April 27, 2018
Why Kegel exercises are NOT the solution to recovery of continence after prostate surgery
The idea that Kegel exercises are “the” solution to the incontinence problem is fundamentally flawed. It assumes that the stronger you make your pelvic floor muscles the better your continence gets. But this is a trap. It then implies that one has to keep doing pelvic floor exercises for the whole of one’s life, otherwise incontinence will come back again.
This is an extremely inefficient “solution”.
Instead, we need to retrain the entire muskulo-skeletal and neurological system to take on new responsibilities. We need to challenge the entire abdomen and related area to learn new way of functioniong. When the entire abdominal area reprograms itself to take on new responsibilities, we will not need to undertake any more special exercises.
This is somewhat like the child who has to learn how to become continent. The child merely pays attention to the relevant muscles and over the course of a few months becomes continent. We do not tell the child to keep exercising specific muscles. Likewise, when we do this properly, there is no need to exercise or strengthen a specific muscle after that.
I gave up Kegel exercises for roughly after the first 4 months after I realised that this was not the kind of thing I wanted to achieve. I wanted to lead my normal life without thinking about my pelvic floor.
One of my physios, Terry, showed me why retraining is important. I extrapolated and almost completely dropped all kegel exercises as soon as possible after I started jogging downhill.
So far I find that this hypothesis is correct, because I have seen continuous improvement incontinence regardless of the fact that I am no longer doing any Kegel exercises.