Pelvic Floor Exercises

An inability to control urine flow as we age can be a socially embarrassing problem, but it can be managed. Stress incontinence - the loss of urine when you cough, sneeze, laugh or jump is generally a result of a weakening of the pelvic floor muscles. It makes sense that if you strengthen those particular muscles you'll reduce the chances of having to endure regular awkward, episodes.

A plan of action can start immediately with Kegel exercises. Named for inventor and American physician A. H. Kegel, these involve contracting and releasing muscles to improve bladder control.

The correct way to perform a Kegel is as follows. Imagine that you are going to the bathroom; imagine that you have interrupted the flow of urine. The muscles you use to stop the flow are your pelvic floor muscles and these are the ones you want to strengthen. You shouldn't condition the muscles while actually going to the bathroom, because many therapists have cautioned that this type of disruption can lead to infections. However, now that you know what the sensation is you can regularly do Kegel exercises to condition these muscles and apply that control when you need it.

There are two protocols for pelvic floor exercises, one for each of the two major types of incontinence: stress and endurance incontinence. Consult your physician or physical therapist; a biofeedback examination can determine which you have. If you have both conditions, or have neither and just want to take a preventive approach, follow both protocols.

For stress incontinence, perform 10 reps of "quick flicks" - short, one- to two- second contractions with two- to four-second rests in between. Start with one session of 10 reps, three times per week. Build up to three sessions of 10 reps, three times per week. For endurance incontinence (trouble holding), contract your pelvic floor muscles for 10 seconds, then relax for 20 seconds. For this protocol, the rest period should always be twice as long as the active period to ensure adequate muscle recovery. Start with 10 reps, four to five times per week. Build to a 20-second contraction, with a 40-second rest, four to five times per week. Many people think they are holding firmly for the full length of the contraction, but biofeedback shows an initial peak contraction followed by a rapid decline. To prevent this, draw the muscles upward tightly, then, throughout the contraction, repeatedly tighten, tighten, tighten, about once per second.

With pelvic floor exercising, some studies show detraining after three months of overtraining. If this occurs, cut back your, program to about 50 percent of effort and continue at this rate until retraining occurs. Then slowly rebuild.

Pelvic floor muscles are co-contractors with other muscles such as abs (especially rectus and transverse abs), glutes and the respiratory diaphragm. If you engage the pelvic floor muscles when training these other muscles, you'll get more power out of latter.

If doing resistance training that involves holding the breath during lifting or other maximal efforts, it's best to engage the pelvic floor muscles. Otherwise, intraabdominal pressure will create strain on them.

Pelvic floor muscles (along with transverse abdominus) play an important part in malalignment of the spine and sacrum, so engage them when doing back exercises, especially for the lower back.

Many therapists are now suggesting that exercisers contract their pelvic floor muscles before they initiate any type of exercise. For example, if you're about to perform an overhead shoulder press, start by contracting your abdominals, lifting your chest up and out and your shoulders back and contracting your pelvic floor muscles. Then you can start the exercise. Kegels are beneficial to both men and women, but since women are at a higher risk for stress incontinence these exercises are a must for them.

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