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  • Writer's pictureLisa Paul IBCLC

To pee or not to pee - sometimes the choice isn't an option

I recently had an experience that brought back memories of a postpartum pelvic floor (aka kegel muscle). During a long bike ride, I pulled a muscle going up a hill at mile 47. My body was fatigued and we were kind of lost, and the hill didn't look that steep but the last bit of muscle push to get to the top was too much for this body. I continued to ride another 3 miles to find the hotel, and was able to say I rode 50 miles that day.

However the next hour was intense. Once I was off my bike, my pelvic floor went into spasm. Sitting, standing, peeing, lying down - didn't matter, it was all painful. Eventually I was able to stand long enough take a shower and that seemed to relax muscles and the pain reduced somewhat. I went to bed early and hoped that my pelvic floor could endure another 42 miles back to the car the next day. Thankfully I was able to ride the next day but made sure to stand up often and take it easy - low gears and slow going but I didn't want a repeat of the pain.

The next day it seemed like everything was back to normal... until I went for a walk. Despite the fact that I didn't have a full bladder, walking caused me to pee or the fancy term is to experience urinary incontinence. I could not hold urine in, partly because I couldn't even feel my pelvic muscle at all. Now granted, I had some control, as this was just leakage, but it is disturbing to be just shy of 50 and not able to walk down the street without a pad on.

Over the years, I have had a slew of interest in the pelvic floor. Before this bike trip, I had a bike fit to make sure that my seat was in the proper position. I have been to physical therapist who specializes in Pelvic Floor Therapy. I have taken a Pelvic Floor Yoga Workshop taught by Leslie Howard. I have taught childbirth classes and my favorite chapter out of of Ina May's Guide to Childbirth is The Sphincter Law. I am well aware of the importance of pelvic floor health. And yet, I don't do the exercises! I forget they exist. I will put reminders on my phone and ignore them. Because it just doesn't seem necessary or important - until peeing is no longer optional. When peeing happens whenever you sneeze, cough, bike or walk, it is time to get serious.

Here is what I am doing to help repair my pelvic floor for now and for the rest of my life. (Urinary Incontinence is a reality for many women as they age.)

Pranayama practice: This is part of my yoga practice. I pay attention to making sure my inhales are happening with a relaxed pelvic floor and my exhales with a engaged pelvic floor. Before I was aware of what I was doing, I actually was doing the opposite - or what is called a reverse breather.

Yoga core work: Instead of embarking on a new regime of yoga for the core, I decided to go back to the basics of my Integral Yoga training and am doing the same basic Level 1 class each day.

Daily kegel training: I found an app for my iPhone that seems to be working well. I do two sessions a day - not the ideal number. I should be doing like 10 sessions per day, but I wanted to be consistent on a daily basis.

After about 1 week of this regimen, I took a 4 mile hike without leakage. About 2 weeks later, I got back on my bike. Oh yea, I still have work to do. I was surprised at how weak I was on the bike, and how quickly I went into spasm at the smallest hill.

If I did this much "damage" riding a bike, imagine the work the pelvic floor has recovering from birth where a baby had to pass through part of it to be born. Mamas give yourself grace and patience as you navigate postpartum recovery. And do yourself a favor and consider going to a pelvic floor therapist earlier rather than later!

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