The Truth about Kegels and Urinary Incontinence-Physical Therapy in Arvada

Nov 14, 2014

The Truth about Kegels and Urinary Incontinence-Physical Therapy in Arvada

Picture this: You are in the middle of your new favorite workout class at the gym. It’s fun, it’s giving you great results, and (uh oh), it’s time for that one maneuver (burpees, kettle bells, insert the move here). You know… the one part of the class you dread because, like clockwork, you leak urine during THAT move. You are frustrated, embarrassed, and now wet and uncomfortable.

If this sounds like you, or like something similar that you deal with, you are not alone. At least 25 million adult Americans (that’s 1 in 10) experience some form of urinary incontinence, also referred to as “loss of bladder control”, “urinary leakage”, and sometimes “overactive bladder”. Although this is a problem of both men and women, young and old, it is more common in women. Approximately 26% of women aged 18-59 years have a form of urinary incontinence. One in 10 of these women will have a surgical procedure to help and, of those who undergo surgery, 1 in 3 risk re-operation.

There are several forms of urinary incontinence or leakage, only a few of which I will briefly discuss here:

  • Stress Urinary Incontinence: Involuntary loss of urine when coughing, sneezing, laughing, exercising, running, lifting, etc.
  • Urge Urinary Incontinence: Involuntary urine leakage after a sudden urge to go. This is often referred to as “overactive bladder” and you may find triggers, such as an urge to go as soon as you arrive at home, right before a long run or workout, or getting up in the middle of the night to urinate
  • Mixed Urinary Incontinence: Involuntary bladder leakage due to a combination of the above two types

So then, what’s the deal with all of this leakage going on? You are probably saying to yourself “But I do my Kegels, so this is as good as it will get, right?”. Unfortunately, many of us are told to “do Kegels” and nothing more is said about the topic. However, are any of us actually taught how to properly perform a Kegel exercise? How about form, repetition, sets….all of the things you would want to consider when building your biceps and triceps muscles with weights at the gym should also be considered when strengthening the pelvic floor. By the way, what exactly is a Kegel supposed to be exercising?

The Kegel is an exercise designed to help strengthen the musculature of the pelvic floor. The “pelvic floor” refers to several muscles, joints, ligaments, & other soft tissue in the groin area around the vagina (or penis) and anus that support the body’s weight, the organs of the pelvis (reproductive organs, bowel, and bladder), and function to prevent urine or fecal leakage. A research study of women with urinary incontinence found that nearly half of the women needed “hands on” coaching by a medical professional to help correctly use the pelvic floor muscles and perform a correct contraction. Additionally, 25% of these women actually performed the OPPOSITE of a Kegel contraction when not provided with individual coaching. This means that they were actually doing exercises to make their urinary leakage worse! So no wonder some of you who have exhausted yourself with the Kegel have not had success!

On the other end of the spectrum, some people may be performing perfect Kegels and feel that they have a strong pelvic floor, yet continue to have urine leakage. Urinary incontinence is not just a matter of muscular weakness of the pelvic floor. There may also be overactive pelvic floor muscles that have become tight or inefficient, thus preventing the bladder from filling with fluid and causing the sensation of needing to pee often.

Of course, nothing is ever perfectly compartmentalized. By this I mean that our bodies function as a whole unit from head to toe. It is extremely important to first recognize that just because the commercials say that “pee happens” doesn’t mean it needs to happen TO YOU. It is also important to have a candid conversation with your doctor or medical specialist to rule out any serious medical problems that may be causing urine leakage and to discuss conservative options, such as pelvic floor physical therapy, to actually take control of your symptoms. Ask your physician about being evaluated by a pelvic floor or women’s health physical therapist who can perform an assessment of your pelvic floor, hip, & abdominal musculature in order to provide you with the help you need to be leakage-free and worry-free.

Many individuals with pelvic floor dysfunction have great success with pelvic floor rehabilitation and physical therapy. You may not necessarily need to live with the cost of medications, adult pads and diapers, and the embarrassment of urinary leakage.

Contact us today to set up an appointment or to speak with our physical therapist to find out how we can help!

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