Incontinence is a lack of the ability to voluntarily hold urine or fecal matter, and so based on which one you can’t hold, it is called urinary or fecal incontinence. It is common for people to think that they don’t have incontinence because they don’t pee or poo themselves when sneezing, coughing, or exerting themselves BUT that is only one type of incontinence!

Incontinence is not always a result of a disease or just the weakness of the pelvic floor muscles either. If you think of the torso as a bag with a lid, the bottom of the bag is the pelvic floor, the sides are the oblique muscles of the abdomen, the back is the lower and mid-back muscles, the top is the abdominal diaphragm, and the bottom corners are the hip joints. This is the biggest take-home for you when it comes to understanding incontinence and pelvic floor dysfunction.

What Causes Incontinence?

  • Disc Disease:

Any dysfunction related to torso stabilization and movement can impose enough toll on the urinary tract, bladder specifically, the intestines, and the nerves that go to those areas, leading to incontinence. What gets missed the most when it comes to incontinence is the fact that incontinence is the result but not necessarily the be-all, end-all. For instance, disc issues can irritate the lower back/sacral base nerves and show up as urinary incontinence or cause issues with the sphincters related to urination or defecation. The fix is not always disc surgery and proper evaluation can rule in or out surgery. I have had many cases where surgery was recommended but the patient never needed such measure and the treatment was the combination of Postural Neurology, Functional Movement. and Emsella Chair.

  • Other Diseases:

Sometimes, the nerve-related malfunction has to do with neurological diseases such as Multiple Sclerosis, Diabetes, or Parkinson’s. Celiac disease, chronic constipation, and irritable bowel syndrome are all examples of conditions that may lead to incontinence.

  • Improper Breathing:

This is the most under-appreciated, under-treated, and under-utilized method of prevention when it comes to incontinence and pelvic floor dysfunction. To understand how watch the video below.

  • Lifestyle:

Smoking, poor eating habits, and a sedentary lifestyle are examples of everyday ways of living that impact incontinence. For instance, it is understandable how a diet poor in the nutrients necessary for stronger muscle tone and conditioning, or a sedentary life where the posture is impacted and the muscles of the pelvic floor get weakened by not exercising (walking is a great exercise) can end with incontinence.

  • Enlarged Organs:

Enlarged internal organs such as uterine fibroid, enlarged prostate, or obesity can exert pressure on the floor of the pelvis, causing incontinence.

  • Anatomical:

One of the common issues leading to incontinence is Interstitial Cystitis or Pelvic Pain Syndrome; this is when the lining of the bladder is softened and stripped of the normal membrane, causing chronic pain as a result of chronic infection. Endometriosis is another anatomical issue that can lead to scar tissue and incontinence.

  • Trauma:

Not all trauma is childbirth-related. There are cases where the individual is raped or has gone through ‘extreme’ sexual acts voluntarily.

  • Surgery:

Scar tissue from surgery or just the surgical procedures themselves may lead to incontinence. Listen to my podcast with Dr. Sam Siddighi on this very subject.

The bottom line is that the solution to all incontinence is not always pelvic floor muscle manual work and this is not one of those things you can try to simplify and go to one area.

How To Prevent Incontinence?

Except for surgical and medication-induced incontinence, the most proactive measure we can take is to make sure and improve our posture.

  • Breathing:

Watch this video if you have no clue what I am talking about!! Remember that with proper breathing, the downward movement of the internal organs from the abdominal diaphragm toward the pelvic diaphragm will not only ensure healthier internal organs but strengthen the structures whose weakness leads to weak pelvic floor muscles.

In nature, breathing out when done right (biological breathing) strengthens the pelvic muscle and when breathing in, relaxes the same muscles. Kegel exercises are our attempt to duplicate that which fails most often, why? Because we don’t do them right and frankly, most don’t know if they are doing it to begin with. I teach biological breathing to ensure proper relaxation and strengthening of that area. If this is how nature does it, why reinvent the wheel?

  • Pelvic Stability Exercises:

Let’s start by saying that isolating an area and trying to strengthen or stretch it is not going to work!! That is because if the movement was a concert, your body parts would be the musicians and the concert would never improve fully if we only concentrate on let’s say the pianist!! The stability of any area in your body depends on the rest of the body as well so don’t waste time isolating your pelvis to work it out. It won’t last!

In my practice, I only recommend Developmental Kinesiology exercises because look at how we all go from helpless infants to running toddlers without any bands and weights, trainers, or coaches. The same exercises that we are programmed to follow are the ones that involve the whole body and are look-impact, yet highly effective in bringing strength and stability back into the picture.

Baby doing both push up

It is after my patients understand the basic principles of movement that I utilize the Emsella Chair to address the muscles INSIDE the pelvis to bring everything on the inside and outside of the pelvis back for better stability.

  • Diet:

As far as diet is concerned, my recommendation is to always make it organic veggies, and pasture-raised meat and eggs; I like the recommendations found on Avacaremedical. I, however, would stay clear of GMO veggies such as corn and soy, while adding fermented foods such as Natto to your diet for infection prevention purposes.

  • Lifestyle:

Health lives in movement and movement makes the muscles of the pelvic inlet get stronger. We are not meant to live the sedentary lifestyle we do and our ergonomics play a huge role in the occurrence of incontinence. I have written a blog on the role of ergonomics on pelvic floor dysfunction and I strongly recommend you read it.

In conclusion, thinking incontinence is a linear problem with a linear solution is one of the worst approaches to have in its treatment. Treating incontinence with medication is hardly a bandaid when the cause is not an infection for example and the real solution requires a thorough assessment of what is mentioned in this blog. If you still have questions, don’t hesitate to contact me.

Dr. Shakib

Recommended Reading:

Constipation And Pelvic Floor Dysfunction

The Top Pelvic Floor Exercises For A Healthy Core And Beyond