The slow build-up has begun, and you notice the tickle sensation in the back of your nose, are you ready for it? Here it comes, AHHHCHOOO!!! 

Do you dread it when you feel a sneeze approaching? Are there racing thoughts of: 

…..Remember to cross my legs!

…..I hope I don’t leak onto my clothes!  

…..phew, I didn’t actually sneeze!

A sneeze: it's an important bodily function to rid our body of dirt, pollen, and dust. However, this natural occurrence can be uncomfortable for many, especially if the end result is urine leakage. How does one get back the joy of a worry-free sneeze? Keep reading as I explain common reasons leakage occurs and a few tips to stop leaking!

Leakage, when you sneeze, is called “Stress Urinary Incontinence”. According to the National Association of Incontinence, it is the most prevalent form of incontinence in women, affecting an estimated 15 million in the United States. There are a few main culprits when it comes to stress urinary incontinence, so let’s dive into those reasons: 

Don't Let Poor Abdominal Pressure Ruin Your Day: Tips to Avoid Leaks

The poor regulation of abdominal pressure can be caused by one or a combination of factors, including poor posture, impaired breathing patterns, and/or core weakness. Your pelvic floor and diaphragm (a muscle that helps you breathe) work as a team to handle increases in intra-abdominal pressure. This is important when you sneeze because a sharp increase in abdominal pressure will occur. If your rib cage is not stacked over your pelvis, or your core muscles are helping to take pressure off your pelvic floor, your body loses the ability to manage the extra pressure adequately. As a result, the pressure is often more than what the pelvic floor can handle, and leakage can occur. 

Pelvic Floor Overactivity: When Tight is Too Tight for Your Bladder 

Overactivity can also be described as the pelvic floor muscles being too tight. This tightness limits the muscle’s ability to contract and relax through its full range fully. Over time the chronic tightness can lead to weakness and ultimately reduce the amount of pressure your pelvic floor can handle. As we talked about above, if the pressure on the pelvic floor is greater than the muscle can hold, the pelvic floor will “give out,” and leakage can occur. 

The Hidden Danger of Scar Tissue: How It Weakens Your Pelvic Floor 

Experiencing a birth trauma, perineal tear, or abdominal surgery can cause a build-up of adhesions and scar tissue in the area. If there is scar tissue or adhesions near the pelvic floor, there can be limited movement and ability for the muscles to function. A limited range of motion in the pelvic floor creates a snowball effect, first creating tightness and eventually muscle weakness over time. Overall this effect leads to pelvic floor dysfunction with one outcome of leakage. 

Leakage Be Gone: Tips to Take Control of Your Pelvic Floor

Now that we understand a few reasons behind why leakage occurs let’s discuss a few strategies to reduce leakage: 

1) Focus on your Posture - It is important to keep your rib cage stacked directly over your pelvis when you sneeze. This posture will optimize the core, pelvic floor, and diaphragm so the system can adequately manage a big increase in abdominal pressure during a sneeze. A slouched posture compresses the overall system, making it more difficult for the body to manage the increase in pressure demand during a sneeze.

2) Sit Down if Possible - This does not address the main cause of your leakage, but it is a quick strategy to provide external support to your pelvic floor and reduce the overall demand during a big increase in pressure. 

3) Don’t Cross Legs - Crossing your legs can actually be counterproductive, especially if you are already tight or overactive in the muscles surrounding your pelvic floor. Crossing your legs leads to additional tightening action, reducing your pelvic floor’s ability to handle more pressure.  

4) Pre-set your Pelvic Floor if you can. This is also known as “the knack.” Sometimes a sneeze comes on so quickly that you don’t have time to prepare. However, if you feel that sneeze is starting to brew, gently pre-contract the pelvic floor muscles (aka a kegel) before a sneeze. This can help manage the spike in pressure, providing greater support to the pelvic floor. 

Conclusion: 

By starting with these at-home tips, give yourself back the ability to sneeze without the fear of leakage. Additionally, you can download this FREE guide, “7 Easy Steps to END Incontinence”. If you still have concerns regarding symptoms, contact Revitalize Physical Therapy to book a full evaluation.  Let us help you be leakage free!

References: 

National Association for Incontinence, Facts, and Statistics

WomensHealth.gov, Urinary incontinence fact sheet