What is the pelvic floor?
LESSON 1: URINARY INCONTINENCE
Urinary incontinence is an accidental loss of urine. About 50% of all people have urinary incontinence. Urinary incontinence although common is not normal. Urinary incontinence can be "cured” with bladder training exercises.
There are 4 main types of urinary incontinence.
1-Stress Urinary Incontinence-this is when urine leakages with extra pressure or stress on the bladder, such as with a laugh, cough or sneeze.
2-Urge Incontinence- this is when you get a sudden urge to urinate that is beyond your control to hold, often happens when you get home and put the "key in the door”.
3-Functional Incontinence-this is when your body or mind does not allow you to get to the bathroom in time, such as from a mobility impairment.
4- Mixed Incontinence -is when more than one type of incontinence is present i.e. urge and stress incontinence.
Other common bladder conditions are overactive bladder and urinary frequency. Overactive bladder is having a strong urge to urinate, incomplete bladder emptying and urinary frequency which contributes to urine leakage. Urinary frequency is having to go to the bathroom more than 1 time in 2 hours.
Bladder Control Tips
Having a voiding diary gives insight to how frequently you are going to the bathroom and what may be causing you to leak.
Keep a log for 3 days. Consider sharing with your health care provider.
Voiding Log PDF
Try to wait 2-4hr in-between trips to the bathroom. If waiting 2 hrs is difficult, start by adding 15 minutes to your current habit i.e if you go every hour, try to go every 1 hr and 15 minutes, then 1hr and 30 minutes for the next few days, progress to 1hr and 45 minutes until you can wait 2-4 hr between trip to the bathroom.
Take a look at the % Daily Value of your vitamins. Aim for no more that 300% on water soluble vitamins i.e Vit C and Vit B etc. Some foods also can irritate the bladder such as artificial sweeteners, caffeine, carbonated beverages, and alcohol.
Fruits and veggies are a win! Managing constipation is important as full bowels prevent proper bladder contraction which leads to incontinence.
To help prevent UTIs consider real cranberry juice, apple cider vinegar, and yogurt.
Lesson 1 Exercise: Diaphragmatic Breathing
Place your hands on your stomach and notice your hands rise as you take a deep breath in, exhale and let a long breath out. Keep your shoulders relaxed. Practice daily for 2-5 minutes.
After you feel comfortable performing diaphragmatic breathing, bring your attention to your pelvic floor muscles and see if you can get some movement. The pelvic floor movement is subtle and similar to gently bearing down as if initiating a bowel movement.
Being able to relax your muscles helps improve bladder control. We perform diaphragmatic breathing as a stretch in order to prepare us for an effective kegel.
LESSON 2: Locating the right muscles
March 2020, 3D medical animation is still shot depicting levator ani its exact position and structure, Creative Commons, accessed 2 June 2020,
Lesson 2 Exercise: Kegels
A word on muscle fiber type: Fast vs. Slow
Our bodies are made up of 2 muscle fiber types from head to toe. Fast twitch-fibers that do not need oxygen and slow twitch-fibers that need oxygen and thus a rich blood supply.
Fast twitch fibers get us across a busy street fast or help us jump, while slow twitch fibers keep us walking long distances.
Our pelvic floor muscles also have fast and slow twitch fibers. 30% of our pelvic floor muscles are made up of fast twitch fibers and 70% are slow twitch.
So what does that mean for you? Well to get dry performing quick kegels all day alone will not work. You need to challenge those slow twitch-fibers that need oxygen. The way you do that is performing the endurance kegel. If you cannot hold a kegel for 10 full seconds, start where you are and add one second per week until you can reach 10 seconds contracting and 10 seconds resting for 10 repetitions three times a day.
Lesson 2 Exercise:
Balance Counter Series 1
Tip: Keep a chair behind you for safety, place your hands on the counter as needed for balance
1- Stand with feet together x 30 sec
2- Stand with feet together and eyes closed x 30 sec
3-Place on foot on top of the other x 30 sec
4-Switch sides and place the other foot on top x 30 sec
5-Place on foot on top of the other and close your eyes x 30 sec
6-Switch sides and place the other foot on top and close your eyes x 30 sec
7-Return to standing with your feet together x 30 sec
5 Abdominal exercise
Aim for 3 sets of 10 repetitions every other day.
There is only so much time in a day and there are so many exercises to do. So your best bet is to do exercises that involve the major muscle groups, we call these multi-joint exercises or compound exercises.
1-Push: do a push up. If you cannot do a full push up, start by doing a pushup standing using a wall.
2-Pull: In your chair grasp your hands and try to pull your hands apart using the force of each hand.
3-Bend: Do a bridge. Start on your back in a comfortable position and lift your butt off the bench.
4-Squat: Have a chair behind you and a table or counter in front of you and slowly lower yourself to the chair and return to standing.
5-Abdominal Exercise: Perform a deep ab contraction and a kegel throughout the exercises above to work on your core.