Are you experiencing bladder leakage? Have you tried kegels exercises, but are not noticing any improvement in your bladder leakage?
Many of our patients ask when they come to see us… “aren’t you just going to teach me how to do Kegel exercises? I have already been doing those exercise and they are not helping. I am still leaking so what are you going to tell me that’s different.”
I am going to give you 3 reasons why Kegel exercises may not be helping your bladder leakage.
First, a brief explanation:
A Kegel exercise is the Layman’s term for a contraction of the pelvic floor muscle. When our pelvic floor muscles contract, they lift up and into our body and they close off around the urethra, vagina, and anus preventing pee and poop from coming out. These muscles are working all day for us but they need to work extra hard in situations where there’s more the load through the pelvis such as when we cough, laugh, sneeze, jump, run, or lift. Therefore, if a person is experiencing bladder leakage, they are told by their doctor, or they read in a magazine that they should be doing Kegel exercises to stop the leakage.
You maybe doing the exercise incorrectly. Research studies have shown that of women who are told to do Kegel exercises, about 40% of them are doing the exercise wrong. They think they are contracting the pelvic floor muscles but they may actually be pushing out on the muscles instead or using all together different muscles.
Your pelvic floor muscles might be too tight instead of too weak. A tight, tense muscle is not a muscle that does its job effectively. A muscle needs to be able to contract relax and move. Some women keep their pelvic floor tight all day long and they do not even realize that they are doing it. If the pelvic floor muscles are already too tight, doing more Kegel Exercises, tensing the muscle more isn’t going to help. You need to first learn to relax the pelvic floor and teach it how to move better before you can strengthen it.
Your leakage might not be a strength issue at all. It might be a timing issue. You may not be recruiting the muscles at the right time. You may need to work with someone to help you figure out how to get the pelvic floor muscles to contract at the right time. Many women can do Kegel exercises just fine when they are laying down or sitting still, but when they have to coordinate them with other movements the timing goes out the door.
So if you are experiencing bladder leakage and have tried Kegel exercises and they don’t seem to be working, it may be time to partner with a pelvic health physical therapist to help you figure out the root cause of your leakage and get you on the right path to dry days.
In our last blog post we discussed the 10 sign that you may have pelvic floor dysfunction.
If you missed that post, CLICK HERE to read it.
Did you answer YES to any of the 10 signs in our last post? Are you wondering what you can do about it? Read on…
5 things you can do today to help pelvic floor dysfunction
- Learn to kegel. A “kegel” is a contraction or squeezing of the pelvic floor muscles. Try to contract your pelvic floor muscles as if you are trying to stop the flow of urine or hold back gas. If you can feel a squeezing sensation or successfully stop a flow of urine, then you are likely able to kegel. If you cannot kegel or aren’t sure if you are doing a kegel correctly, a pelvic physical therapist can help assess your kegel and then teach you how to properly contract your pelvic floor muscles. It is worth saying that it’s not all about squeezing your pelvic floor muscles or kegeling! The pelvic floor muscles need to be able to relax too.
- Avoid bladder irritants such as caffeine, alcohol, fried foods, citrus fruits and fruit juices, spicy foods, tomatoes and tomato based products, and/or artificial sweeteners. Once you have eliminated the potential irritants for a couple weeks, you can try to add them back in one by one to tease out which substance seems to have the most effect on your symptoms.
- Avoid constipation and straining. Keeping your stools soft through a diet rich in fiber and plenty of fluids (ideally water) will reduce the strain and stress placed on the pelvic floor. Tools such as the “squatty potty” can position you properly to further reduce the strain on the pelvic floor making bowel movements easier. Pelvic physical therapy can also be helpful in teaching you how to properly relax your pelvic floor muscles to reduce constipation or straining with bowel movement.
- Breathe! A few repetitions of deep belly or diaphragmatic breathing throughout the day can help pelvic floor dysfunction. When you breathe diaphragmatically, as you inhale your diaphragm moves down and your belly expands, and as you exhale your belly retracts and your diaphragm goes back up. Deep breathing helps calm the nervous system and reduce urgency and pain symptoms. Not sure how to belly breathe? Pelvic physical therapists can teach you the proper technique.
- If you think you have a pelvic floor dysfunction, the best thing you can do is to have an evaluation done by a trained pelvic floor physical therapist. In your evaluation, you and the pelvic physical therapist will discuss what your symptoms and goals are; the therapist will perform an evaluation to determine the source of your problem; and you will decide together what the best treatment plan for you will be.
It is our mission at Legacy Physical Therapy to help people overcome pelvic floor dysfunction. We would be honored to partner with you in your care. If you are wondering if you are dealing with pelvic floor dysfunction and you would like to talk with one of our talented pelvic physical therapists, you can email or call us at 636-225-3649 to set up a free discovery session.
“Pelvic floor dysfunction, what’s that? I have never heard of pelvic floor dysfunction. Sure I have had a few kids, but I doubt that I have any pelvic issues. Pelvic issues only happen to little old ladies, not me”
Does this sound like what is running through your head right now? You are not alone. Many women suffer from pelvic floor dysfunction, but are unaware that the symptoms they are experiencing are related to their pelvic floor.
Have you ever experienced any of the follow?
- Bladder Leakage– Whether it be a small drop with a sneeze or a complete loss of urine while on the way to the restroom, bladder leakage is NOT NORMAL. However it is common. One in three women will experience bladder leakage in their lifetime.
- Urgency and Frequency– Do you know where all the bathrooms are in town? Do you urinate more than 7 times a day? Do you constantly feel like you need to pee? Are you getting up at night to pee? If you answered YES to any of these then you are probably dealing with urgency, frequency, and pelvic floor dysfunction.
- Fecal Incontinence– This can come in many forms: inability to control gas, staining or smearing on the underwear, fecal urgency, or complete loss of stool.
- Bladder pain or Burning with Urination– Many women think that they are dealing with frequent recurrent UTIs and subject themselves to countless rounds of anti-biotics only to have the symptoms not go away. The missing factor may be pelvic floor dysfunction.
- Constipation and/or Straining to Have Bowel Movement– We are designed to push to have a bowel movement, but not to strain. Our pelvic floor needs to relax appropriately to let the bowel movement pass We should be having regular bowel movements that are the consistency of soft log.
- Pain with Sex, Tampon Use, or Gynecological Examination– These things are not supposed to be painful. Too many women, “grin and bear it” thinking that pain with sex is just part of it. I am here to tell you that it is NOT!
- Vaginal Heaviness, Bulging, or Feeling of Falling Out– These symptoms are common signs of a pelvic organ prolapse, where one or more of the pelvic organs starts to push into the vaginal canal and cause these symptoms. TOO MANY WOMEN are told that these symptoms are normal after having children and they just need to live with it until the symptoms are bothersome enough that surgery is needed. This is NOT THE CASE for many women. By identifying and working to rehabilitate their pelvic floor dysfunction, many women can alleviate these symptoms.
- Low Back Pain, Abdominal Pain, or Pelvic Pain– Many women are surprised to learn that their low back pain may be caused by pelvic floor dysfunction. The pelvic floor is part of our core support system, so if it is not working appropriately then we can get extra stress and strain on our low back, abdominals, or hips.
- Difficulty Starting Urine Stream or a Hesitant Urine Stream– We were not designed to push to pee, but many women feel like they need to push to get the urine to come out.
- Inability to ‘Kegel’– A kegel exercise is the generic name for a pelvic floor muscle contraction. Contracting the pelvic floor prevents urine or feces from escaping. Research has shown that over 40% of women think they are doing a Kegel exercise correctly, but they are not.
If you answered YES to any of the above then you may have pelvic floor dysfunction. The National Institutes of Health found that pelvic floor disorders affect 10% of women ages 20-39; 27% of women ages 40-59, 37% of women ages 60-79 and nearly 50% of women over 80.
If you have experienced any of the 10 signs listed above you are a perfect candidate to explore the possibility of your pelvic floor being the cause or a contributing factor.
Remember there are treatment options for you! Don’t suffer and compromise your quality of life when the treatment is so easy! If you believe you or someone you know may be dealing with
pelvic floor dysfunction, call our office at 636-225-3649 and
we will help you determine your best treatment options.