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Want to know more about fitness, physical therapy, and exercise (Kegels and beyond)? Find out here.
Our expert Kendra L. Harrington (click here to read her bio) answers your questions. |
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Q:I'm a 35 year-old mother of four. I noticed after the last pregnancy that my bladder has decided to call it quits. If I don't cross my legs before I cough or sneeze, I will end up urinating on myself. Is there anything I can do to strengthen my bladder? |
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A:Your symptoms describe “stress urinary incontinence.” This involves urine leakage when increased abdominal pressure squeezes the bladder in an environment of weak pelvic floor muscles. Abdominal pressures on the bladder are common, and routinely occur during exercise or even with a mere cough, sneeze, or laugh.
The good news is that stress urinary incontinence can often be prevented or resolved with the strengthening of the pelvic floor muscles. This can be achieved with simple pelvic muscle contraction exercises, commonly known as “Kegel exercises.” To properly perform a Kegel contraction, you must isolate the pelvic floor muscles and try to limit the use of abdominal, buttocks, and inner thigh muscles. The pelvic floor muscles are contracted as if you were holding back gas. General guidelines suggest starting with 3 to 6 groups of 10 contractions, holding each contraction for 3 seconds. As you feel your muscles strengthening over time, increase the hold time for each contraction to 10 seconds. In addition, it is recommended that 10 contractions without any holding time be performed (“quick Kegels”) anywhere from 5 to 10 times per day. Kegels can easily be performed during routine daily activities, such as working at the computer, brushing and flossing teeth, reading the newspaper, etc. It is important to make these exercises a part of your daily routine, so you won’t forget to do them.
Symptom improvement begins slowly, but many women will begin to see a difference within approximately 3 to 4 weeks after starting the exercises. Maximum improvement usually occurs within a 6- to 8-month period, and continued regular exercise has been found to effectively maintain long-term symptom relief. |
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Q:I'm having incontinence problems. I drink a lot of fluids and feel the need to go constantly. I try to hold it as long as possible before finally going to the bathroom. Are kegels the best solution to this or is it just as helpful to keep stopping the urine flow when you are urinating? |
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A:Before making any changes to your diet or exercise, you want to see your physician to make sure you do not have a urinary tract infection. For some people, when urinary incontinence first begins, or worsens, this could be a sign of infection. You need to be treated with medications first to eliminate the infections.
Proper fluid intake should consist of about 60 to 80 ounces of water per day. By drinking water slowly and equally throughout the day, your bladder should be able to wait 2 to 4 hours between voids. On the other hand, consuming too little water can result in the production of concentrated urine, creating chemicals that can irritate the bladder and produce spasms with symptoms of urgency and/or frequency. There are also fluids and foods that are considered to be “bladder irritants,” which may produce these same symptoms. For more information regarding bladder irritants, please refer to the American Physical Therapy Association’s Section on Women’s Health at www.womenshealthapta.org. |
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Q:I would love to begin running at the age of 45. I have had 4 children, and now suffer from stress incontinence. I am opposed to taking medications for this issue. How do other women deal with exercise and stress incontinence? |
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A:The easiest way to deal with stress urinary incontinence during exercise is to ignore it and just use a pad on to absorb the urine. Unfortunately, however, this is merely hiding the symptoms from public view but does nothing to improve or eliminate them. As time goes by, your symptoms will likely worsen and you may develop other pelvic floor dysfunctions like pelvic organ prolapse.
The best way to control leakage symptoms, and hopefully resolve them, is through exercises targeting the strength and endurance of the pelvic floor muscles. Many women know pelvic floor muscle exercises commonly referred to as “Kegels.” Kegels are most effective when you have been examined by a health care provider, such as a specialized physical therapist, to ensure the proper contraction is occurring. There are many different techniques for performing Kegels, but two basic exercises are “slow” Kegels and “quick” Kegels.
A slow Kegel involves contracting the pelvic floor muscles in the same manner as if you were holding back gas, maintaining the contraction for 3 seconds before releasing. You eventually want to progress to a 10-second contraction, and slow Kegel exercises should be performed 3 to 6 times per day in groups of 10. “Quick” Kegels differ because you do not hold the contraction—the pelvic floor muscles are contracted and immediately released—and should be performed 5 to 10 times per day in groups of 10. Try to associate these exercises with other activities performed during the day—it’s easy to incorporate them into your daily routines.
A physical therapist who specializes in pelvic muscle dysfunction can evaluate your symptoms and muscle function and personalize a treatment program of Kegels and other exercises to help alleviate or prevent incontinence. To locate a physical therapist that specializes in pelvic muscle dysfunctions, go to the American Physical Therapy Association’s Section on Women’s Health website at www.womenshealthapta.org. Click on the “For Consumers” link and send an email to the State Representative where you live requesting the name(s) and phone number(s) of physical therapists in your region. |
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