“Requiring disposable underwear as I age is my personal goal,” said no one ever!
No one ever set a goal to go to a nursing home either! Just sayin’.
Kegel Is Just the Beginning of the Story
Many have heard of Kegel exercises. The main premise of performing Kegel exercises is to consciously squeeze your “bathroom” muscles with the intention of strengthening the sphincter muscles, so unwanted urine leakage doesn’t happen. We must be thankful to Dr. Arnold Kegel for bringing much-needed attention to this very private issue that impacts countless lives; yet, these exercises are just the beginning of the story.Your Pelvic Floor Is More Than a Sphincter
A healthy pelvic floor is designed to successfully support the organs positioned above it (bladder, prostate for men, uterus for women, and bowel). A healthy pelvic floor will support a full, heavy bladder without leaking, even when there is no bathroom in sight. The major player providing this support is the levator ani muscle group, which is made up of the puborectalis, pubococcygeus, and iliococcygeus. This muscle group is designed to provide a force forward and upward to support those organs. I won’t veer off into the topic of organ prolapse but know this issue is often created by the same impairment, weak pelvic floor muscles.The main reason Kegel exercises fail to fully restore strength to the pelvic floor is because you can’t think about squeezing your levator ani muscle and improve its ability to support all those organs including a full, heavy bladder. It is designed to work subconsciously, without thinking about it.
The bottom line is you can consciously squeeze your external sphincter till the cows come home but if your levator ani muscle isn’t strong enough to support the weight of your bladder as it fills with urine, you will be buying disposable underwear.
If you look at the muscles in the pelvic floor, you will see the levator ani is connected to a hip muscle called the obturator internus. When it comes to human function, everything is connected to everything else. This hip muscle isn’t just responsible for rotating your leg and helping to stabilize your hip joint, but it also stimulates levator ani activity.
Guess what happens if your hips weaken due to injury, or being non-weightbearing from a knee or ankle issue, or from years of prolonged sitting? Your obturator internus stops stimulating your levator ani muscle, and strength in the pelvic floor decreases slowly and steadily. Then one day, without warning, you cough or sneeze or jump down a step and wham—you leak. Or one day, you feel the urge to go to the bathroom and shockingly leak on the way there.
The best exercise to stimulate and strengthen the levator ani muscles is to work the hip rotation muscles in weight bearing. That weight can be your own body. Weight bearing allows you to benefit from something called ground reaction force and gravity as you naturally restore strength in the levator ani muscles. When doing the right training for these muscles, improvements are often seen in just a few weeks. Since the pelvic floor is an important part of the pelvic core, sports performance is also enhanced with this type of focused training.
Of course, it is always a good idea to seek out an expert to be sure you don’t hurt yourself or aggravate an existing condition before embarking on a new exercise routine.
- Is natural. We don’t lay on a table (as many do with Kegel exercises) when we live real life. We walk, run, climb stairs, and get in and out of cars, etc.
- Complies with gravity and ground reaction force. These forces are what work to stimulate healthy muscle function.
- Leverages mass and momentum. Neglecting this will inhibit success.
- Trains the body in three planes. We move forward and back, side to side, and turn right and left. Training in just one plane breeds failure.
- Elicits a reaction. Muscle reaction to motion is more important than creating said motion.
- Facilitates joint proprioceptors, which tell the brain how your body is moving. Moving more body parts enhances this, sitting or standing still inhibits this as your proprioceptors are concentrated in your joints.
- Creates subconscious reactions. Muscles need to be able to react properly without the need for conscious thought.
- Promotes transformation versus stagnation. Muscles must adapt specifically to opposed demand.
- Enables mobility and stability. Muscles must provide both strength and control of motion.
- Provides success, internal locus of control, and relevance. Achieving steady progress, gaining control of the issue, and knowing the work being done is relevant to the problem brings joy to life.
Hopefully, you now understand incontinence isn’t an age-related issue; it’s a mobility and functional strength issue. Medical interventions may address some of the symptoms, but they don’t restore proper strength to the pelvic floor. Thankfully, the right training can.