhs.uk/live-well/exercise/exercise-guidelines/physical-activity-guidelines-for-adults-aged-19-to-64/
3 “Exercising with incontinence”, Phil Wilkinson, n.d., Source: https://www.independenceaustralia.com.au/health-articles/continence/exercising-with-incontinence/
4 “Urinary incontinence”, NHS, 7 November 2019, Source: https://www.nhs.uk/conditions/urinary-incontinence/
5 “10 ways to stop leaks”, NHS, 7 November 2019, Source: https://www.nhs.uk/conditions/urinary-incontinence/10-ways-to-stop-leaks/
6 “Exercising with incontinence”, Phil Wilkinson, n.d., Source: https://www.independenceaustralia.com.au/health-articles/continence/exercising-with-incontinence/
7 “10 ways to stop leaks”, NHS, 7 November 2019, Source: https://www.nhs.uk/conditions/urinary-incontinence/10-ways-to-stop-leaks/
8 “Exercising with incontinence”, Phil Wilkinson, n.d., Source: https://www.independenceaustralia.com.au/health-articles/continence/exercising-with-incontinence/
9 “Loss of bladder control and sport: What can I do?”, Fizimed, 19 June 2019, Source: https://www.fizimed.com/en/blog/bladder-control/
10 “10 ways to stop leaks”, NHS, 7 November 2019, Source: https://www.nhs.uk/conditions/urinary-incontinence/10-ways-to-stop-leaks/
11 “12 tips to help you lose weight”, NHS, 29 November 2019, Source: https://www.nhs.uk/live-well/healthy-weight/managing-your-weight/12-tips-to-help-you-lose-weight/
12 “Urinary incontinence: 5 ways you may be making your symptoms worse”, King Edward VII’s Hospital, n.d., Source: https://www.kingedwardvii.co.uk/health-hub/urinary-incontinence-5-ways-you-may-be-making-your-symptoms-worse
13 “What NOT to do at the gym”, Continence Foundation of Australia, 22 September 2016, Source: https://www.continence.org.au/news/what-not-do-gym
14 “7 Urologic Conditions Impacted by Smoking”, Urology Care Foundation, 14 March 2018, Source: https://www.urologyhealth.org/healthy-living/care-blog/2018/7-urologic-conditions-impacted-by-smoking
15 “Alcohol and The Impact It Has on Your Bladder and Bowels”, Ruth Hilton, 8 August 2018, Source: https://www.hartmanndirect.co.uk/information-centre/alcohol-and-the-impact-it-has-on-your-bladder-and-bowels/
This article was originally published on iD Direct and has been edited and republished here with permission.
iD is the flagship brand of Ontex's range of adult care personal hygiene solutions. With over 40 years of experience, Ontex has developed innovative personal hygiene solutions to deliver high quality, affordable products to our customers across the globe.
Ontex's iD brand of disposable continence solutions is developed using the latest innovation and technology to provide maximum discretion as well as keep you safe and secure through fast absorption technologies. It is through our products, our practices and our people that we have got you covered for all your continence needs. Try one of our products today and choose to be confident - choose iD!
ADHD (Attention-deficit hyperactivity disorder) is a relatively common condition that affects a person’s behaviour, which can become evident in childhood, particularly when a child starts school1. In fact, studies show that around 2% to 7% of people experience ADHD globally2. While there are many signs that a child may have ADHD, such as difficulty maintaining attention on tasks, fidgeting and trouble waiting for their turn and sharing3, bedwetting can also be an indicator of ADHD4. Read on to find out why, and how you can manage this combination of issues in children.
Attention deficit hyperactivity disorder (ADHD) is a condition that affects how a person behaves. It is usually diagnosed when a child is under 12 years old, if it wasn’t picked up when they started school initially5. It is a neurodevelopmental disorder, meaning it affects the development of the brain, and refers to a pattern of behaviour that affects a child in most situations6. While symptoms may change as a child matures, the two main signs of ADHD are inattention and hyperactivity7. These can be seen in the following behaviours:
Despite its commonness, little is known about what causes this condition, but it is believed to potentially have neurological and/or genetic origins9. There is, unfortunately, not just one test to diagnose ADHD, so your doctor will likely assess any ADHD symptoms your child has been experiencing for the past six months, as well as do a physical exam and take a medical history to rule out any other potential causes10.
Furthermore, ADHD is the most common coexisting condition for children with autism, though the two may also be confused due to similar presenting signs11. It’s important to seek help through your doctor if you suspect your child has one or both of these conditions, particularly if you have any concerns. Nonetheless, with the correct support, people with these conditions can lead happy, fulfilling lives12.
As we said, ADHD and bedwetting can be linked; in fact, the rate of accidents is almost three times higher in children with ADHD19. While it’s not entirely clear why, some research has suggested that this connection may be due to ADHD causing a developmental delay in the central nervous system, which may cause children to not recognise when their bladder is full20. Also, the link between ADHD and bedwetting could be caused by the following:
If your child is wetting the bed due to ADHD, the iD Comfy Junior range is a good option to consider. The iD Comfy Junior Pants are suitable for children from eight to 15 years old. They fit just like normal underwear, offering a great absorbency capacity and maximum discretion and comfort. We highly encourage you to seek a doctor's opinion to learn how to support your child further.
Bedwetting is also very prevalent in children, with around 15% of children over seven years old experiencing it13. It can run in families, and most children and young people will grow out of it14. Also known as nocturnal enuresis, it is when a person involuntarily urinates while asleep15. There are many things that could cause bedwetting, including:
If you have any concerns about your child’s health, we recommend that you speak to your doctor.
Both bedwetting and ADHD can be difficult conditions for parents to cope with. Nonetheless, there are lots of tips and tricks you can follow to help manage nocturnal enuresis, such as:
With all these tips in your arsenal, you’ll be sure to reduce any distress caused by bedwetting and ADHD.
1 “Attention deficit hyperactivity disorder (ADHD)”, NHS, 24 December 2021, Source: https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/
2 “ADHD Incidence”, ADHD UK, n.d., Source: https://adhduk.co.uk/adhd-incidence/
3 “Symptoms and Diagnosis of ADHD”, Centers for Disease Control and Prevention, 9 August 202, Source: https://www.cdc.gov/ncbddd/adhd/diagnosis.html
4 “What's the link between ADHD and bedwetting?”, Beth Sissons, 24 November 2022, Source: https://www.medicalnewstoday.com/articles/adhd-bedwetting
5 “Attention deficit hyperactivity disorder (ADHD)”, NHS, 24 December 2021, Source: https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/
6 “Attention deficit hyperactivity disorder (ADHD)”, The Child and Adolescent Mental Health Service, October 2016, Source: https://www.gosh.nhs.uk/conditions-and-treatments/general-medical-conditions/attention-deficit-hyperactivity-disorder-adhd/
7 Ibid.
8 “Everything You Need to Know About ADHD”, Traci Angel, Source: 13 October 2021, https://www.healthline.com/health/adhd
9 Ibid.
10 “What Is ADHD? Attention Deficit Hyperactivity Disorder in Children and Adults”, ADDitude Editors, 19 January 2023, Source: https://www.additudemag.com/what-is-adhd-symptoms-causes-treatments/
11 “ADHD and Autism Spectrum Disorder”, CHADD, n.d., Source: https://chadd.org/about-adhd/adhd-and-autism-spectrum-disorder/
12 “ADHD and Autism”, John Perritano, 18 May 2022, Source: https://www.webmd.com/add-adhd/childhood-adhd/adhd-or-autism
13 “Bedwetting – reasons and how to stop it”, eric, October 2022, Source: https://eric.org.uk/childrens-bladders/bedwetting/?gclid=Cj0KCQjwiZqhBhCJARIsACHHEH_oHASfveh6hF4PnKNCnZAQO0bO_JU1W_KMKuqSfB7a1OLopw91XUoaAs0kEALw_wcB
14 “Bedwetting in children”, NHS, 27 April 2020, Source: https://www.nhs.uk/conditions/bedwetting/
15 “Nocturnal Enuresis (‘bedwetting’) in children”, Cambridge University Hospitals, 11 May 2020, Source: https://www.cuh.nhs.uk/patient-information/nocturnal-enuresis-bedwetting-in-children/
16 “Bedwetting – reasons and how to stop it”, eric, October 2022, Source: https://eric.org.uk/childrens-bladders/bedwetting/?gclid=Cj0KCQjwiZqhBhCJARIsACHHEH_oHASfveh6hF4PnKNCnZAQO0bO_JU1W_KMKuqSfB7a1OLopw91XUoaAs0kEALw_wcB
17 “Bedwetting in children”, NHS, 27 April 2020, Source: https://www.nhs.uk/conditions/bedwetting/
18 “Nocturnal Enuresis (‘bedwetting’) in children”, Cambridge University Hospitals, 11 May 2020, Source: https://www.cuh.nhs.uk/patient-information/nocturnal-enuresis-bedwetting-in-children/
19 “What’s the Link Between ADHD and Bedwetting?”, Next Step 4 ADHD, 15 March 2021, Source: https://nextstep4adhd.com/whats-the-link-between-adhd-and-bedwetting/
20 “What's the link between ADHD and bedwetting?”, Beth Sissons, 24 November 2022, Source: https://www.medicalnewstoday.com/articles/adhd-bedwetting
21 “What’s the Link Between ADHD and Bedwetting?”, Next Step 4 ADHD, 15 March 2021, Source: https://nextstep4adhd.com/whats-the-link-between-adhd-and-bedwetting/
22 “What's the link between ADHD and bedwetting?”, Beth Sissons, 24 November 2022, Source: https://www.medicalnewstoday.com/articles/adhd-bedwetting
23 “What’s the Link Between ADHD and Bedwetting?”, Next Step 4 ADHD, 15 March 2021, Source: https://nextstep4adhd.com/whats-the-link-between-adhd-and-bedwetting/
This article was originally published on iD Direct and has been edited and republished here with permission.
iD Direct is the flagship brand of Ontex's range of adult care personal hygiene solutions. With over 40 years of experience, Ontex has developed innovative personal hygiene solutions to deliver high quality, affordable products to our customers across the globe.
Ontex's iD brand of disposable continence solutions is developed using the latest innovation and technology to provide maximum discretion as well as keep you safe and secure through fast absorption technologies. It is through our products, our practices and our people that we have got you covered for all your continence needs. Try one of our products today and choose to be confident - choose iD!
Bedwetting (or nocturnal enuresis) refers to the involuntary leaking of urine while you sleep1. While the percentage of kids experiencing this condition decreases as they get older, it’s still a fairly common condition, affecting around 21% of four-and-a-half-year-olds2. Nonetheless, older children and adults can experience it too, and can be very frustrating, particularly when it comes to protecting your mattress from leaks. Read on for our top tips on managing night-time leaks and keeping your furniture dry.
Bladder issues are common in young children as they are being potty trained3. However, the frequency of bedwetting does decrease with time; once they reach nine-and-a-half years old, only 8% of children are wetting the bed and this drops further to around 3% of adolescents and about 1% of adults4. While it’s often just a perfectly natural part of growing up, other things can cause nocturnal enuresis, including:
While most children grow out of this issue, you should always consult your doctor if you have any concerns. This is particularly recommended if your child:
Understandably, many parents and carers find the extra washing associated with bedwetting frustrating and potentially overwhelming. However, there are plenty of things you can try to make life easier, such as:
Another way to protect a mattress from leaks caused by bedwetting is to get to the root of the problem, by taking steps to improve bedwetting symptoms. Here are some tips to try:
Hopefully, by following these tips, you can enjoy more frequent dry nights, and if the occasional leak happens due to bedwetting, you can rest assured that the mattress is protected.
We have written an Incontinence Guide for additional help and advice. Please also speak to a medical professional if you have any questions.
1 “Nocturnal Enuresis (‘bedwetting’) in children”, Cambridge University Hospitals, 11 May 2020, Source: https://www.cuh.nhs.uk/patient-information/nocturnal-enuresis-bedwetting-in-children/
2 “Bedwetting: The facts”, Bladder & Bowel UK, 18 May 2021, Source: https://www.bbuk.org.uk/bedwetting-the-facts/
3 “Nocturnal Enuresis (‘bedwetting’) in children”, Cambridge University Hospitals, 11 May 2020, Source: https://www.cuh.nhs.uk/patient-information/nocturnal-enuresis-bedwetting-in-children/
4 “Bedwetting: The facts”, Bladder & Bowel UK, 18 May 2021, Source: https://www.bbuk.org.uk/bedwetting-the-facts/
5 “Bedwetting – reasons and how to stop it”, eric, October 2022, Source: https://eric.org.uk/childrens-bladders/bedwetting/?gclid=Cj0KCQjw_r6hBhDdARIsAMIDhV-6pCAD8Odvz9qhy_xg5SyA_Ei1lpGWtsvPAyiv_Htc5odYDj6d3nMaAom6EALw_wcB
6 “Bed-wetting”, Mayo Clinic Staff, 26 October 2017, Source: https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685
7 “Bedwetting in children”, NHS, 27 April 2020, Source: https://www.nhs.uk/conditions/bedwetting/
8 “Bed-wetting”, Mayo Clinic Staff, 26 October 2017, Source: https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685
9 “Bedwetting in children”, NHS, 27 April 2020, Source: https://www.nhs.uk/conditions/bedwetting/
10 “Bed-wetting: How to protect and clean bedding and mattresses”, Heleina Burton, n.d., Source: https://www.babycenter.com/child/sleep/bed-wetting-how-to-protect-and-clean-bedding-and-mattresses_10408732
11 “Treatment of Bladder Control Problems & Bedwetting in Children”, National Institute of Diabetes and Digestive and Kidney Diseases, September 2017, Source: https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-bedwetting-children/treatment
12 Ibid.
13 Why Some Guys Wet the Bed After a Night Of Drinking”, Cassie Shortsleeve, 1 September 2016, Source: https://www.menshealth.com/health/a19528026/bedwetting-and-alcohol/
14 Ibid.
15 “HOW SMOKING CONTRIBUTES TO INCONTINENCE”, NAFC, n.d., Source: https://www.nafc.org/bhealth-blog/how-smoking-contributes-to-incontinence
This article was originally published on iD Direct and has been edited and republished here with permission.
iD Direct is the flagship brand of Ontex's range of adult care personal hygiene solutions. With over 40 years of experience, Ontex has developed innovative personal hygiene solutions to deliver high quality, affordable products to our customers across the globe.
Ontex's iD brand of disposable continence solutions is developed using the latest innovation and technology to provide maximum discretion as well as keep you safe and secure through fast absorption technologies. It is through our products, our practices and our people that we have got you covered for all your continence needs. Try one of our products today and choose to be confident - choose iD!
Hello, I’m Phillipa Butler, a Chartered Physiotherapist and Certified Pilates and Yoga Teacher.
I believe that a regular programme of appropriate exercise is the key to a fitter and healthier future. The pelvic floor is a group of muscles that, when trained, can help to ease the symptoms of bladder weakness. The good news is that it’s never too late to take action and tackle health problems!
Our bodies are complex, with each of our body systems interconnected and dependent on each other. However, it is not always obvious how these connections can influence distant parts of the body and the pelvic floor is a prime example of this phenomenon.
You may be aware that posture is important for the health of your spine, but did you know that how we hold our bodies can have an impact on the pelvic floor?
Posture is defined as the position in which someone holds their body, for example when standing or sitting. Our posture changes and varies as we move through our day performing our different tasks and roles. However, some general principles apply, regardless of what we are doing, that will differentiate a poor posture from an ideal posture.
A poor posture can increase the stresses and strains on joints, muscles, and even your pelvic floor. Making adjustments that improve your posture could help to improve the functioning of the pelvic floor and support the management of incontinence and pelvic floor dysfunction.
We need to explore all possibilities when seeking to address health issues that impact our quality of life. Standing and sitting up straighter could help your pelvic floor, your back, neck, and shoulder joints. Why not give it a try and discover the benefits for yourself?
As you can imagine, the answer to this is not simple. However, there are ways that we will move and use our bodies that are less efficient mechanically and can put undue stress and strain on joints and muscles.
Our modern lives have changed how we use our bodies every day. Much of the physicality that was once an integral part of our lives is now reserved for our hobbies or pastimes, and so it is much more optional.
We are also up against our primitive programming that leads us to conserve as much energy as possible just in case we might need to run for our lives. This is much less likely nowadays but if we put this tendency together with our sedentary lifestyles, we have a recipe that can create poor postural habits that we will barely notice. That is until something goes wrong!
So, what does good posture look like and how could that help our pelvic floor?
Some general principles will differentiate an ideal posture from a poor posture. When we examine the ideal working position of the body, we could imagine standing alongside a line passing vertically from the floor to the ceiling. Ideally, this line should pass adjacent to the following points:
In between the shoulder and the hips, you can see the natural curves of the spine, concave in the neck (cervical spine), convex through the upper back (thoracic spine), and concave in the lower back (lumbar spine). These curves should be even and sweeping, not exaggerated or flattened.
As part of a postural assessment, we would also examine the position of the pelvis and the knee joints.
The pelvis is an important element of posture for a variety of reasons. The centre of gravity lies within the pelvis and the position of the pelvis influences how the spine, ribcage, shoulders, and head will all stack up above it.
It has been suggested that the angle of the pelvis is one of the postural characteristics that can influence the performance of the pelvic floor. Deviations from the normal range of pelvic tilt can influence the symmetry of pelvic floor muscles, which in turn can have an impact on their efficiency and effectiveness. (Oleksy et al. 2019)
When we examine posture, the pelvis could be neutral, which is the ideal, tilted forwards (anterior tilt) or backwards (posterior tilt) when we stand at rest. The most common fault is an exaggerated anterior pelvic tilt (Figure 2). This forward tilt reduces the body’s ability to resist forces efficiently and as mentioned could contribute to pelvic floor dysfunction.
We can get an idea of whether the pelvis is tilted or not by observing the direction that the bony prominences on the front of the pelvis (the anterior superior iliac spines or ASIS) are pointing.
If you imagine two headlights shining out of these pointy hip bones, in an ideal world these ‘headlights’ should be ‘shining’ more or less straight ahead of you horizontally (A more technical method to measure this angle is described by Suits et al 2021).
Figures 1 and 2 show differences between an ideal posture and a poor postural presentation.
 |
 |
| Figure 1: Neutral Pelvis | Figure 2: Anterior Tilted Pelvis |
The ideal alignment of the pelvis is what we call the neutral position. When the pelvis is neutral it brings the lumbar spine into neutral, this allows the spine to stack up above it in the most ideal ‘S’ shape; also referred to as the Natural Curves of the spine.
This ‘S’ shape arrangement of the bones allows the spine to distribute the load most effectively between all the appropriate load-bearing structures, the bones, discs, ligaments, and muscles.
This ideal body position also aligns the pelvic floor in an optimum position for function (Fig 1 above).
The first step is to develop our ability to ‘tune in’ and increase our awareness of HOW we HOLD our bodies. Then to practice this as we go about our daily lives; sitting at a desk, hanging washing, vacuuming, driving to work, mowing the lawn, carrying a baby, or hitting a golf ball!
Posture and alignment are key elements of pilates practice, and we can improve the alignment of our bodies by becoming familiar with our own bony landmarks of the pelvis and learning how to adjust and position the pelvis closer to that ideal neutral alignment.
Now join Phillipa to learn how to find the neutral position of the pelvis and improve your posture as you sit and stand.
Making a lasting change to improve posture and alignment of the pelvis and lumbar spine can help to reduce back pain, improve respiratory function, and could reduce the symptoms of urinary incontinence.
We hope you are feeling more confident about some steps you can take to improve your pelvic health. It is important to act sooner rather than later to improve your symptoms and prevent a worsening of your condition. Always seek out professional help if your symptoms are affecting your quality of life and/or not responding to simple self-help measures.
Oleksy Ł, Mika A, Kielnar R, Grzegorczyk J, Marchewka A, Stolarczyk A. The influence of pelvis reposition exercises on pelvic floor muscles asymmetry: A randomised prospective study. Medicine (Baltimore). 2019 Jan;98(2):e13988. doi: 10.1097/MD.0000000000013988. PMID: 30633181; PMCID: PMC6336649.
Suits WH. Clinical Measures of Pelvic Tilt in Physical Therapy. Int J Sports Phys Ther. 2021 Oct 1;16(5):1366-1375. doi: 10.26603/001c.27978. PMID: 34631258; PMCID: PMC8486407.
This article was originally published on iD Direct and has been republished here with permission.
iD Direct is the flagship brand of Ontex's range of adult care personal hygiene solutions. With over 40 years of experience, Ontex has developed innovative personal hygiene solutions to deliver high quality, affordable products to our customers across the globe.
Ontex's iD brand of disposable continence solutions is developed using the latest innovation and technology to provide maximum discretion as well as keep you safe and secure through fast absorption technologies. It is through our products, our practices and our people that we have got you covered for all your continence needs. Try one of our products today and choose to be confident - choose iD!
Many health conditions can interfere with bladder function, contributing to Bladder weakness and unexpected leaks of urine. A relatively recent addition to this list is the COVID-19 virus. Common COVID-19 symptoms include a persistent cough and shortness of breath or difficulty breathing. But what on earth does that have to do with your pelvic floor?
If you have ever had a persistent cough, you might have a better understanding of the downside. Coughs and colds can all predispose you to accidental leaks of urine but a prolonged bout of covid could leave you despairing.
Fear not, there are things you can do to help. Let’s begin with what happens when we cough.
We can see that the diaphragm, intercostal muscles, and abdominal muscles all play a key part in this process. (A LoMauro and A Aliverti, 2019)
Now let’s examine the role of the pelvic floor when we cough or sneeze.
The abdominal cavity is a pressurised cylinder with a floor; the pelvic floor, a ceiling; the diaphragm, and walls; the abdominals, and back muscles. This system works in synergy to maintain the body in equilibrium.
The pressure in the abdominal cavity is increased by our everyday actions such as pushing, pulling, standing up from sitting, laughing, and coughing. (Yamasato at al. 2014)
The pelvic floor contracts in response to increases in intra-abdominal pressure (IAP). This is a reflex mechanism intended to resist the effects of pressure changes within the abdominal cavity that occur when we cough and sneeze or lift something heavy.
Astonishingly, the pelvic floor muscles can respond in anticipation of IAP pressure changes. This phenomenon is known as a fast feed-forward loop contraction or pre-contraction.
There are instances when this reflex activity of the pelvic floor is inadequate or absent altogether. This can contribute to leaks of urine when the intra-abdominal pressure is raised suddenly or unexpectedly.
Research by Berghmans and Seleme (2020) suggests that the importance of the feed-forward loop contraction or pre-contraction of the pelvic floor has been widely underestimated. However, it is an important element to consider as we train pelvic floor muscles.
Research has demonstrated that we can help the pelvic floor to withstand pressure changes by performing a strong active pelvic floor muscle contraction just before a voluntary cough or lifting something we know is heavy. This timely, rapid and strong pelvic floor muscle contraction was termed ‘The Knack’ by Miller et al (1998).
This strategy can certainly help to support the maintenance of continence if we can feel the cough or sneeze approaching, but it can also help if applied partway through a peal of coughs; several coughs occurring in rapid succession.
It is important to contract the pelvic floor in the correct way at the correct time. If you are unsure whether you are doing this correctly, please refer to our earlier article Strengthen your pelvic floor, why bother? to be certain that you are contracting the right muscles in the right way.
Now, join in and practice ‘the knack’ together.
Being able to apply ‘The Knack’ when needed could make all the difference to your confidence to deal with winter coughs, colds, and even an unfortunate encounter with COVID-19. It is a technique that we can use in addition to daily pelvic floor muscle training to maintain continence and prevent leaks of urine.
It is important to get professional help for any problem that is affecting your quality of life. If you seek help sooner rather than later, it will improve your chances of a positive outcome and can prevent a worsening of your condition.
To Sum Up
We hope you are feeling more confident about the steps you can take to improve your pelvic health. It is important to act sooner rather than later to improve your symptoms and prevent a worsening of your condition. Always seek out professional help if your symptoms are affecting your quality of life and/or not responding to simple self-help measures.
Hello, I’m Phillipa Butler, a Chartered Physiotherapist and Certified Pilates and Yoga Teacher.
My philosophy in my own life is that prevention is better than cure, so I believe that a regular programme of appropriate exercise is the key to a fitter, healthier future. Bladder weakness is no different, but it can be a bit trickier to get right.
I hope this blog will support you to arm yourself with some information and advice to take your health into your own hands.
Bary Berghmans, Maura Seleme. The ‘5 F’s Concept for Pelvic Floor Muscle Training: From Finding the Pelvic Floor to Functional Use. Journal of Women’s Health and Development 3 (2020): 131-134.
Miller JM, Ashton-Miller JA, DeLancey JO. A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc. 1998 Jul;46(7):870-4. doi: 10.1111/j.1532-5415.1998.tb02721.x. PMID: 9670874.
Antonella LoMauro, Andrea Aliverti, Respiratory muscle activation and action during voluntary cough in healthy humans, Journal of Electromyography and Kinesiology,
Volume 49, 2019, 102359, ISSN 1050-6411,
https://doi.org/10.1016/j.jelekin.2019.102359.
De Keulenaer BL, De Waele JJ, Powell B, Malbrain ML. What is normal intra-abdominal pressure and how is it affected by positioning, body mass and positive end-expiratory pressure? Intensive Care Med. 2009 Jun;35(6):969-76. doi: 10.1007/s00134-009-1445-0. Epub 2009 Feb 26. PMID: 19242675.
Yamasato KS, Oyama IA, Kaneshiro B. Intraabdominal pressure with pelvic floor dysfunction: do postoperative restrictions make sense? J Reprod Med. 2014 Jul-Aug;59(7-8):409-13. PMID: 25098032.
Bibliography
Addington WR, Stephens RE, Phelipa MM, Widdicombe JG, Ockey RR. Intra-abdominal pressures during voluntary and reflex cough. Cough. 2008 Apr 30;4:2. doi: 10.1186/1745-9974-4-2. PMID: 18447952; PMCID: PMC2427048.
This article was originally published on iD Direct and has been republished here with permission.
iD Direct is the flagship brand of Ontex's range of adult care personal hygiene solutions. With over 40 years of experience, Ontex has developed innovative personal hygiene solutions to deliver high quality, affordable products to our customers across the globe.
Ontex's iD brand of disposable continence solutions is developed using the latest innovation and technology to provide maximum discretion as well as keep you safe and secure through fast absorption technologies. It is through our products, our practices and our people that we have got you covered for all your continence needs. Try one of our products today and choose to be confident - choose iD!
Urinary Incontinence affects a substantial proportion of women and men, which can have a significant impact on an individual’s quality of life. In this article, we’ll focus on the effects of urinary incontinence on women.
Population studies from numerous countries have reported that the prevalence of Urinary Incontinence among women is between 25-45%. The prevalence increases with increasing age, and women aged 70 years or over have a more than 40% chance of experiencing symptoms. (Milsom and Gyhagen 2019)
Despite this, the evidence suggests that less than half of women experiencing symptoms will seek out assistance for urinary incontinence. (Kinchen et al, 2003)
A study by Waetjen et al. (2018) revealed the common reasons why women with Urinary Incontinence might not seek treatment:
It is important to get professional help for any problem that is affecting your quality of life. If you seek help sooner rather than later, it will improve your chances of a positive outcome and can prevent a worsening of your condition.
Incontinence is defined as the involuntary leakage of urine from the bladder. Incontinence can affect both men and women in any age group but is more common in women. (nhs.uk)
The most common types of urinary incontinence in women are:
The good news is that there is a relatively simple treatment approach that can cure or improve symptoms of stress urinary incontinence and all other types of urinary incontinence. Pelvic floor muscle strengthening exercises, alternatively known as Kegel Exercises, is the treatment of choice. Better still, the potential negative side effects of performing pelvic floor exercises are rare and minor. (Dumoulin et al 2018)
Guidance from NICE (National Institute for Health and Care Excellence) recommends a supervised programme of pelvic floor muscle training of at least three months' duration for the first-line treatment of stress urinary incontinence or mixed urinary incontinence.
Other self-help measures include:
Firstly, it is important to be sure that you are contracting the right muscles in the right way. If you are in any doubt about where the pelvic floor muscles are and how to contract them, check out the ‘Get to know your Pelvic Floor’ article and video first.
A training regime should include a series of maximal voluntary muscle contractions of varying duration incorporating a period of relaxation between sets.
Work towards 3 sets of 10 of each type every day.
As you become more familiar with these exercises you can progress by practising your pelvic floor muscle exercises in a variety of positions such as lying on your back, on all fours, kneeling up, sitting, and standing.
Finally, we can incorporate pelvic floor muscle exercises into movement and into your everyday activities. You can also practice contracting the muscles in situations where you might have experienced leaks of urine previously.
We hope you are feeling more confident about the steps you can take to improve your pelvic health. Remember, movement is medicine for the body and mind and in most cases, if you do your homework, it will make a difference. Act sooner rather than later to improve your outcome and prevent a worsening of your condition.
If you are in any doubt about whether this advice is appropriate for you, please seek help from a medical professional.
You can watch this video to practice your pelvic floor muscles exercises with Phillipa Butler below.
Exercising your pelvic floor muscles video transcript
Think of the openings in the pelvic floor:
Or you could try:
A training regime should include a series of maximal voluntary contractions of varying duration incorporating a period of relaxation between reps and sets.
Work towards 3 sets of 10 of each every day.
When contracting your pelvic floor muscle you might feel a gentle tightening of the abdominals, but this shouldn’t be overly prominent. You should NOT feel your buttocks tighten, legs rotate out, any movement of your spine or pelvis or downward pressure into the perineum.
Remember it is important that you DO NOT ‘bear down’ as you perform these exercises. Try not to hold your breath and wherever possible coordinate a contraction with an exhalation.
Incorporate Pelvic floor training into the Pilates clam.
References
Dumoulin C, Cacciari LP, Hay Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No.: CD005654. DOI: 10.1002/14651858.CD005654.pub4. Accessed 07 November 2022.
https://www.nice.org.uk/guidance/ng123/chapter/recommendations#non-surgical-management-of-urinary-incontinence Accessed 07/11/22
https://www.nhs.uk/conditions/urinary-incontinence/ Accessed 07/11/22
Kinchen KS, Burgio K, Diokno AC, Fultz NH, Bump R, Obenchain R. Factors associated with women's decisions to seek treatment for urinary incontinence. J Womens Health (Larchmt). 2003 Sep;12(7):687-98. doi: 10.1089/154099903322404339. PMID: 14583109.
Milsom I, Gyhagen M. The prevalence of urinary incontinence. Climacteric. 2019 Jun;22(3):217-222. doi: 10.1080/13697137.2018.1543263. Epub 2018 Dec 21. PMID: 30572737.
This article was originally published on iD Direct and has been republished here with permission.
iD Direct is the flagship brand of Ontex's range of adult care personal hygiene solutions. With over 40 years of experience, Ontex has developed innovative personal hygiene solutions to deliver high quality, affordable products to our customers across the globe.
Ontex's iD brand of disposable continence solutions is developed using the latest innovation and technology to provide maximum discretion as well as keep you safe and secure through fast absorption technologies. It is through our products, our practices and our people that we have got you covered for all your continence needs. Try one of our products today and choose to be confident - choose iD!
As November is Men’s Health Awareness Month, it’s the perfect opportunity to shine a light on Men’s Health, specifically Men’s Pelvic Health. That is why we’ve collaborated with Phillipa Butler from Precizion Ltd by Phillipa Butler, once more to bring you her insights!
Incontinence continues to be a taboo subject; it’s a topic of conversation we would happily ignore, and this is especially true for men. A recent conversation with my husband revealed a disturbing lack of knowledge, which I will be working to remedy!
FACT: Men are NOT immune to pelvic health problems.
Factors that contribute to pelvic floor muscle weakness and incontinence include:
Pelvic floor muscles can be strengthened like any other weak muscle and need regular exercise to stay strong.
The pelvic floor muscles are a supportive sling of muscles, reaching from the tailbone at the back to the pubic bone at the front. They support the pelvic organs, the bladder and the bowel to help to maintain your continence.
When you pass urine or open your bowels, these muscles should relax and then tighten afterwards to prevent leakage of urine, faeces, and wind.
The first step is ensuring you are working the correct muscles in the right way.
Pelvic floor muscle training is surprisingly difficult, but if you practice, it will get easier.
To check that your pelvic floor muscles are working correctly, you could stand in front of a mirror when you practice your pelvic floor exercises. You should see the base of your penis and your testicles lift.
If you are in any doubt about whether you are doing these exercises correctly, get professional help.
In this video, Phillipa talks about the relationship between the decline of the pelvic floor muscles and Prostate cancer and also includes other causes of incontinence for men and some exercises to activate and keep your pelvic floor engaged.
Read the full article on: https://www.id-direct.com/blog/lower-urinary-tract-symptoms-luts-in-men-meaning-causes-treatments/
Wondering who Phillipa is and what she does? Read her introduction here: https://www.id-direct.com/blog/meet-phillipa-butler/
iD is the flagship brand of Ontex's range of adult care personal hygiene solutions. With over 40 years of experience, Ontex has developed innovative personal hygiene solutions to deliver high quality, affordable products to our customers across the globe.
Ontex's iD brand of disposable continence solutions is developed using the latest innovation and technology to provide maximum discretion as well as keep you safe and secure through fast absorption technologies. It is through our products, our practices and our people that we have got you covered for all your continence needs. Try one of our products today and choose to be confident - choose iD!
World Menopause Day is held every year on the 18th October. The purpose of the day is to raise awareness of menopause and the support options available for improving health and well-being.
This year we've collaborated with Phillipa Butler from Precizion Ltd by Phillipa Butler, and she has shared sound health information and advice to help you take your health into your own hands.
The hormone oestrogen plays a part in maintaining a healthy genitourinary system. As the oestrogen levels decline around menopause the tissues of the vulva, vagina and urethra can become thinner and more fragile. The pelvic floor muscles become weaker and slower to react and other tissues like fascia offer less support to the pelvic organs.
More than 50% of postmenopausal women will suffer genitourinary symptoms including:
The symptoms will vary in severity, and it is possible to experience more than one symptom at once. This Assessment Tool can be used to help you to decide when to seek assistance from a doctor or a Pelvic Health Physiotherapist (also called Women’s Health Physiotherapist)
Vulvovaginal Symptom Questionnaire (Erekson EA et al 2013)
Please Note
If you experience any of the following potentially serious symptoms, it would be wise to seek immediate medical attention.
In the first video, Philipa talks about the relationship between Menopause and the decline of the pelvic floor muscles. In the second video, Philipa guides us through some exercises to activate and keep your pelvic floor engaged.
Read the full article on: https://www.id-direct.com/blog/menopause-and-pelvic-health-for-women/
Wondering who Phillipa is and what she does? Read her introduction here: https://www.id-direct.com/blog/meet-phillipa-butler/
iD is the flagship brand of Ontex's range of adult care personal hygiene solutions. With over 40 years of experience, Ontex has developed innovative personal hygiene solutions to deliver high quality, affordable products to our customers across the globe.
Ontex's iD brand of disposable continence solutions is developed using the latest innovation and technology to provide maximum discretion as well as keep you safe and secure through fast absorption technologies. It is through our products, our practices and our people that we have got you covered for all your continence needs. Try one of our products today and choose to be confident - choose iD!
Frequent urination is not uncommon and, in general, should not be cause for alarm in teenagers experiencing puberty and its associated hormonal fluctuations. However, it is worth knowing what signs to look out for when it comes to your child’s bladder health and general well-being.
During puberty, teenagers experience a wide range of physical, emotional and psychological changes in their bodies. The hormones which are naturally released during puberty vary significantly between boys and girls, and how these hormones affect the individual is dependent on numerous factors such as age, health and personal development.
Boys typically start puberty between the age of 9 and 15, and girls start between the age of 7 and 13. In general, puberty is something each young person will experience, and one symptom that may occur is frequent urination.
Puberty can have an impact on your child’s bladder health. In most cases, this is due to changes in hormone levels that occur throughout the teenage years. As a result, some teenagers might experience various bladder issues, including:
Of all the major causes of frequent urination during puberty, a Urinary Tract Infection or (UTI) is one of the most common bacterial infections that occur during puberty. This is a condition where a person may have an increased urge to urinate; it is typically treated with antibiotics.
Bed-wetting through the teenage years is not uncommon as hormones change during puberty. Research suggests that teenagers may experience bed-wetting for multiple reasons including emotional and psychological factors such as hormonal imbalance, mood, trauma, diet, sleep routine, stress and anxiety. In certain cases, teenagers may sleep more deeply and not wake up in time for the bathroom.
Another cause of frequent urination or involuntary urination in teenagers is sporting injuries (running, gymnastics, high-impact sports) that may damage the pelvic floor muscles. Frequent urination can also be due to physical conditions such as teenage obesity, pressure on the bladder, constipation, hormone imbalance, cystic fibrosis or physical disability.
Frequent urination is not often a cause for concern, however, in teenagers, it can be symptomatic of a more serious health condition. If you are concerned your teenager is experiencing bladder health issues, consult with your general practitioner to discuss ongoing symptoms.
Frequent urination may be a sign of a urinary tract infection, diabetes, bladder cancer or endometriosis, so be sure to seek medical advice as needed.
Urinary incontinence is defined as the involuntary passing of urine and is also referred to as bladder weakness or an overactive bladder. This condition is not uncommon, with around 20,000 - 60,000 Australian teenagers experiencing some form of incontinence.
Urinary incontinence during puberty is unlikely to be caused by a severe medical condition with the kidneys or bladder. It is commonly occurring due to the brain not developing the appropriate control over bladder function.
If your teenager is experiencing frequent urination, urge control issues or any type of bladder incontinence, Ontex Healthcare has a range of junior continence products that are designed to manage the condition effectively. Each product in the range is comfortable, discreet and breathable, ensuring your teenager will not feel embarrassed whilst continuing with their usual daily routine.
Our junior range includes the Ontex Healthcare Comfy Junior Slip, the Comfy Junior Pants (4-7 years) and the Comfy Junior Pants (8-15 years). All products are dermatologically tested and work to provide optimal absorption. Frequent urination is nothing to be ashamed of and that is why Ontex Healthcare are here to help you and your teenager manage the symptoms and feel at ease.
Contact us today for a free sample or browse our online range here.
For concerns about your teenager’s general or bladder health during puberty, Ontex Healthcare recommends speaking to your family doctor.
References
https://kidshealth.org/en/teens/puberty.html
https://www.continence.org.au/who-it-affects/teenagers-and-young-adults
https://www.news24.com/health24/medical/incontinence/incontinence-in-children/why-some-teenagers-also-suffer-from-incontinence-20190318
https://kidshealth.org/en/teens/uti.html
Urinating should never be painful, even for newborns. Painful urination is usually a sign of an underlying medical condition. However, crying prior to urination is likely to be a form of communication and a newborn will normally urinate every one to three hours in the first few days. At any stage, crying before and during urination are two different things, and it is important to establish the difference. Let’s take a look at 3 possible reasons a newborn may cry before or during urination.
Newborns may cry while urinating because they are experiencing some level of discomfort. Paediatricians generally believe that this is normal; the bladder stretches as it fills up, putting pressure on the bladder. This should not be painful or cause for concern.
Aside from the natural process of sensing the urge to urinate, another more painful reason a newborn may cry is a nappy rash. A rash or skin irritation may make urinating uncomfortable and is sometimes known as diaper dermatitis. Nappy rash can cause discomfort due to the bacteria, and can also be caused by the material of the nappy.
If your little one has a nappy rash, try switching to our iD Comfy Junior range. Our nappies and slips are soft, breathable and approved by dermatologists, meaning you can be sure that your baby will be kept dry and comfortable day and night.
Urinary Tract Infections (UTIs) are quite common in babies, and could cause a newborn to cry out during urination due to pain and discomfort. Research shows that about 4% of babies will have a UTI in the first 12 months. At this age, boys get more UTIs than girls.
Here are some of the key signs your newborn may have a UTI:
Baby Elimination Communication (EC) or Natural Infant Hygiene is a form of toilet or potty training for infants. Parents listen and watch for the newborn to signal their need to urinate, often crying or fussing. This is a perfectly healthy alternative to using diapers and is not uncommon. With EC, your baby is simply communicating their need to urinate.
While some babies are able to communicate through different signals when they need to urinate, other cues might take careful observation. In addition to crying, a baby might signal their need to urinate by:
If you have any concerns about your baby’s health, especially if your baby has a temperature, Ontex Healthcare recommends you speak to your doctor as soon as you can.
References:
https://raisingchildren.net.au/guides/a-z-health-reference/urinary-tract-infection-in-babies-and-toddlers
https://www.mamanatural.com/baby-elimination-communication/
