Hi friends! Spring is in the air: the flowers are blooming, the temperature is warming up outside, and oh, look at all the pollen out there. Aaaachooo! Wait, what was that? My pants feel wet. Did I just pee when I sneezed?
Has this ever happened to you? Maybe you’ve joked around with friends about it. Some individuals have a special name for this: peezing (sneezing + peeing). While peezing is a funny name and can be a good way to laugh it off, leaking pee when you sneeze is a form of stress incontinence and is a sign that something is not working properly.
Stress urinary incontinence (SUI) is urine leakage with activities or exercise that increase pressure on the bladder. The action causes increased force or "stress" on the bladder, and depending on the severity of your SUI, leaking could be brought on by more or less strenuous activities. (Ghaderi, 2014) Things like sneezing can place large amounts of stress on the bladder rapidly and cause leakage. Other activities that commonly cause stress incontinence are laughing, jumping, and lifting heavy objects.
Why exactly does stress incontinence happen? Imagine that your bladder is like a water balloon. When you squeeze a water balloon without adequately closing the outlet, leaking will occur. The same thing happens with your bladder and your pelvic floor muscles (PFM)--the pelvic floor muscles aren’t closing off the urethral canal and preventing leakage as they should so you pee a little.
The good news is that we can train the pelvic floor muscles to be strong and to engage at the right times! Bladder and pelvic floor muscle retraining can be very effective at relieving many urination issues. (Radziminska, 2018)
Although surgery is an option, we strongly urge you to consider pelvic therapy and noninvasive treatments first. Pelvic floor muscle training (PFMT) is the first-line recommended intervention for stress incontinence by the International Continence Society (ICS).
PFMT taught by a pelvic floor physical therapist has shown significant improvement within 3 months, (Davila, 2011), and is more effective than training at home alone (Felicissimo 2010, Ferreira 2010, Hung 2010). A dedicated and expert pelvic floor physical therapist should perform a thorough evaluation to assess how your entire body is working. They will check the strength and flexibility of your hips, back and abdominals, legs, and the pelvic floor. Depending on what they see, a pelvic floor therapist will develop an individualized treatment plan to address your specific needs. They can help you train the pelvic floor muscles to make them stronger. They can help teach you proper breathing techniques to take extra strain off of the pelvic floor.
They may also discuss certain habits with you like what you eat and drink, how your bowel movements are, and what your activity levels are. Certain food and drinks as well as being constipated can cause increased leakage.
You can ask your provider for a referral to a pelvic floor therapist near you, or find one at https://www.mypfm.com/find-a-pt.
Whether you have just started peezing or if it has been happening for a long time, there is hope! Remember, while urinary leakage is common, it is not normal and it is a sign that something is not working the way it was designed to.
To learn more about the pelvic floor muscles, check out these great resources:
Watch our YouTube playlist on Bladder Concerns and Your Pelvic Floor
Watch Netflix for Your Pelvic Floor at Pelvic Flicks
Learn more about your pelvic floor on our Instagram
Visit our Amazon store for our favorite pelvic health products
Sign up for our email newsletter
For providers, check out our online courses to help your clients. Consider joining our Ambassador Program and most of our courses are included with your membership!
Urinary Incontinence and Urogynecology with Dr. Tessa Krantz, MD
The Hip and Urinary Incontinence: A look beyond the pelvic floor at what keeps us dry with Lauren Trosch, PT, DPT, OCS
Pelvic PT Evaluation of the Pelvic Floor Muscles with Dr. Samantha Richter, PT, DPT, WCS
Exploring the Evidence: Effect of Rehabilitative Ultrasound Imaging (RUSI) Biofeedback on Improving Pelvic Floor Muscle Function in Individuals with Stress Urinary Incontinence: A Systematic Review with Jenny LaCross, PT, DPT, PhD(c), ATC, CLT-LANA BCCS in WHPT and Laurel Prouix, PT, PhD, DPT, BCCS in OPT
Written by Emily Reul, PT, DPT
References
Davila G. W. (2011). Nonsurgical outpatient therapies for the management of female stress urinary incontinence: long-term effectiveness and durability. Adv Urol. 2011: 176498. doi:10.1155/2011/176498
Felicissimo MF, Carneiro MM, Saleme CS, Pinto RZ, da Fonseca AM, da Silva-Filho AL. Intensive supervised versus unsupervised pelvic floor muscle training for the treatment of stress urinary incontinence: a randomized comparative trial. Int Urogynecol J. 2010;21 (7):835-840.
Ferreira M, Santos PC. Impact of exercise programs in women's quality of life with stress urinary incontinence. Rev Port Saude Publica. 2012;3(1):3-10. Ghaderi, F., & Oskouei, A. E. Physiotherapy for women with stress urinary incontinence: a review article. J Phys Ther Sci. 2014;26(9), 1493–1499. doi:10.1589/jpts.26.1493
Hung HC, Hsiao SM, Chih SY, Lin HH, Tsauo JY. An alternative intervention for urinary incontinence: retraining diaphragmatic, deep abdominal and pelvic floor muscle coordinated function. Man Ther. 2010: 15(3):273-279.
Radziminska A. et al. (2018) The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: a systematic literature review. Clin Interv Aging. 2018 May 17;13:957-965. doi: 10.2147/CIA.S60057.