Incontinence Exercises

We all have an understanding that urinary incontinence is any involuntary leakage of urine. You have no control over it and it happens. What you may not know is that there are three types: urge, stress, and mixed.

Image: Pexels

Image: Pexels

Urge is when the bladder muscle spasm creating in sudden need to pee. 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 leak. Mixed urinary incontinence is when both types are present. While vaginal delivery is one of the highest risk factors, urinary incontinence is not a consequence of aging or of size.  It is estimated that as many as 28% of all varsity college female athletes have some form of incontinence.  Chronic repetitive motion and strain on the musculoskeletal structure contribute to the risk for urinary leakage.

Question: Why is it that in Europe, pelvic floor muscle tone integral aspect of postpartum care in the birthing hospital with a physical therapist.

Answer: 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. 

Ways of Toning Your Pelvic Floor Muscles:

Exercise!  
It is that simple and there are many ways to help you.

Have an orgasm
Yeah, you read that right. Did you know that the female orgasm is all about pelvic floor muscle tone for continence and the integrity of the musculoskeletal structure? In a recent article “The role of the pelvic floor muscles in the female orgasm.”, it was shown that the female orgasm can also minimizing back, knee and hip/thigh pain.

Image: Pexels

Image: Pexels

Kegels
Kegels are an effective exercise to treat incontinence. Their 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. If you do not know how to do them properly, this basically makes the Kegel exercise useless. But that’s where NMES devices come in.

Electronically Controlled Muscle Stimulation
When we exercise naturally, our mind sends a mild electrical impulse to the muscles to work. NMES (or E-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 pre-set 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.

Biofeedback Devices
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.

Weights & Cones
Inserted vaginally, your pelvic floor muscles work to hold the device in place.  Clinical evidence on how well these devices work is scarce.  For adequate exercises to treat incontinence use these devices with Kegels. 

Doing the exercises

  1. 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.
  2. Then do the same exercise quickly and immediately let go again. These are called fast pull-ups or short squeezes.
  3. 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.

Tip: Try to 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.

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.

Charlotte Bee