Tuesday 20 March 2018

Opening the floodgates: How to cope with incontinence

Kate Winslet
Kate Winslet

Cathy Bussey

When Kate Winslet admitted she suffered from incontinence, many mums applauded her honesty. Cathy Bussey has some coping tips

It’s not often a Hollywood star opens up about their undercarriage, but A-list actress Kate Winslet has done just that. Speaking to Graham Norton on his chatshow last week, Winslet revealed that she is one of the estimated one-in-three women who have given birth who suffer from a weakened pelvic floor, just days after TV presenter Blathnaid Ni Chofaigh also spoke out about her own adult incontinence.

Or, as mother-of-four Winslet put it: “I just can’t jump on trampolines any more. I wet myself.”

The star has been hailed across parenting forums ever since for being so open about an issue that affects so many women.

Blathnaid ni Chofaigh admits she struggled with incontinence for years
Blathnaid ni Chofaigh admits she struggled with incontinence for years

“This is a hugely common problem and every GP has seen it hundreds of times,” says GP, marathon runner and mum of three Dr Juliet McGrattan. “As this is estimated to affect up to one-in-three women who have given birth, it’s a topic we desperately need to talk about.”

I count myself among these women. After two larger-than-average babies my own once-watertight pelvic floor has joined Winslet’s in becoming a little bit compromised in its integrity.

It took me by surprise when I realised, not long after the birth of my first baby, that I hadn’t escaped unscathed. I was 30 seconds into a skipping workout when I realised I had to change my capris.

What really shocked me was that I hadn’t felt I needed the toilet before I began. The pressure created by the repetitive jumping was simply too much for my pelvic floor.

After my second child I began to notice that I needed to use the toilet more in general. In fact I’ve become so predictable that my two-year-old has begun to remind me “Mummy have a wee-wee” before we go out anywhere.

I can’t say I’m delighted to find myself blessed with a condition that’s generally considered the preserve of the elderly. But like Winslet, I refuse to feel embarrassed or ashamed about it. I have wiped up countless fluids and excretions on a daily basis in the four years since I became a mother — not just from my children.

It’s going to take more than a bit of stray urine to shatter my pride in what my beautifully ordinary, life-making body has done.

Instead I have become focused on what I can do to help myself. Happily the solution for me, and many others, isn’t just to never leave the house unless armed with Tena Lady.

Dr Juliet advises a visit to the GP and says 60pc of women can improve their pelvic floor to an acceptable level just through pelvic floor, or Kegel, exercises (see right).

Celebrity personal trainer and pre and postnatal exercise specialist Jane Wake says with specific women’s health physiotherapy up to 80pc of pelvic floor issues can be cured.

Read more: 'I feared I was the only one living with incontinence'

“At my classes we have 100pc success,” she says. “I myself had issues and as a runner and high exerciser it caused me many a problem after childbirth. Now I’d say my pelvic floor is healthier and stronger than any other muscle in my body, and that is all through exercise.”

However some women still need extra help — especially during exercise.

Yvonne Brady, founder of EVB Sport clothing, says that she was inspired to create a range of sportswear which helps support the core and pelvic floor after finding exercises weren’t quite enough.

“After my third child I suffered light bladder leakage and I was completely mortified and felt I was losing control of my body,” she says.

“Pelvic floor exercises became part of my training regime but I realised the repetitive downward forces from running would continue to place strain on my deep core muscles.”

Her range of support shorts, capris and leggings, which she describes as ‘a sports bra for the bum,’ are now recommended by leading international physiotherapists, hospitals and medical professionals working with top athletes. A pilot study found the shorts helped women stop leaking during exercise, and gave them a confidence boost too.

For those, like me, who can be a bit forgetful when it comes to daily Kegels, one of the multitude benefits of yoga is the strengthening of the pelvic area. “I’ve had that embarrassing moment when I’ve sneezed and a little something has come out,” admits dancer and yoga teacher Kristy Robinson. “Yoga can help a weak pelvic floor and in particular, the practice of Moola Bandha focuses on contracting and lifting the muscles around the cervix and pelvic area.”

Similar to pelvic floor exercises, Moola Bandha is a ‘deep lock’ that focuses on engaging the area, also known as the root of the body.

“Energetically this is a place of security, trust and our foundations,” says yoga teacher Anja Brierly-Lange. “Postpartum the connection to our whole being as a new mother and woman is important – not just for the pelvic floor and physical body but also for our emotional wellbeing.”

She recommends that “everyone, men and women, should start to become more intimate and friendly with the pelvic floor. These are amazing, hardworking muscles.”

Incontinence be damned, let’s hear it for the pelvic floor!

How to do pelvic floor exercises

Ω Sitting tall or preferably standing, place one hand on your chest and one on your abdomen. Take a deep breath and breathe out, slowly through the nose, closing the back of your throat. You sound a bit nasally as you breathe out — it’s called Ujaya breath in yoga or ‘ocean breath’.

Ω Try to relax tension away from the neck and shoulders as you breathe. Do this a few times.

Ω On your next breath, relax as before, then start to connect to your pelvic floor by a) thinking of stopping a fart, b) thinking of stopping a wee, c) imagining you could pull these two points up and inside your vagina — think of a rocket — in slow motion, up through your vagina and out through the top of your head.

Ω If you are doing it correctly you will feel your deep

abdominal muscles draw in away from your hand. Relax, letting it come back down and repeat up to 10 times. You need to do this every day and for the rest of your life.

— Jane Wake, Baby-A-Wake/Pilates Flow

How to practice moola bandha

Ω Sit in a cross legged position and place the heel next to the cervix and put slight pressure on it. The upper body should remain straight and relaxed.

Ω Place your hands on your knees, close the eyes and bring awareness on a normal rhythm of breath. Exhale and hold the breath out.

Ω Begin inhaling slowly and deeply. Hold the breath in and tilt your head forward so that your chin presses tightly against your chest or sternum. Bring your attention to the cervix and without force pull in the cervix and hold the breath for a few seconds. Try not to contract the anus. Release the contraction, release your chin from the chest, lift the head up and then exhale slowly.


— Kristy Robinson, Ground Bloom Flourish


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