Exercise and Pelvic Floor Dysfunction

(Nanci’s aside: Please note, if you have pelvic floor muscles that are hypertonic, hypotonic, have fascial adhesion's between the muscles and other pelvic structures, edema, scar tissue and other soft tissues issues, then the Kegel exercises might not work completely.  Why?  Because if you cannot contract and relax the muscle due to restrictions, inability to connect with due to nervous system issues or somato-emotional blockages, and other pelvic region distress, then you cannot perform the exercise.  So the Kegel exercise works great for muscles that you can contract and relax.  This is why your own self massage or Holistic Pelvic Care bodywork, physical therapy (which can include biofeedback and other forms of manual applications) is so important: this type of attention can help to free the restrictions and blockages that keep the muscles from being able to be used and the organs from functioning properly. For somato-emotional blockages, mind-body meditation, movement and qigong coaching is incredibly helpful.  )

Both articles Below are from the Cleveland Clinic Foundation, with links attached:

What are Kegel exercises?

Kegel exercises (also called pelvic floor exercises) are done to strengthen muscles of the pelvic floor. Kegel exercises not only can help prevent urine leakage, but can be helpful for accidental passing of stool or gas, and may even help to improve orgasm. Keeping these muscles 'fit,' helps keep the uterus, urethra (tube that carries the urine from the bladder to the outside of the body), and bowel from sagging down into the vagina. If this happens, the condition is called pelvic organ prolapse.

What happens if pelvic organ prolapse does occur?

Urine and stool (feces) can both leak out (conditions called urinary incontinence and fecal incontinence, respectively). Loss of sexual sensitivity in the vagina can also occur.

What causes pelvic organ prolapse to develop in the first place?

Any health conditions that put stress on the muscles of the pelvic floor, causing them to weaken, can lead to pelvic organ prolapse. These include:

  • Pregnancy and vaginal child birth.
  • Being overweight/weight gain.
  • Surgery in the pelvic area – including cesarean section (“C-section”).
  • Genetics – some people are born with a higher risk than others to develop weakness in the tissues that support the muscles of the pelvic floor.
  • Natural aging process – the muscles of the pelvic floor, as well as muscles in the rectum and anus, naturally weaken with age. Loss of estrogen also weakens muscles in this area.
  • Frequent bouts of sneezing, coughing, laughing
  • Exercises (especially jumping, running and other ‘jarring’ exercises; heavy weight lifting); and contact sports.

How do I find my pelvic floor muscles?  It’s pretty simple:

Try stopping the flow of your urine when you are sitting on the toilet. Only do this until you learn how it feels (otherwise this stopping and starting of urine flow can lead to other health problems). You can also insert a finger into your vagina and squeeze the muscles in your vagina around it. You should feel pressure around your finger. The muscles you feel ‘lifting’ inside of you when you are trying these activities are the same ones you strengthen during Kegel exercises.

How do I perform Kegel exercises?

Kegel exercises consist of lifting and holding and then relaxing the pelvic floor muscles. Start by doing a small number of exercises (ie, lifts/squeezes, holds, and relaxes) over a short period of time, then gradually increase both the length of time and the number of exercises you are doing in each ‘session’ (which is called a set). You should perform at least two sets of the exercises a day.

Start by lifting and holding for 3 seconds then relaxing for 3 seconds. Repeat this 10 times in a row – this would be one set. (If 10 times in a row is too high to start with, reduce this number.) Do this set of exercises at least twice a day. As you improve, increase all of these numbers. In other words, increase the length of time you are lifting, holding and relaxing; the number of exercises making up a set and the number times per day you are doing these exercises. For example, instead of holding for 3 seconds and relaxing for 3 seconds, hold and relax for 4 seconds each, then up to 5 seconds each. Increase the number of exercises in a set to 10 in a row (if not already there). Finally, increase the number of times you do these exercises from twice a day to three times a day.

Biofeedback and other techniques.  (Please read further down my page for specific tools offering and more on this)

For women who have trouble doing Kegel exercises, two techniques can help – biofeedback training and electric stimulation of the pelvic floor muscles. Biofeedback is done to help determine if the correct muscles are being squeezed; electrical stimulation recreates the sensation of what a properly done Kegel exercise should feel like.

Biofeedback training (done by a health care professional) involves inserting a probe into the vagina. When instructed to perform a Kegel exercise, a monitor shows if the correct muscles are being squeezed.

With electrical stimulation, the pelvic floor muscles are touched with a small, painless amount of electric current. This causes these muscles to squeeze. This sensation mimics what a Kegel muscle exercise should feel like if done properly.

Kegel Exercise Tips (Please see some youtube video offerings further down my page)

  • You can do the Kegel exercises lying down or while sitting or standing. If your pelvic muscles are weak, you may want to do them laying down at first. A few minutes in the morning and again before bedtime are good times to start the exercise program.
  • When starting out, only do the number of Kegel exercises that are fairly easy for you to do (eg, 5 Kegels for 3 seconds each twice a day). Slowly increase these numbers as you gain strength and endurance.
  • Do not hold your breath while doing the exercises – breathe out. Also, be careful not to bear down or squeeze the muscles of your inner thighs, back, buttocks, or stomach. Squeezing these muscles means you are not doing the exercise correctly.
  • There’s no need to purchase “Kegel muscle strengthening” equipment. Although it may help, some equipment may not work as advertised.

When can I expect to see improvement?

Most women say they notice less urine leakage within 12 weeks after starting – and sticking with – a Kegel exercise routine.

Did you know that Kegel exercises are also helpful for men?

It’s true. Men with certain health and sexual health issues can also benefit from doing Kegel exercises. In men, these exercises can:

  • Help improve incontinence (depending on the cause)
  • Help manage prostate pain and swelling that occurs with prostatitis and benign prostatic hyperplasia (BPH)
  • Increase men’s sexual pleasure through greater control of ejaculation and improved orgasm sensation

© 1995-2010 The Cleveland Clinic Foundation. All rights reserved. This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/28/2010…#14611


Pelvic Floor Dysfunction

The pelvic floor is a group of muscles in your pelvic area. These muscles support the organs in your pelvis like a sling. The organs in this area include the bladder, uterus (women), prostate (men), and rectum (the area at the end of the large intestine where your body stores solid waste). By contracting and relaxing these muscles, you control your bowel and bladder movements.

What is pelvic floor dysfunction?

When you are unable to control the muscles in your pelvic floor to have a bowel movement, it is called pelvic floor dysfunction. People with pelvic floor dysfunction contract these muscles rather than relax them. Because of this, they cannot have a bowel movement, or they have an incomplete one.

What causes pelvic floor dysfunction?

Most of the causes of pelvic floor dysfunction are unknown. Traumatic injuries to the pelvic area, such as in an accident, and complications from vaginal childbirth can contribute to this condition.

What are the symptoms of pelvic floor dysfunction?

Several symptoms may suggest pelvic floor dysfunction. If you have any of these, you should discuss them with your physician. Some symptoms may also indicate other conditions, but a complete physical exam should be able to determine what is causing your symptoms.

Symptoms of pelvic floor dysfunction include:

  • The feeling that you need to have several bowel movements during a short period of time.
  • The feeling that you cannot complete a bowel movement.
  • Constipation or straining pain with bowel movements.
  • A frequent need to urinate. When you do go, you may stop and start many times.
  • Painful urination.
  • Pain in your lower back that cannot be explained by other causes.
  • Ongoing pain in your pelvic region, genitals, or rectum.
  • Pain for women during intercourse.

How is pelvic floor dysfunction diagnosed?

Your physician will begin your exam by asking about your symptoms and taking a careful history. Questions he or she may ask include:

  • Do you have a history of urinary tract infections?
  • Have you given birth to a child?
  • Do you have interstitial cystitis (a long-term inflammation of the bladder wall) or irritable bowel syndrome (a disorder of disorder of the lower intestinal tract)?
  • Do you have pain with intercourse?

Next, he or she will do a physical examination to evaluate your ability to control your pelvic floor muscles. Using his or her hands, the doctor will check for muscle spasms, muscle knots, or muscle weakness.

Your physician may also test your pelvic muscle control by placing surface electrodes (self-adhesive pads) on the perineum (the area between the vagina and rectum in women, and between the testicles and rectum in men) or sacrum (the triangular bone at the base of your spine). A small device called a perineometer may also be placed into the rectum or vagina to test your muscle control.

How is pelvic floor dysfunction treated?

Pelvic floor dysfunction can often be successfully treated without surgery. Treatments for pelvic floor dysfunction include:

  • Biofeedback. The most common treatment for pelvic floor dysfunction is biofeedback, done with the help of a physical therapist. This non-painful, non-surgical technique provides improvement in more than 75% of people with pelvic floor dysfunction.
    Physical therapists may take several approaches to biofeedback. These include using special sensors and video to monitor the pelvic floor muscles as the patient attempts to relax or contract them. The therapist then provides feedback and works with the patient on improving their muscle coordination.
  • Medication. In some cases, your physician may prescribe a low-dose muscle relaxant to deal with pelvic floor dysfunction.
  • Relaxation techniques. Your physician or physical therapist may recommend relaxation techniques such as warm baths, yoga, and exercises.
  • Surgery. If your physician determines your pelvic floor dysfunction is the result of a rectal prolapse or rectocele, surgery may be necessary. A rectal prolapse is when the tissue that lines the rectum falls down into the anal opening. A rectocele occurs in women when the end of the rectum pushes through the wall of the vagina. By using the defecating proctogram test, your physician should be able to determine if these conditions are causing your pelvic floor dysfunction.

Pelvic floor dysfunction is a very treatable condition, usually though the use of biofeedback and physical therapy. Seeing your physician if you have any symptoms of pelvic floor dysfunction can provide treatment for this often debilitating condition and improve your quality of life.


© Copyright 1995-2014 The Cleveland Clinic Foundation. All rights reserved. This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 2/14/2014…#14459 http://my.clevelandclinic.org/disorders/pelvic_disorders/hic_pelvic_floor_dysfunction.aspx