Feel like your bladder and bowel are out of control? Women’s health specialist Kappu Raghunathan explains pelvic floor muscle dysfunction and how you can treat it.
By Kappu Raghunathan
What are pelvic floor muscles?
Pelvic floor muscles are a group of muscles that stretch between the pubic bone in the front and the coccyx in the back. It is shaped like a hammock and supports the uterus and all the other pelvic organs. It has three major openings through which the urethra (urine passage), anus (bowel) and vagina pass.
Causes of Weakness: Childbirth, major abdominal surgeries, menopause or hormonal changes, persistent constipation and excessive coughing.
Signs and Symptoms
Stress incontinence: Loss of bladder control when you run, jump, cough or sneeze
Urge incontinence: Frequent trips to the bathroom.
Mixed incontinence: A combination of both stress and urge incontinence.
Pelvic organ prolapse: A feeling that the bottom is falling out.
When do I seek medical attention?
If you experience any of the above symptoms, it is imperative that you see your doctor or women’s health specialist.
How do I find the pelvic floor muscle?
Try the Stop Urine Test. When urinating, attempt to slow the flow of urine. If you can stop it or at least deflect or slow down the stream, you have found the pelvic floor muscles. Note: Do not use this as an exercise.
How do I strengthen the pelvic floor muscles?
It is always better to start the exercises lying on your back, with knees bent. Close your eyes and imagine what muscles you would tighten to prevent passing gas or hold your urine. If you are unable to feel or identify, consult a pelvic floor therapist.
If you can identify them, tighten and hold it for 3-5 seconds and relax slowly. Rest 5 seconds. Repeat this around 10 times, and you should feel a contraction and relaxation. You can gradually increase the hold time up to 8-10 seconds but not more than that, and this can take several months to achieve. Make sure the rest period is the same as the hold time. This exercise improves the endurance and allows you to strengthen the slow long hold fibers that help control urine leakage.
It is important to also perform quick contractions or “quick flicks.” Squeeze your pelvic floor for 1 second and rest for 5 seconds for 25 repetitions around lunch time. This exercise focuses on your fast twitch muscle fibers that catch your urine when you cough, sneeze or laugh. Therefore, it is useful to contract the pelvic floor during exhalation, which occurs when you cough, sneeze and laugh.
Your Program for Success
|20 10-second squeeze with 10-second rest in the morning|
|25 1-second squeeze with 5-second rest at lunch|
|20 10-second squeeze with 10-second rest in the evening|
|65 total contractions a day of sustained and quick contractions|
Tips to Prevent Incontinence
- Avoid constipation. Eat a diet rich in fiber and drink plenty of water.
- Avoid weight gain.
- Do not consume too much of caffeine.
- Prepartum and postpartum pelvic floor assessment and exercises (after 6 weeks).
- Pelvic floor assessment and exercises following major abdominal surgery (usually after 6-8 weeks).
Incontinence is 100 percent reversible most of the time. Do not hesitate to seek assistance from your women’s health provider.
Kappu Raghunathan is a physical therapist and co-founder of Mi Therapy Clinic in Southfield. She is also a vestibular therapist who treats clients who suffer from vertigo. Kappu is a member of the MI Physical Therapy Association and American Physical Therapy Association. She is also the founder of Detroit Duchess Club, which is a nonprofit ladies club empowering women in Metro Detroit.