October 21, 2017
Advanced/ dynamic/ integrated Kegel exercises to curb incontinence
These are my notes from my visits to physios and readings. Unfortunately, there is no book available that documents these exercises systematically. Time permitting, I might write a book on this (plus one on RSI and one on eystrain – on which I have had a similar experience that there is lack of systematic information and I’ve had to figure out everything on my own).
NOT use glutes/ abdominal muscles/ anal muscles
The key is to focus on the two urinary muscles and avoid unnecessarily activating the anal muscle.
DYNAMIC EXERCISES IN DIFFERENT POSTURES
Use paper towel in each case to ensure you are do these till the point that you do not leak.
While lying down, pull PFM and take knee to the side, and back.
While sitting, pull PFM and rise, then release
While standing, pull PFM and sit down, then release
While standing, pull PFM then lift legs as if walking
While standing, pull PFM, then bend forward and stop
While standing, pull PFM, then cough
Dynamic Hip Flexor Stretch
Stand in a neutral position with your feet shoulder-width apart and your hands hanging naturally by your side. Lift your right foot off of the ground and take a long step forward coming into a lunge. Hold for one second before carefully coming back to the starting position. Repeat with your left leg forward and then continue alternating legs. Complete this movement for 30 seconds.
Dynamic Side Lunge Stretch
Stand with your feet hip-width apart with your toes pointed directly forward. Bring your hands together in front of your chest. Take a step to the side with your right foot. Once it’s planted, push your hips backward and bend your right knee to 90 degrees. Your left knee should stay straight as you lower into the lunge. Come up out of the lunge and then bring your right foot back to the starting position. Go right into the next repetition, this time stepping to the side with your left foot. Complete this movement for 30 seconds.
With your feet shoulder-width apart, keep your back straight, spine neutral, chest up, and your shoulders square. As you squat down, focus on keeping your knees in line with your feet. Your knees should not move in close to one another nor should they fall out to the sides. Also, you want to make sure that your shins stay as vertical as possible as you lower yourself into the squat position. Try using a chair to help you as you learn the technique. As you get stronger, you can lose the chair and start to go deeper into the squat or start doing them quite a bit faster while maintaining that good posture. Perform 3 sets of 10 repetitions.
With your feet shoulder-width apart, keep your back straight, spine neutral, chest up, and your shoulders square. Step forward with your right foot and bend at your knees until they both make a 90 degree angle and then step back to your starting position. Next, step to the side with your right foot. Once it’s planted, push your hips backward and bend your right knee to 90 degrees. Your left knee should stay straight as you lower into the lunge. Then return to the starting position. Finally, step backwards with your right leg so that your right knee is almost touching the floor and both knees are at a 90 degree angle. Return to the starting position and then repeat on the opposite side. Add speed to the movements in all three directions to advance the exercise. Perform 3 sets of 10 repetitions on each side.
Lie face down on the floor. Place your forearms on the floor, elbows under your shoulders. Place your legs together with balls of your feet on the floor. Lift your body off of the floor maintaining a straight line from your head through your torso to your feet. You don’t want your lower back to drop down or sag, nor do you want your butt to be high up in the air. Remember, a nice straight line. If you notice that your form starts to falter and you aren’t able to maintain the straight line, stop the exercise and rest. Perform 3 sets of holding for 15-20 seconds. Once you are able to hold for 20 seconds without losing form, try to gradually add more time to the exercise.
Keep in mind that proper posture is important with these exercises. Keep your shoulders back, your back straight, and engage your abdominal muscles throughout the exercises by drawing your belly button in toward the spine. Notable changes can be seen when you perform pelvic floor exercises every day. As your symptoms improve, you can begin a maintenance program of three times per week.
Strengthen the core to improve continence