Sit Up Straight! – Posture and its Relationship to Bladder Incontinence

posture and incontinence

Sherry Knight, CAT(C)

It would seem as though we have yet another reason to heed the orders of our mothers, much to our chagrin!

The muscles of the pelvic floor have an important role in the control of bladder function. Studies have shown that pelvic floor muscles are much more activated when we maintain an upright seated position. In 2008, a study was performed to determine whether resting activity of the pelvic Floor Muscles (PFMs) vary in different sitting postures in women with and without stress urinary incontinence. Three sitting postures were assessed: slump supported, upright unsupported, and very tall unsupported. It was found that greater upright sitting postures produced greater resting activation of pelvic floor muscles.

posture and incontinence

Therefore, increasing the action of our pelvic floor muscles, including those that surround the urinary sphincter, could be as simple as sitting up straight!?! But how?

In a 2007 study it was determined that the anterior pelvic floor muscles followed the respiratory cycle. On inhalation, the breathing diaphragm lowers, which pushes the abdominal contents (organs) down and increases the intra-abdominal pressure which in turn stabilizes the lower spinal vertebrae together. The downward movement of the viscera causes elastic loading of the pelvic floor and tranversus abdominus muscles. This elastic loading excites muscle proprioceptors , which respond by eliciting a reactive contraction to oppose the stretch. This happens in time with the expiration of a breath. The pelvic floor muscles, snapping back into place, causes stabilization of the vertebrae on exhale. So, if the diaphragm is not positioned properly above the viscera and pelvic floor ( ie. sitting with poor posture), this reactive contraction mechanism is compromised, and the activation of the muscles that control the bladder and stabilize the spine can be decreased.

This is where your athletic therapist can help! In recognizing this research, therapists can offer a variety of core exercises that re- train the proper posture/breathing/pelvic floor muscle mechanism. These exercises can be combined with gross body movements and contraction of larger postural muscles, which could treat and/or reverse symptoms of incontinence and low back pain, as well as a multitude of other injuries related to poor core strength. Book an appointment with our athletic therapist – Sherry Knight for more information!


Pelvic floor muscle activity in different sitting postures in continent and incontinent women

Different ways to balance the spine: subtle changes in sagittal spinal curves affect regional muscle activity

Postural and respiratory functions of the pelvic floor muscles

Experimental muscle pain changes feed forward postural responses of the trunk muscles

Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain