Recently I was at the ball field watching my son play baseball and chatting with some girl friends. Someone suggested that we take our kids to the local trampoline park for the day – and then the common joke of “maybe I won’t jump much because I don’t want to pee my pants” came up and everyone laughed.
Because moms pee their pants, right? Especially when jumping (or laughing, sneezing, doing boot camp…..)
Yes, a lot of moms do.
But it’s not normal – very common, yes. But not a fate that we all have to accept.
Since this is one of my favorite conversations – educating moms that they don’t have to settle for a less active life – I delved into my speech on how to build up your pelvic floor muscles so they work when they are supposed to. It’s not just about doing Kegels in the car at red lights! It’s about coordinating them with everything you do.
We laughed as we talked about pelvic floor muscles and motherhood. I love our generation of mothers and that we are not shy to talk Kegels at a ball field!
In this discussion, I hope my friends saw new possibilities for their bodies.
I also learned something new – a great new analogy for the pelvic floor that my friend had learned from her Yoga teacher.
The Cardboard Box.
Imagine your core like a cardboard box. The front of the box is your six pack, or Rectus Abdominis muscles, the two sides your Oblique muscles, your back muscles in the rear of the box. The top is your diaphragm and the bottom of the box is your pelvic floor muscles (aka Kegel muscles).
At first my brain wanted to reject The Cardboard Box analogy. So many times we, more “scientific” Physical Therapists, like to say a pressurized canister or a balloon that can bulge in many directions as the analogy for the abdominal cavity and pelvic floor – but really, who can relate to that?
Everyone can relate to a cardboard box. And everyone has had the bottom of a cardboard box fall open when there were too many heavy things inside of it.
So I am adopting this brilliant analogy. Another tool in my educational tool belt.
Ok, back to the trampoline. Why do many of us pee our pants while jumping on a trampoline? The bottom of the box opens a little, or a lot, with the load of your body weight forcefully coming down on your pelvic floor muscles when you jump. And some pee comes out.
There are three ways to fix this situation:
- Never jump on a trampoline again
- Use a pantyliner (or Depends!) to catch the pee
- Fix the bottom of the box
Since we are Physical Therapists who like to do fun stuff with our kids, we like option #3!
Now this topic of good pelvic floor muscle strength and coordination is a huge topic! One that cannot be fully explored in this blog. There are Physical Therapists whose entire specialty is helping women with this problem – so it would be completely incorrect for me to say that I can fix you just by describing the process to you.
But what I want the world to know is this is not a laughing matter. On the most part it is completely fixable and avoidable with a little education. And if that doesn’t work, then talk to your doctor about seeing a Women’s Health Physical Therapist who can teach you how to do this right – or she can figure out what is preventing you from being able to do this correctly.
You will benefit seeing a Women’s Health Physical Therapist if you can’t do a Kegel properly because of:
- muscle weakness
- episiotomy or perineal tear scar tissue
- uncoordinated muscles
- poor posture
- overly tight pelvic floor muscles that don’t know how to relax
- painful tissue that doesn’t know how to relax or contract
- spasming bladder
- nerve damage
- psychological trauma
- the list goes on…….
Meg has written 3 awesome blogs about Kegels here. Check them out to delve further:
- Do you pee your pants at fitness class?
- Do you know how to Kegel?
- Kegel Exercises…. Critical or Dangerous?
Now, let’s learn how to jump on a trampoline.
For simplicity sake, let’s assume you have run of the mill postpartum mildly weak pelvic floor muscles and a lack of coordination (they don’t activate when you really need them or you accidentally bear down on them when you think you are contracting – both scenarios are so common).
You need strength and coordination.
Strength is the ability to close up the bottom of the box.
Coordination is closing the box at the right time (jumping, sneezing) and not using your leg muscles to assist in trying to close the bottom of the box. I think this is where jumping gets difficult – you are using your legs to move, so if your usual habit is to clench your legs together or squeeze your butt, then your body has no idea how to close the bottom of the box with just your pelvic floor muscles while you are using your legs for jumping.
This is the series of things that have to happen to jump and not pee your pants:
- Be able to tighten your pelvic floor without tightening your thighs, tipping your pelvis backwards or holding your breath. [This is easiest to practice lying on your side, on your back]
- Tighten your pelvic floor to about a 30% effort while standing [again without holding your breath, etc]
- Keep your pelvic floor 30% tight while squatting
- Keep your pelvic floor muscles 30% (or more ) tight while jumping. [Because there is more force on your bladder a light Kegel might not be enough to prevent the bottom of the box from opening.]
If your goal is to jump on a trampoline, practice each of these steps. If you can’t do one, then go back to the easier step and try to do your pelvic floor contraction with the least amount of effort as possible. Often practicing a light contraction allows your brain to decrease the accidental co-contraction of nearby muscles. This is about isolating and re-training.
You can do it!
Let us know if you are able to get this right for the first time in years or if you are still struggling. I cannot tell you how many women struggle with this! You are not alone.
Happy (dry) jumping!