It is not rare to hear women leaking when exercising and considering it to be normal! This blog goes to show you why that way of thinking is the beginning of a downward spiral and something to be stopped. Is leaking a bladder issue or a pelvic floor dysfunction issue? This is the question that the blog is designed to answer.

Where Is The Pelvic Floor?

If you think of your pelvis as a bowl, the bottom surface of the bowl and the lower wall of the bowl close to the bottom are where the pelvic floor is. The detail of the 3 layers of the pelvic floor where internal manual work addresses are discussed in one of my blogs. Of course, the walls of the pelvis cannot be ignored in the treatment of the pelvic floor, nor the spine and the hips which are directly connected to the pelvis. Therefore, their stability (or lack of) impacts the pelvic floor as well.


The biggest mistake that is often made about pelvic floor therapy is considering it as a separate entity and focusing mostly on that area. While most pelvic floor therapists focus on breathing to some degree, the majority of the time is spent on internal manual work. Internal manual work is often necessary, however, when the pelvis stability and its role in movement is hardly addressed, we are looking at a ‘floor’ when the ‘house’ is unstable.

What Is Pelvic Floor Dysfunction?

The subtle signs of pelvic floor dysfunction that most often are missed or considered as their own separate issues according to the blog:  Pelvic Floor Dysfunction Symptoms are:

  • “Lower back pain
  • Pain in the back joints of the pelvis (SI Joints)
  • Pain in the front pubic area
  • Arched lower back
  • Slouched lower back
  • Slouched mid-back or hunchback
  • Military posture with the chest pushed out
  • A V-stance where the torso is positioned behind the hip joints on the side view
  • Chronic forward neck
  • Inability to bend down below the knees
  • Habitually standing on one leg with the other leg bent
  • Chronic one-sided pain in the lower extremity
  • Hip pain on one or both sides”


How To Treat Incontinence From Pelvic Floor Dysfunction

As conditions get worse, more and more areas of the body become compromised and when it comes to leaking when exercising which is categorized as stress incontinence, it is often looked at as a weak pelvic floor but what made the pelvic floor weak? And will working on the inside of the pelvis, learning how to tighten those muscles, be sufficient?

If that were the case, then those suffering from Stress incontinence would be cured. The part of the treatment for pelvic floor dysfunction that is missed is the holistic approach that is necessary for this complex condition. The true holistic treatment of pelvic floor dysfunction, which includes those who leak when exercising, should include the following from the blog, Are Yoga Exercises Good for Pelvic Floor Dysfunction:

  • “Behavior modification which is always part of the solution list to all issues (your behavior about life changes how you do everything in life), is not going to correct any dysfunction fully but addresses some of the feeders of the problem.
  • Postural Neurology: Movement is like a concert and the body parts are like the musicians; in that the musicians not only need to know their part but to know when to chime in and phase out. That means the pelvis and pelvic floor need to know how to ‘play’ with the rest of the body if they are to sustain their strength and integrity. This is what Postural Neurology is all about.
  • Functional Movement: Common sense says that the most authentic way to move is the way babies move. After all, all babies from all over the world go through the same developmental stages of movement (Developmental Kinesiology) which means that we are hard-wired to move that way. So if the issue is movement-related or supported, then we should see how we compare to the way we moved as babies. All discrepancies are then highlighted and can be corrected through Dynamic Neuromuscular Stabilization (DNS) exercises which are baby movements.
  • Kegels? There are machines like the Emsella Chair that do 400 Kegels per minute involving all of the muscles of your pelvic floor and not the ones that you hope to be engaging. Note that Kegel exercises are not for all types of incontinence and pelvic floor muscle issues.
  • Breathing is what babies do automatically and that is what we need to do in order to sustain the bottom of the breathing apparatus, the pelvic floor!
  • Internal manual work which ideally should be done to assess the muscles inside the pelvis BUT does not have to be done in all cases.
  • Nutrition:  Avoid Citrus, caffeine, soda, artificial sweeteners, spicy foods and take collagen, Vit. C, Vit. D, Omega 3, protein if no conflict with any other conditions that suggest their avoidance.
  • Ergonomics: Sit on an exercise ball vs a chair, get a keyboard that is as wide as your shoulders, limit your sitting to no more than one hour and alternate with standing, make sure the middle of your monitor is at the eye level to name a few.
  • Postural Awareness: It is important to pay attention to the posture and catch yourself when not standing on both feet, slouching, shifting the pelvis forward and in front of the ankles. Best to associate the increase in attention with activities done each day; for instance, when talking to someone to pay attention to the feet and pelvis positioning.
  • Sleeping habits: do not sleep on the stomach and if you are a stomach sleeper, to get a body pillow to minimize that.”

If you are tired of the limitations imposed by Pelvic Floor Dysfunction and need help, do not hesitate to contact me.

Dr. Shakib

Who Does Pelvic Floor Therapy?

Will Pelvic Floor Exercises Help Incontinence?