Why Do I Pee My Pants When I Laugh?

Oh the embarrassment!  Having a good laugh with the kids and all of a sudden you have a little accident, or worse yet, a big accident.  Do I need to wear a pad?  Will it happen again?  Why did this happen at all?There can be several reasons that leaking, or urinary incontinence, can occur.  The most common reason is muscle weakness. This includes muscle weakness of the pelvic floor muscles that form the bottom of the pelvis and help to support the bladder and other organs.  But just as importantly, it can be weakness of the abdominal, or core, muscles and poor coordination of the abdominal and pelvic floor muscles with activity.  Imagine the area from your pelvic floor to your diaphragm is a pop can–the tops, sides, and bottom all maintain a constant pressure until you pop the top and have a swig.  Now imagine that your pop can has a hole in it–all of a sudden you have pop all over the place!  Ideally, your core–the pop can–has a solid pelvic floor, abdominal wall, and diaphragm.  However, if you have had a baby, abdominal surgery, prostate surgery, a hysterectomy, carry your weight in the tummy, or are a smoker, all of a sudden you may have a hole in your pop can.  All of a sudden, you may pee your pants when you have a good laugh!

Often, when someone goes to their physician or nurse practitioner about leaking, they are asked if they are doing their Kegels.  The question is–how do you know if you are doing your Kegels correctly??  At our clinic, we use biofeedback so that you can see on a computer screen how your muscles are engaging–or not engaging–then your brain is telling them to fire.  Oftentimes after baby or surgery, our pelvic floor muscles and abdominal muscles have difficulty getting back in sync.  The biofeedback is an easy, non-invasive way to help them find their rhythm again with exercises, lifting, and laughing.

Pelvic floor physical therapy for urinary incontinence can help prevent the leaking!   Excellent pelvic floor PT focuses on not only the pelvic floor, but making sure that the entire system is working together to prevent leaking.  Are you activating your pelvic floor when you cough, sneeze, or laugh?  Are you holding your breath when you lift something heavy?  Are your abdominal and hip muscles strong enough to play a supporting role to the pelvic floor muscles when you go from sit to stand or climb the stairs at work?

So, before you consider buying pads or having a more invasive treatment for urinary incontinence, consider pelvic floor physical therapy at Foundational Concepts.  Many times, with a little help for pelvic floor and abdominal muscle strengthening and improved coordination of the core muscles, we can make a big difference in eliminating the embarrassment of having an accident while just having a good laugh!

–Jennifer Cumming, PT, MSPT, CLT

This blog is here for your help. It is the opinion of a Licensed Physical Therapist. If you experience the symptoms addressed you should seek the help of a medical professional who can diagnose and develop a treatment plan that is individualized for you.  If you enjoyed this blog, check out our website at foundationalconcepts.com for more blog entries and to learn more about our specialty PT practice, Foundational Concepts.  Follow us on Twitter @SarahpelvicPT or @Jenn_pelvic_PT and like us on Facebook at Foundational Concepts for updates.