Incontinence

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KEGELS AND KEGEL BREATHING


            There’s so much controversy over Kegel exercises, do they work or not and what’s the point of doing them if they don’t fix UI (urinary incontinence) or POP (pelvic organ prolapse) issues. I thought I would throw my two cents in for whatever it is worth; every woman needs to make the decision on her own whether or not it is worth investing the effort in either Kegels or Kegel Breathing. I’ll give an explanation of how to do each at the end of this article for those of you who are not sure about Kegel method.

            Part of the issue with Kegels is that we are not looking at this exercise technique from the right angle. The PC muscle is muscle tissue just like any other kind of muscle tissue. There is no point in doing any type of exercise whether strength training external muscles like biceps, quads, or glutes or internal ones like the PC unless you are going to do it properly. Doing Kegels improperly is about as beneficial as going to the fitness club and just standing around looking at the weight machines.

             Kegels or Kegel Breathing should be approached as being helpful and beneficial in your UI/POP maintenance regimen, not as a one stop “fix-it” path. Whether you are in early stages of UI or POP and are trying to avoid surgery or you have already had surgery and have shifted to the maintenance path (seriously, all women who have had surgery for POP should be aware that they should still be doing maintenance, the point of having hip replacement is so you can continue to walk isn’t it?), continuing to do Kegels will certainly not hurt anything. The point is, if they help, even to some little degree, and they are so easy to do, why wouldn’t you want to do them? Even if they don’t fix your UI or POP completely, they will help control that degree of leakage or bulge and wouldn’t you rather leak or bulge a little bit less even though the problem wasn’t fixed completely? Women who are waiting to make the decision whether or not to have surgery should truly want to experiment with what they  can do to make themselves more comfortable.

            On top of the ramble about leakage and bulging is the added benefit of sexual sensation getting bumped up and who doesn’t want that? For women who truly enjoyed their sexual relationship prior to UI/POP, regaining some PC muscle strength has the potential to “bring back that loving feeling”. I can’t begin to tell you how much this benefits  relationships that are suffering from lack of intimacy fueled by sexual pain or lack of sensation. Relationships often shift sideways as a result of bedroom scenarios where you “weren’t that into it” because you’d lost sexual sensation. Since most of us are continuously multi-tasking and are running on empty to begin with, engaging in intimacy when there is no physical satisfaction makes having sex seem like just one more job to do.

            Let’s also talk about the impact being full of poop has on your ability to do Kegels. Seriously. Constipation is an issue that many women with POP have to deal with. For women who have both IBS (irritable bowel syndrome) or other causes of constipation plus incontinence or  the IBS/POP combo (another article is in the works on this combination of health issues), the ability to do Kegels is compromised. When your bowels are full of fecal material, your ability to contract your PC is severely compromised. As a woman with long term IBS issues, believe me when I say that some days it is simply impossible to get much contraction if any at all. It gets a bit frustrating and at times I wonder if I am losing PC contraction strength, but as soon as I have one of those lucky days where everything “comes out alright”, my ability to contract is fully restored. Rest assured ladies, you should continue to do your Kegels even on the days when you feel like nothing is happening.

KEGEL TECHNIQUE

            Here’s a how-to for Kegel exercises; once you have mastered the technique and understand the sensations, you can do them anytime. Your PC  muscle is like a hammock that sits below your pelvic organs. When you stop the flow of pee, this is the muscle you are contracting. Try to empty your bladder if possible prior to doing Kegels. When you are first trying to figure out the proper way to do Kegels, you should do them lying down. Once you have your technique perfected, you can do them anytime, anywhere.

            Take a full breath in and let it out completely; the more you relax prior to doing Kegels, especially when first trying to figure them out, the more you will be in touch with the sensations you experience. Take another full breath in, letting your tummy expand out-this is important. It is natural for most of us to contract our tummies when breathing in and you may need to retrain this habit. As you let the air out, let your tummy go flat and slowly feel the muscle contraction that causes the same sensation as when you stop the flow of pee. Continue to contract slowly, deliberately, visualize that a cord is attached to the inside of your belly button and is pulling inward while you feel the sensation of contraction from within your vaginal area. Try to hold this contraction as tightly as you can for as long as you can; it may only be a very short time initially but your ability to contract should improve as time goes on. Release and repeat 5-10 more times. Do not go beyond 10 contractions, fatiguing your PC muscle will not gain you strength. You can also alternate between sustained contractions and fluttering contractions (contract, release, contract, release) once you have some control in your PC muscle. Once you understand the sensations, you can advance to doing your Kegels at a time and place that is easy for you to remember. Personally I like to  Kegel while stopping at stop signs and stoplights because I am on the road nearly every day. It has become a habit to contract when I roll up to a stop sign, quite subliminal. I also occasionally Kegel using a ceramic egg ,a device for advanced Kegeling. This is one of several types of Kegel devices you can utilize for additional strengthening.  With this device you insert and contract against it, it acts like a weight for more resistance. When your PC is strong enough, you can contract and gently pull a cord that is attached to it for even more resistance training.

KEGEL BREATHING

            With Kegel Breathing, the steps are very basic. This is a technique you can use when you are doing yoga, reiki, pilates or pfilates. You can also use this technique while doing  regular exercise or for that matter whenever the whim strikes you. Simply take in a long, deep, relaxed breath with your belly loose and sticking out, then on the exhale you contract your PC or pelvic floor. Be aware of the sensation, you want to contract as tightly as you can and hold the contraction for as long as you can. That’s it, not much to it! Every time you contract your PC you are helping establish the subliminal habit. Do it often enough and you will do it without conscious thought.

            We all have so  much on our plates today, who has time to put into an extra “workout”? The cool thing about Kegels is you can do them anytime, anywhere; you can adapt the technique to fit your personal needs. You can do them when you are brushing your teeth. (Common now, you know you multi-task all the time!) You can do them when you are pushing a shopping cart at the grocery store. You can do them when you are driving in your car, every time you stop for a stop sign or traffic light, do your Kegels. You can do them when you are riding your lawnmower. You can do them when you are weeding your flower bed. You can do them when you are sitting on the couch watching TV. The list of potential times to do them is endless. It doesn’t matter when you do them, just do them. As you establish the habit to do Kegels in whatever way works best for you, after a very short period of time you will find it becomes more of a subliminal ritual. I say Kegel on!

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