Myth: Doing Kegels is Always the Answer to your Leakage

In theory, it would make sense to do Kegels to decrease incontinence; however, a tight (high-tone or tense) pelvic floor can often be the cause of urine leakage.  Kegels are repeated contractions of the pelvic floor muscles, while urinary incontinence is the loss of bladder control with leakage of urine.

Need a comparison? Let’s compare the pelvic floor muscles to our bicep. If we keep our bicep contracted all day and then ask it to do work (such as pick up our purse) failure will happen, usually showing up as pain or weakness. In the same sense, if we hold our pelvic floor tight at all times and then ask it to do work (support a sneeze, cough or jump) failure will happen resulting in leakage of urine. Healthy pelvic floor muscles are able to relax and stretch as well as shorten and contract to support the bladder and block the urethra to stop leakage. When the muscles are tight they are unable to do their job optimally. If you are continually practicing Kegels, but still experiencing incontinence, one reason may be that your muscles are tight.

So now what do I do if Kegels aren’t the answer?

See a pelvic floor physical therapist! The physical therapist will assess the unique issue and help you understand your pelvic floor better. We want YOU to be in control, NOT your bladder.

                   One exercise your pelvic floor physical therapist will have you try is diaphragmatic breathing. Breathing!? Yes, just breathing! When we inhale our diaphragm drops down and pelvic floor extends, when we exhale our pelvic floor recoils creating a pistoning motion. Breathing with use of our diaphragm helps to decrease a tight and over active pelvic floor, so contracting is possible when needed.

EXERCISE: Diaphragmatic Breathing

Position: Lying on your back or in a tall seated position place hands at base of your rib-cage.

  1. Inhale through your nose filling your abdominal canister from bottom (pelvic floor) to top (lungs).

         Should feel: Belly and back expand and back/rib-cage flare to each side. The pelvic floor expands and opens.

         Should NOT feel: Shoulder’s elevate or neck strain.

  1. Exhale through your mouth-forced (like blowing out candles) emptying your abdominal canister top (lungs) to bottom (pelvic floor).

         Should feel: Abdomen shrink, pelvic floor lift and close

Should NOT feel: abdomen bulge, bottom tuck under and abdominal crunch

*Complete at least two to five minutes per day to reconnect mind to pelvic floor for improved functioning and healing. *

Please note, the diaphragmatic breathing exercises is a beginning exercise. If you are interested in further recovery please call us at 616.827.3010 or email us at receptionist@hjpjysicaltherapy.com to set up a FREE consultation with one of our pelvic floor physical therapists. We will help you learn more about what you can do to get started with physical therapy and how we can help you with pelvic floor issues.

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JoEllen Bender