My name is Laura Marin, I am the director of Welove2befit . When last year I spoke with Carol, a married woman, athlete and mother of 3 children, I felt in her voice the low self-esteem, frustration and anguish. Carol suffered from a combined type of urge incontinence and stress.
First step, find out why you cannot bear to urinate
“When I need to pee I need a toilet on sight or I do it on myself and also when I cough, sneeze, lift weight or laugh, I feel always a few drops sometimes more scaping my body“
Carol was recommended by a close friend of hers whom I had been treating for more than a year. When she confessed her situation, her friend told her to contact me because my sessions had given her life back.
On our first date, after doing a physical and health questionnaire and a posture analysis, I got to the root of her problem: the pelvic floor or perineal muscles.
Poor thing, she was sharing with me her best kept secret. She had tried everything including physiotherapy for women however unsuccessfully.
She was entering menopause, having erratic menstrual cycles and noticing that he was no longer having control over her body. Hot flushes, changes of mood were part of her every day for a while.
Here we must take into account the pregnancies, although many women may suffer the same problems without having had children; be it for impact sports, bad posture or because they don’t breathe well. She had children and that had an impact these muscles.
With all this I reassured her as much as I could by explaining in a concise way what was happening to her, that she was not alone and that there were solutions.
Incontinence is neither more nor less than a loss of tone in the muscles that make the bladder diagonal to the floor. These muscles retract it at rest-when we do not need to pee, bladder is empty or not full enough to cause the urge to go- and when one needs and goes to pee they relax, the bladder moves to a more vertical position and the pee falls through the conduct called urethra.
If those muscles are not toned and strong, they do not have the ability to retract the bladder to its normal diagonal position at rest and so the pee escapes the body without control. These muscles are part of the pelvic floor as they are in the pelvic cavity.
Pelvic floor, where is it, its functions and why it fails
The pelvic floor is made up of the diaper-like perineal muscles that surround and hold all the organs of the pelvic cavity: vagina, bladder, anus, uterus, and urethra. From our 40s/50s they lose their tone and strength if we do not take care of them.
Their main function is to hold and give support to all those pelvic organs but, with time, pregnancies and the pressure to which we put these tissues when sneezing, coughing, laughing, urinating or defecating and exerting physical power, they lose their tonicity and we start to suffer some problems such as incontinence, (with more or less loss of urine depending on the person), organs downfall, prolapse, etc.
Menopause does not help since there is a loss of collagen that prevents the tissues from having tone, looking taut and healthy; wrinkles come out and the skin falls out when we get older. We can see this clearly in the face and skin but it also affects the internal tissues.
Labour and child delivery promote hypotrophy of these muscles, not only because of the pressure at the time of the delivery where the baby -as he goes through- stretches, tears, and breaks some of those tissues that must hold and protect the pelvic cavity.
On top of all, women have two holes that men do not have, the vagina and the urethra. Let’s just say we have a quasi-horizontal muscle holding up to a lot of pressure every day, but right in the middle two holes. It is like having a broken sheet, sooner or later the areas around this tears will be weaker and this obviously will make us much more vulnerable to hold the organs and manage all the internal pressures (men also suffer from pelvic floor in the form of inguinal hernia and in the peritoneum as hiatus hernia)
Techniques for treating urge incontinence
I use anything from Kegel exercises, hypopressives/low pressure exercise, Pilates through vaginal contractions. Depending on the case, I focus on one or combine several of those, as for wen executed correctly, they all help.
I explained to her that with the practice of these low-pressure exercises what I am looking for is to decrease the pressure of the abdominal and pelvic cavities. The more the diaphragm relaxes the more the pelvic floor and perineal muscles contract. They become stronger, less atrophic and they start to support the organs and daily pressures as they should.
Benefits of Hypolates(low pressure pilates)
-Better tone on the pelvic floor, perineal and abdominal muscles
-Sculpting the abs
-Reduction of the waist contour
-Improves the practice of physical activities
-Prevention and improvement of hernias, prolapse
-Prevents the descent of the pelvic organs
-Improves sexual practice
-Improves stress management
With all this we got down to work. I took measurements of her entire body, weight and height so that I could track changes and improvements and also to calculate the % of fat and muscle. It is essential to measure the waist since with the practice of these technique the waist gets slimmer and trimmer.
What technique have we used for these exercises?
1-Complete column elongation
Trying to touch the ceiling with the crown of your head and the chin tucked in, pulling the back of the head backwards and upwards. The stomach goes in straight away if done correctly.
2-Lateral opening of scapulae
In this case we open the scapula laterally creating more space between the thoracic vertebrae and the shoulder blades. Avoid rotating the shoulders forward. The clavicles must be as wide as possible.
Opening the scapulaes activates the anterior serratus muscles from the middle edge of the scapulae, hugging it forward until ending in the 9 upper ribs. This muscle is the one we use for breathing, it opens the ribs sideways but also help us to have the shoulders wide in place. It gives hold to the upper body.
3-Abdominal nasal breathing
We breathe in with the nose, allowing the tummy to expand to the sides and outwards, releasing the air through the mouth; the navel tries to reach the vertebrae moving inwards and upwards as when you zip a pair of jeans up, seeking maximum elongation without tightening the neck.
We started with an activation of the respiratory muscles, then postures, then both combined and at the end I included a mild apnoea to increase the intensity of the session a little bit more.
My mission was to focus the work on the diaphragm, the rectus abdominis, the 6 pack, oblique abdominals and the transverse abdominal that acts as a wide belt or girdle from the lumbar vertebrae hugging the sides to the groin and the 6 lower ribs.
As you breathe in the diaphragm contracts, it lowers by putting pressure on abdominal and pelvic cavities.
As you breathe out the diaphragm relaxes and the pelvic floor and abdominal muscles contract because there is no pressure or only very little and the organs have room to position themselves without being crushed. The more relaxed the diaphragm, these muscles involuntarily contract. It is a reflex effect like closing your eyes when sneezing.
Carol realized she could not breathe
Poor Carol was sweating only by practicing this type of breathing with this new optimal posture. There and the she realized that she did not know how to breathe and that most of the time she breathed without having emptied her lungs. We all do the same especially in stressful situations. This is terrible for the respiratory muscles and the diaphragm.
I used Hypolates from standing and in all fours posture, hands and knees to the floor and with the head flexed looking towards the navel to further activate the abdominal girdle so that she could see too how her stomach went inwards, disappearing and the muscles were activated.
I farewelled her happier and much more relaxed
She was looking forward to our next appointment. Feeling all the work we did together she knew that this path was finally the right one for her.
Upon saying goodbye Carol was a different person than the one that knocked on my door an hour before. Positive and relieved.
Result and feedback on my sessions with Carol
Three weeks later she told me that on a car trip with her husband, despite wanting to pee, she perfectly endured 30 minutes more until they stopped for a break. This would not have happened a few months earlier. She could not believe it, finally she was able to control it.
I notice that she looked trimmer so I decided to measure her again. Her waist line was 2cm less. She was very pleased.
To this day, I continue training Carol and many other women who benefit from these techniques for these reasons or simply because they want a more sculpted abs, narrower waist line. Vanity is a good thing, believe me.
These maverick women are successful, strong, hard working. Being able to contribute to improving their lives is an honour.
Hypolates method exercises should not be done if the person has high blood pressure, pregnant, or is undergoing treatment to become pregnant.
If, like Carol, you have an incontinence problem, or pelvic floor related issue and need help, you can contact me by email at: Laura@welove2befit.com
Laura Marin is a former ballet dancer and founder of WeLove2BeFit.com a company obsessed with health and fitness for everyone and more specifically for women.
Laura is also a celebrity coach, master in Hypolates, Pelvic Floor and Pilates, Nutrionist and Lifestyle Coach.
Original translated from website