Bladder Control Exercises
In simple terms, bladder control exercises are the exercises used to re-establish control over the involuntary leakage of urine. These exercises are to train or re-educates more than the two “U” shaped detrusor muscles at the neck of the bladder function as a musculature gate (sphincter) that helps closure. These two detrusor muscles work in concert with the many muscles of the pelvic floor to hold the bladder in its natural position as well as the trigonal muscles at the bladder neck and the striated slow-twitch fiber muscles of urogenital sphincter of the urethra which can interrupt the urine stream when the social situation is inappropriate for voiding. In other words, for bladder control exercises to be effective, they must address the many muscles in the pelvis, not just the bladder wall.
Urinary incontinence is not a disease. Urinary incontinence can be a symptom of certain conditions like inactivity of obesity or the result of certain events during a woman’s life, like childbirth or participation in sports with repetitive bouncing (horseback riding or volleyball). Indeed, Chronic repetitive motion and strain on the musculoskeletal structure contribute to the risk for urinary leakage. While a number of studies suggest vaginal deliveries significantly increase the chances of developing urinary incontinence. Nor is urinary incontinence a consequence of aging. Female college athletes experience a substantial rate of incontinence as well as mothers in their 30’s and 40’s. It is estimated that as many as 28% of all varsity college female athletes have some form of incontinence For younger women the cause may be hypertonus, so the ability to learn to relax the muscles of the pelvic floor are just as critical as strengthening.
There are three types of incontinence: urge stress and mixed. Urge is when the bladder muscle spasm creating in sudden need to void. Stress is when the muscles of the pelvic floor slacken causing a shift in the position of the visceral organs putting pressure on the bladder so a sudden movement causes a urine leak. Mixed urinary incontinence is when both types are present. The sudden involuntary loss of urine can be embarrassing sometimes inciting a pervasive fear of judgement by others limiting activity outside the home.
In Europe, pelvic floor muscle tone integral aspect of postpartum care ― in the birthing hospital with a physical therapist. Muscle tone is the key to treating urinary incontinence. Muscle tone achieved by muscle re-education, keeps the visceral organs in place naturally, correcting factors that can cause stress incontinence and keeps the muscles nourished correcting factors that can cause the muscle spasms that cause urge incontinence. There are a number of methods for regaining and maintaining effective muscle tone of the pelvic floor muscles.
Enjoy an orgasm! Yep, The female orgasm is all about pelvic floor muscle tone for continence and the integrity of the musculoskeletal structure – minimizing back, knee and hip/thigh pain. Read about it in the British Peer Review Journal article entitled, “The role of the pelvic floor muscles in the female orgasm.”
Kegels are effective exercises to treat incontinence though they Kegels may be best known for their use to enhance sexual response. Indeed, the muscles that spasmodically contract in orgasm are those toned exercises to treat incontinence. Unfortunately, most women who try to tone their pelvic floor muscles with Kegel exercises find it difficult to determine if they have performed the exercise correctly. As with any exercise, the benefit gained from the exercise is significantly diminished if the Kegel exercise protocol is poorly executed. Steps for proper Kegels follow these few comments on effective exercises to treat incontinence.
Biofeedback devices record muscle activity only. If you are contracting the wrong muscles, like those in your bottom or abdomen, the biofeedback device reports the wrong musculature activity. The time and effort spent following the wrong muscle activity on a biofeedback device can be a virtual waste of your time. If you are already performing the Kegels correctly, why do you need a biofeedback device?
Electronically Controlled Muscle Stimulation:
When we exercise naturally, our mind sends a mild electrical impulse to the muscles to work. E-Muscle Stim differs only in that a device communicates the exact correct instructions to your muscles through your skin. In as little as 20 min a day you can have a comfortable clinically proven effective work-out. These are medical devices that must be FDA Cleared. The Yarlap® is one such device, FDA Cleared for personal use for that “in and up feeling” for effective muscle tone. Plus, the Yarlap® has three preset clinically proven programs for pelvic floor muscle massage. The Yarlap® does all the work for you and allows you to be doing something else, like watching television while working out! You should start to see results in as little as two to three weeks, but outcomes vary from person to person.
Please know that any exercise is only as effective as the protocol you follow. Your doctor may refer you to a continence advisor or physiotherapist for advice on the exercises. They may ask you to do a pelvic floor exercise while they examine you internally, to make sure you are doing them correctly.
Learning exercises to correctly treat incontinence
- Sit in a chair with your knees slightly apart. Squeeze the muscle just above the entrance to the anus. You should feel some movement in the muscle. Don't move your buttocks or legs.
- Now imagine you are passing urine and are trying to stop the stream. You will find yourself using slightly different parts of the pelvic floor muscles to the first exercise (ones nearer the front). These are the pelvic floor muscles you should be strengthening (not the ones near your anus).
- If you are not sure that you are exercising the right muscles, put a finger or two into your vagina. You should feel a gentle squeeze on your finger(s) when doing the exercise. Alternatively, you can use a mirror to check if you are doing the exercises correctly. When you squeeze the correct muscles, in the mirror’s image, the area between your vagina and your anus will appear to move away from the mirror when you squeeze.
Quick Mention: The first few times you try these exercises to treat incontinence, you may find it easier to do them lying down. Now that you have isolated the correct muscles:
Doing the exercises
- Sit, stand or lie with your knees slightly apart. Slowly tighten your pelvic floor muscles under the bladder as hard as you can. Hold to the count of five, then relax. These are called slow pull-ups or long squeezes.
- Then do the same exercise quickly and immediately let go again. These are called fast pull-ups or short squeezes.
- The aim is to do a long squeeze followed by ten short squeezes, and repeat this cycle at least eight to ten times. It should only take about five minutes.
- Perform the above exercises at least three times a day, every day for the rest of your life.
Ideally, do each group of exercises in a different position; sitting, or standing or lying down.
As the muscles become stronger, increase the length of time you hold each slow pull-up or long squeeze.
Remember, do not squeeze other muscles at the same time as you squeeze your pelvic floor muscles. For example, do not use any muscles in your back, thighs, or buttocks.
After several weeks the muscles will start to feel stronger. You may find you can squeeze the pelvic floor muscles for much longer without the muscles feeling tired.
It takes time, constant focus on the correct muscles and practice to become good at these exercises. You should start to see benefits after a few weeks. However, it often takes two to five months for most improvement to occur.