An incontinence expert has revealed how women can train their bodies to avoid succumbing to the dreaded leaky bladder issue after giving birth.
According to Dr Jenny Kruger, women should start exercising their pelvic floor muscles as soon as they’re pregnant – rather than wait until potential issues appear.
Dr Kruger is a world-renowned authority on incontinence, which affects one in three women globally and has spent 15 years studying pelvic floor function.
She says many women are still unaware they even have a pelvic floor – and, if they are, often don’t know where it is or how to boost it through exercise.
“Leaking is common but it’s not normal and it’s not something women have to ‘just put up with’,” said Dr Kruger, co-founder of JUNOFEM.
“It is definitely best to try and start pelvic floor exercises while pregnant.
“Don’t wait until after the baby is born.
“You are at a higher risk of incontinence once the birth has occurred.
“Even if there is no leaking during pregnancy, pelvic floor muscle training will help prevent urinary incontinence post-birth.
“Many women experience symptoms of both urgency and stress, particularly as we get older.
“Stress incontinence is leakage that occurs when you laugh, cough, jump, sneeze, or anytime there is extra pressure on the bladder.
“It is the most common type of incontinence, but again, the good news is that you can do something about it.”
There is a way to improve the strength of the pelvic floor – which Dr Kruger describes as a ‘big trampoline’ or ‘hammock’ – which, when strong and functioning normally, holds the bladder firmly in place and helps keep the urethra closed.
Exercise-wise, walking or swimming around four times per week, for around 30 minutes a time, is a good starting point.
Stopping smoking and reducing caffeine intake are also good strategies, and if you need to lose weight, this will also help reduce the symptoms of incontinence.
Dr Kruger, a member of Auckland Bioengineering Institute in New Zealand, said: “You should really be able to walk briskly and still be able to hold a conversation with your walking partner which helps your general fitness, and the pelvic floor.
“But you should try to be as consistent as possible, so aim for four times a week for at least 30 minutes.”
However, Dr Kruger warns mums not to expect an improvement overnight.
She said: “You have to train and it will take at least three months for it to have a lasting effect, usually depending on the severity of incontinence.
“But after about six to eight weeks, many women start to feel better and notice their symptoms have lessened and they can do stuff again.
“Exercises should be ‘targeted’ and ‘effective’ – that means the exercises need to activate the pelvic floor muscle, which is not always easy, and the exercise programme needs a sufficient intensity to make a difference.
“Many women will start to notice a difference in their symptoms about six weeks into the programme – but they shouldn’t stop.
“We do find typically women exercise their pelvic floor for a little while then think, ‘Ah, great that’s it, I’m fixed now’, but that’s not the case.
“Changes to muscles, such as increase in strength and function, usually take about 12 weeks.
“So even though you may feel like the problem is resolved, it is unlikely that the pelvic floor muscles have changed significantly.”
Dr Kruger is also the co-founder of JUNOFEM, a New Zealand-based medical tech company that has just released its pelvic floor training device, femfit®, onto the UK market.
Millions of mums feel too ashamed to reveal to friends or colleagues that they leak after childbirth, often after returning to physical activity or trying new sports or activities for the first time.
According to Dr Kruger, stress incontinence – the most common postnatal type – is likely to occur while jumping on trampolines, horse-riding, jogging, jumping or sometimes even doing yoga, or other activities which involve stretching.
She added: “Most women’s first engagement with their pelvic floor, or even the first time they realise how important it is, is during pregnancy and it plays a vital role in the whole birthing process.”
As well as exercising the pelvic floor muscles, bladder training can help women who have struggled with an overwhelming sensation to rush to the toilet to empty their bladder, often finding that there is not much there when they do go.
Top tips for ‘calming the bladder’ or ‘training the brain’ to help with those sensations of urgency are to practise deep belly breathing when you get the urge to empty your bladder and curl up your toes.
Or use other methods to distract your brain, such as counting backwards.
Dr Kruger added: “Contracting your pelvic floor – usually rapid on and off contractions – can also help.
“Another widely held belief is that you should restrict your fluid intake to help with incontinence and urgency.
“In fact, the opposite is true – you should be drinking water regularly/as you normally would.
“Restricting your fluid intake can increase your risk of dehydration and bladder infection, so again, it’s about training the bladder to fill as much as possible before you go to the toilet.”