Does Jumping Cause Incontinence?

Does Jumping Cause Incontinence?

This is a guest article written by Dr. Maureen O’Keefe, DPT who specializes in pelvic health.  She has been specializing in pelvic health and helping people overcome incontinence caused by jumping for over 2 decades.  You can find Dr. Maureen at Purple Mountain Physical Therapy in Grand Rapids, Michigan.  www.purplemountainpt.com.  Here at MUV Therapy Physio & Sports Medicine, we also treat pelvic floor dysfunction and athletes who experience incontinence with jumping by providing you much of the in-depth analysis and treatment that Dr. Maureen discusses here.  

In this article you will gain insights into why jumping causes incontinence and how you can correct it. 

Should I expect that jumping causes incontinence after giving birth?  

The short answer to this question is no.  You should never leak urine, even when jumping and after giving birth. Unfortunately, women have come to believe that it is normal.  But leaking urine is never normal, whether it is when jumping, sneezing or laughing.   Just because many of your friends’ experience incontinence with jumping does not make it normal.  One contributor to this problem is that postpartum physical therapy rehabilitation is not provided to you, so you never recover your pelvic floor muscles, core muscles and bladder control ability.  Research supports that working with a specialized pelvic health physical therapist will help your postpartum recovery, including your ability to jump without leaking urine.  

Are my pelvic floor muscles just weak and that’s why jumping causes incontinence?

It is unlikely that weakness in the pelvic floor muscles is the one and only cause of your leakage.  Many women falsely assume their pelvic floor muscles are stretched out and weak, because they gave birth vaginally.  Yes, vaginal birth lengthens and stretches the pelvic floor.  But, by the time you are back to jumping, your muscles likely have improved this somewhat and now those muscles are working in overdrive to try to stop leaking with jumping.  This overdrive is the problem and layering Kegels on top of a muscular system that is already overworked can worsen your leakage.  We need to take the pressure off the pelvic floor by treating your entire bladder control system, which means your back, posture, breathing, ribcage, abdominal wall, hips, knee and feet.  

Why does jumping cause incontinence?

Jumping creates so much up and down forces that jostle the bladder, urethra and pelvic floor.  When jumping we are also generating intra-abdominal pressure to achieve the explosive lift off and landing.  Sometimes we also generate excess intra-abdominal pressure when we hold our breath or bear down when jumping, which causes incontinence.  This jostling + intra-abdominal pressure strains the bladder control system.  When the pelvic floor muscles are overwhelmed by the entire experience, you are asking too much of them.  This is why Kegels don’t solve the problem.  The problem is not to solely strengthen the pelvic floor, the problem also involves your intra-abdominal pressure generators and learning how to optimize the forces  and movement patterns that are jostling and straining your bladder control system.  

When jumping causes incontinence, your pelvic physical therapist will sleuth out the numerous contributing factors to this leakage.  

Pelvic health PTs are specially trained to rehabilitate problems related to bladder and bowel control, pelvic organ prolapse, pelvic floor dysfunction and pelvic pain.  We have training that includes sports and orthopedics physical therapy plus pelvic-specific rehabilitation.  

Common things that cause leakage with jumping that a pelvic floor physical therapist treats:

1.  Diastasis recti abdominis:  this is a widening and thinning of the linea alba in the abdominal wall and is common after giving birth.  Physical therapy can correct this.  A problematic diastasis recti abdominis will not effectively transfer loads as you move around, so when you jump you lack the intra-abdominal pressure control management system necessary to keep you dry.

2. Weak deep abdominals:  Research shows that the abdominal muscles and pelvic floor work in tandem.  If the abdominals are not functioning well for you then your pelvic floor will not function optimally.

3. Lower back pain:  People who have lower back pain have been found in research to also have pelvic floor dysfunction.  Therefore, if you want to stop your incontinence with jumping, then we need to effectively treat your lower back, as well.  Otherwise, the tightness or stiffness you experience in your lower back leads to pelvic floor problems and more bladder leakage can happen.

4. Pelvic floor dysfunction: The muscles are slow, weak, stiff, tense, overworked or somehow not effectively generating the support necessary to prevent leakage.

5. Postural misalignment:  this is a very important contributor to jumping causing incontinence.  We often find our patients jump with the ribcage and pelvis not in optimal alignment.  This can lead to an easier pathway for the bladder and urethra to leak urine.  Correcting your posture during higher level activities, like jumping, requires a skilled physical therapist to help you, otherwise you won’t know what you are doing wrong. It is very difficult to make some of these micro-adjustments and figure it out on your own.

6. Weak hips:  If the glutes, hip flexors or hip rotators aren’t strong and flexible, you are setting your body up to overwhelm the bladder control system, including the pelvic floor muscles. 

7. Feet or knee problems:  We often see women jumping and experiencing a very slight (or quite large) misalignment of their ankles or knees when they jump.  For example, some women are flat footed, so they jump and the arch of their foot collapses and their knee deviates inward slightly.  Deviations in how the feet or knees land can imbalance the pelvis and alter the ability of the pelvic floor muscles to lift and squeeze to help keep the urethra closed.

8. Pelvic organ prolapse:  Prolapse is one of the most common things that pelvic health PTs treat.  If you are having prolapse, activities that generate a lot of downward force through your abdomen will strain your area and can contribute to incontinence. Fortunately, pelvic PT helps restore your pelvic organ support system, by addressing your posture, movement patterns, myofascial restrictions, scar tissue, pelvic floor muscle function, core strength, breathing habits, hips and more.  By working on all of these things, you will find that prolapse and incontinence symptoms improve.  

9. Hypermobile urethra:  If the urethra can move around too much, then urine can easily slip out.  In pelvic PT we work to optimize your body’s ability to support your urethra

10. Altered movement patterns:  This includes your jumping and landing mechanics, including your foot, knee, hip, pelvic, low back, ribcage and head positions.  How you take off and how you land directly impact your ability to control your urine. 

All of these things are treatable with high quality physical therapy, but it takes an in-depth assessment by your physical therapist to determine exactly what you need.   

At Purple Mountain Physical Therapy in Grand Rapids, Michigan and at MUV Therapy Physio & Sports Medicine, we treat athletes of all ages that experience incontinence caused by jumping.  Our pelvic health physical therapists are also fully trained orthopedic physical therapists and provide whole body treatment to comprehensively solve the problem of your incontinence with jumping.  If you are interested to learn more about Purple Mountain Physical Therapy, you can find us at www.purplemountainpt.com.