Now there are a lot of factors that go into why women experience leaking, but perhaps the most common is that the muscles of the pelvic floor and core are not working well together. Consider this study in 2007 by Smith et al, that found between three groups - continent, mildly incontinent and severely incontinent - the incontinent groups actually had stronger pelvic floor and abdominal muscles than the continent group. However, the issue was the balance between these muscles: the incontinent group's abdominal muscles where overpowering their pelvic floor muscles, whereas the continent group demonstrated a "balanced, effiecient and task appropriate system" (J. Wiebe, PT).
We should also consider how alignment fits into the picture as well. Alignment can change the availablility of a muscle; in a study by Sapsford et al in 2006, it was demonstrated that there was greater activation of the pelvic floor muscles as alignment improved. In a later study those same researchers also found that continent women had a better lumbar curve, wherease those with incontinence were more likely to have a kyphosis.
All interesting stuff, but how does that all fit together for someone who can't cough without peeing a little? Well, when we take all of that into consideration, what happens when we improve alignment, re-establish muscle balance and connect both of those to functional tasks? We see that we have set the core up for success. We see less breath holding, less unwanted low back and pelvic movement and best of all less leaking during activity.
My interest in retraining breathing patterns has naturally progressed into how the diaphragm works with the pelvic floor and core muscles to create efficient, funcional movement strategies. I see often people with breathing difficulties who struggle with coordinating tasks of movement with breathing (that is, they hold their breath). By restoring not only breathing patterns, but also the interaction of the diaphragm with the pelvic floor and core, we see an improvement in functional movement as well as symptoms of breathlessness.
And this is now taking me onto a new and exciting area of women's health. By restoring the interactions of the breath, the core and pelvic floor, I can make a real change to women's quality of life and enable them to continue on with the activities they love. For more information on how the pelvic floor and diaphragm work together, see my blog post here or visit www.juliewiebept.com which is a great resource for women.