Bladder and pelvic health
Over time, childbirth, repeated heavy lifting, or even chronic constipation can cause your bladder and pelvic floor to change or weaken.
Common bladder and pelvic floor conditions include:
- Urinary incontinence: not being able to control urine
- Fecal incontinence: not being able to control stool
- Pelvic organ prolapse: when the pelvic organ(s) drop from their normal position
- Other bladder disorders
Many women share these symptoms, but may find it too embarrassing to seek help or even talk about them. We encourage you not to suffer in silence. Your urogynecology team understands how these symptoms can affect your physical and emotional well-being. We are experts in helping you to improve your symptoms and quality of life.
To find:
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Information about a provider is provided to us by the provider or the provider’s network, or is obtained as part of the credentialing process. Board certification may not reflect contracted services available from providers listed in our directory. If you have questions regarding this or about any of our providers, call us at 1-800-611-1811 (toll free). For the hearing and speech impaired: 1-888-865-5813 or 711 (TTY). You can also call the Georgia Composite Medical Board at (404) 656-3913, or visit their website.
Overview
Kegel exercises make your pelvic floor muscles stronger. These muscles control your urine flow and help hold your pelvic organs in place.
Doctors often prescribe Kegels for:
- Stress incontinence.
- This means leaking urine when you laugh, cough, sneeze, jog, or lift something heavy.
- Urge incontinence.
- This is a need to urinate that is so strong you can’t reach the toilet in time.
- Pelvic floor weakness.
- Age, being overweight, pregnancy, childbirth, and surgery are all things that can weaken pelvic floor muscles. And that can cause urine control problems. It can also result in
uterine prolapse
. Doing daily Kegels during and after pregnancy may prevent or help treat prolapse.
- Age, being overweight, pregnancy, childbirth, and surgery are all things that can weaken pelvic floor muscles. And that can cause urine control problems. It can also result in
How to do Kegel exercises
Kegels are easy to do and can be done anywhere without anyone knowing.
- Squeeze your muscles as if you were trying not to pass gas. Or squeeze your muscles as if you were stopping the flow of urine.
- Hold the squeeze for 3 seconds. Then relax for 5 to 10 seconds.
Your belly, legs, and buttocks shouldn’t move.
- Add 1 second each week until you are able to squeeze for 10 seconds each time.
- Repeat this exercise 10 times per session.
Try to do 3 to 8 sessions a day.
If doing these exercises causes pain, stop doing them and talk with your doctor.
- Don’t make it a practice to do Kegels while urinating.
Over time, doing this could hurt your bladder.
Kegels work best when done on a regular schedule.
Your doctor may want you to try doing Kegels with biofeedback. It lets you to see, feel, or hear when an exercise is being done correctly.
What to Expect
At the First Appointment
Like many patients, you may be nervous or anxious when beginning therapy. At the first appointment, your therapist will explain what therapy entails and address all your concerns and questions. The appointment is in a private treatment room; therapy will not begin until you are comfortable and ready to begin. “Many women are familiar with physical therapy, so we explain how this treatment is still physical therapy — just for a different part of the body,” Sydnor said. You should be encouraged to ask questions, and your therapist should take time to answer them.
During Treatment
Like many outpatient therapies, physical therapy for the pelvic floor includes exercises, manual techniques and movement coordination. However, incorporating electronic therapies can also be helpful. One therapy is biofeedback, in which small, painless electrodes are applied to the area being treated; this could be the perianal, genital or rectal area. For many patients, biofeedback can be a very effective way to improve bladder function.
When necessary, your therapist may need to do an internal exam. Although it can be uncomfortable, it’s an important part of the appointment. “Imagine you go to a therapist for a shoulder injury,” Sydnor said. “If they ask you questions but never actually look at your shoulder, that would be weird. To know how your pelvic floor is working, we need to be able to see it and assess it to give you a correct and safe physical therapy diagnosis.”
Length of Treatment
One visit per week for eight weeks is a common scenario for pelvic floor physical therapy. However, the length of treatment will vary depending on the diagnosis, severity of the dysfunction and your individual goals. The goal of any therapy is to help you return to your ideal level of function so you can enjoy a more active, independent lifestyle.
Kegel Tips and Other Exercises
As a pelvic floor physical therapy patient, you’ll be prescribed an individualized home exercise program based on the physical activities you enjoy: low impact walking, biking or swimming. Another familiar exercise is the Kegel, pioneered by gynecologist Dr. Arnold Kegel in the 1940s. Although many patients are familiar with Kegel exercises, Sydnor said they are often performed incorrectly.
“People tend to squeeze way too hard when doing a Kegel,” Sydnor said. “Never do a Kegel while actually urinating, and never hold your breath while doing a Kegel. Do the Kegel contraction gently while breathing out slowly.” She offers these tips on how to perform a Kegel exercise properly.
Pelvic Floor Physical Therapy Results
After pelvic floor therapy, you may be able to enjoy results like:
- Returning to a favorite sport
- Getting through the day without incontinence
- Being able to start a family
Before any of these things are possible, it’s important to reject the idea that your problem doesn’t matter. “I think many women minimize their symptoms as normal,” Sydnor said. “They think, ‘It’s normal to leak urine,’ or ‘pain during intercourse is normal,’ or ‘I did just have a baby’.” With the right treatment and support, problems like these can be corrected.
You’re not alone in the struggle for better pelvic health. Meet women of all ages at Monday Night Out: Support and Solutions for Women’s Pelvic Health, a weekly support group.
Within several visits, patients should start to notice improvement. If you don’t notice any changes, adjustments can be made during a re-assessment appointment. “Recovery is a process and occurs at a different speed for each person,” Sydnor said. “We recommend having a conversation with your therapist regarding gains and setbacks.” After reaching your goals, it is recommended that you check in with your therapist annually or semi-annually.
How to Get Pelvic Floor Physical Therapy
To start pelvic floor physical therapy, you’ll need a physician referral. For women, many referrals come from a specialist in urogynecology or OB-GYN. For men, referrals often come from urology or a physician providing post-prostate surgery care. Primary care providers may also refer patients to this treatment.
To begin pelvic floor physical therapy for a specific condition, request a referral from your primary care provider, or from your OB-GYN, urologist or urogynecologist.
This article is published by Loma Linda University Health to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician.
