Kegel exercises, also known as pelvic floor exercises or Kegels, are exercises that can be done to strengthen the muscles situated beneath the bladder, bowel and uterus.
Performing pelvic floor exercises can benefit males and females alike and can be carried out at almost any time. These exercises are of particular benefit to people who are affected by urinary incontinence or bowel problems.
Contents of this article:
What are pelvic floor muscles? Symptoms and causes of dysfunction
How to do pelvic floor exercises
Fast facts on Kegels
Here are some key points about Kegel exercises. More detail and supporting information is in the main article.
Pelvic floor exercises are also known as Kegels
Kegel exercises can be carried out while sitting down, standing up, walking and lying down
Kegels can also be carried out during pregnancy and following childbirth
The pelvic floor is comprised of many different muscles
Symptoms of pelvic floor dysfunction include urinary leakage and difficulty emptying the bowel
The pelvic floor can be weakened by gynecological and prostate surgery
The pelvic floor muscles can also be weakened by chronic sneezing caused by allergies
Performing Kegels while urinating could lead to bladder infection
Kegel exercises may improve sexual performance in males.
What are pelvic floor muscles?
The pelvic floor muscles are a vital set of muscles that assist both men and women maintain urinary and fecal continence, impact orgasm, provide stabilization to connecting joints, aid in pelvic, venous and lymphatic drainage and, when working in conjunction with the abdominal and back muscles, provide spinal stabilization.
In addition to the aforementioned functions, the pelvic floor muscles aid in controlling abdominal pressure during movements that cause a strain – during exercise, for example.
The pelvic floor is comprised of several different muscles:
Bulbocavernosus
Ischiocavernosus
Superficial transverse perineal
External anal sphincter (EAS)
Compressor urethera
Uretrovaginal sphincter
Deep transverse perineal
Levator ani: pubococcygeus (pubovaginalis, puborectalis), iliococcygeus
Coccygeus/ischiococcygeus
Piriformis
Obturator internus.
Symptoms of pelvic floor dysfunction
Fast facts about uterine prolapse
One study found that women in the US have an 11% lifetime risk of uterine prolapse
Women with a high body mass index have an increased risk of uterine prolapse.
Learn more about uterine prolapse
There are a variety of symptoms associated with pelvic floor dysfunction, many of which are vague and associated with other medical conditions.
Symptoms associated with pelvic floor dysfunction include:
Urinary incontinence (leaking) with laughing, coughing, sneezing or exercising
Urinary urgency or frequency
Difficulty with bladder or bowel emptying
Accidental flatulence
Pelvic pain
Painful intercourse
Organ prolapse.
Causes of pelvic floor dysfunction
Pelvic floor dysfunction occurs when the pelvic floor muscles are weakened, stretched or too tight. Pelvic floor muscles can be weak from an early age, gradually weaken over time or be weakened by a single event.
As with many other medical conditions, there are certain situations and conditions which place a person at a higher risk for developing pelvic floor dysfunction.
Pelvic floor dysfunction can result from a variety of factors, ranging from childbirth to chronic sneezing.
Factors that can increase the risk of pelvic floor dysfunction include:
Pregnancy and childbirth
Menopause
Overuse or underuse of the muscle groups
Back pain
Constipation or straining with bowel movements
Being overweight or obese
Heavy lifting
Conditions such as asthma and allergies that cause chronic coughing or sneezing
Injury to the pelvis
Surgery such as gynecological or prostate surgery.
Elite athletes such as runners and gymnasts have an increased risk of pelvic floor dysfunction, as have older individuals as their muscles weaken over time.
How to do Kegels
Both men and women can benefit from performing exercises to work and strengthen the muscles of the pelvic floor. Pelvic floor dysfunction can be greatly improved with regular exercises targeting these muscle groups.
Kegel exercises for females
How to do a proper Kegel is vital to the success of the treatment. These exercises can be done anywhere and at any time and are beneficial in strengthening the muscles of the pelvic floor.
Your health care provider or physical therapist can instruct you on how to perform a proper Kegel while in their office, at which time proper technique can be evaluated. Pelvic floor exercises can also be done during pregnancy and after childbirth.
At times, a technique called biofeedback may be necessary. During biofeedback treatment, a device will monitor proper muscle contraction, the strength of the pelvic floor and timing of Kegels. Biofeedback reinforces proper technique of the exercises.
Kegel exercises can be carried out discreetly in any location; even while at work in an office.
In order to perform a proper Kegel, you will need to:
Relax the abdomen, chest, thighs and buttocks
Tighten the pelvic floor muscles, as if you are attempting to stop urinating, and hold for 5-10 seconds. If you are able to feel an upward movement and tightening of the vagina, anus or bladder, you have successfully completed a Kegel.
Take a 5-10 second break and repeat for three sets, 10 times per day. The ultimate goal is to hold the contraction for 10 seconds each time the exercise is performed.
To be sure you have correctly identified the pelvic floor muscles and performed a Kegel, some women find it helpful to insert a finger into the vagina and perform the Kegel; if performed correctly, the muscles will tighten and move upward.3. Additionally, some women may also benefit from using a weighted vaginal cone, attempting to hold the cone in place within the vagina while performing a Kegel exercise.3,4
It is not advised to frequently perform Kegel exercises when urinating; this technique can increase the risk of incomplete bladder emptying and urinary tract infections.
Additionally, Kegels should be done as recommended; overexercising of the pelvic floor muscles can worsen pelvic floor dysfunction symptoms due to muscle fatigue. Positive results can be expected within a few weeks to months of Kegel exercise practice
Kegel exercises for males
Men are not immune to the effects of a weak pelvic floor and may benefit from performing Kegel exercises. As well as improving bladder and bowel control, pelvic floor exercises may also improve sexual performance.
The surgical removal of the prostate (radical prostatectomy) is another factor that can weaken the pelvic floor muscles.
It may be necessary to have a health care provider offer proper instruction or biofeedback techniques; biofeedback will use sensors placed in the anus to provide a visual graph showing muscle contraction and relaxation.
A man is smiling and sitting down.
Men can also benefit from performing Kegel exercises if they have a weak pelvic floor.
Additionally, it may be helpful to self-identify the muscles of the pelvic floor used during a Kegel. In order to do this, men can insert a finger into the rectum while tightening and relaxing the pelvic floor muscles (as if you were holding or stopping the urine stream).3
In order to perform a Kegel properly, you will need to:
Relax the muscles of the abdomen, thighs and buttocks while breathing normally
Locate the pelvic floor muscles as above
Tighten the pelvic floor muscles as if you are attempting to stop urinating, hold for 3 seconds and then relax for 3 seconds. Repeat in sets of 10, three times per day.
As above, it is not advised to frequently perform Kegel exercises when urinating; this technique can increase the risk of incomplete bladder emptying and urinary tract infections.
Additionally, Kegels should be done as recommended; over-exercising of the pelvic floor muscles can worsen pelvic floor dysfunction symptoms due to muscle fatigue. Positive results can be expected within a few weeks to months of Kegel exercise practice.
Speak with your health care provider if you have symptoms of or are at risk of developing pelvic floor dysfunction, or if you need additional instruction on how to perform pelvic floor exercises. At times, evaluation with a pelvic floor physiotherapist may be recommended.
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Customized physical therapy may provide more relief for lower back pain than general advice on the best ways to remain active, an Australian study suggests.
Researchers offered 300 patients with lower back pain two advice sessions explaining the source of their discomfort and providing instruction on proper lifting techniques. Roughly half of them also got 10 treatment sessions of personalized physical therapy over 10 weeks.
The physical therapy group had significantly greater reductions in activity limitations at 10, 26 and 52 weeks than the advice group and they also had less back pain at 5, 10 and 26 weeks.
“Our findings suggest that advice works for many people but that individualized physical therapy achieves more rapid reduction in pain and in the long term superior improvements in function/disability,” lead study author Jon Ford of La Trobe University in Bundoora, Australia said by email.
Low-back disorders are one of the most common afflictions that bring people to the doctor, and many of these patients with acute problems have persistent symptoms for at least a year, Ford and colleagues note in the British Journal of Sports Medicine.
To be included in the study, patients needed to have experienced pain for six weeks to six months and have one of five specific types of back pain: disc herniation, reducible disc pain, non-reducible disc pain, joint pain or multifactorial persistent pain.
Patients assigned to customized physical therapy in the study using specific exercise techniques tailored to the type of injury and individual barriers to recovery. Some, for example, focused on posture and lifting to ease disc pain, while others with disc herniation worked on motor control targeting specific muscle groups.
Participants in both the advice and the physical therapy groups improved over time, but the people who received the customized exercise sessions generally did better.
One shortcoming of the study is that the advice group had far fewer encounters with health providers than the physical therapy group, the authors acknowledge.
“There was an 8-session difference in treatment groups, so there was a notable difference in provider attention that could account for some of these group differences,” Steven George, a physical therapy researcher at the University of Florida who wasn’t involved in the study, said by email.
In addition, the differences in outcomes between the two groups aren’t that large, as is often the case in studies of back pain, noted Julie Fritz, associate dean for research at the College of Health at the University of Utah in Salt Lake City.
“Back pain is very common and many patients are advised to attend physical therapy at some point,” Fritz said by email. “The challenge for researchers is to continue to examine which particular physical therapy interventions work for specific types of patients with low back pain and determine the optimal timing for physical therapy intervention.”
SOURCE: bit.ly/1PoQKkC British Journal of Sports Medicine, online October 20, 2015.
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Top 10 tips for back pain
1. Exercise your back regularly – walking, swimming (especially back stroke) and using exercise bikes are all excellent to strengthen your back muscles but anything that you enjoy and helps you keep active will be beneficial.
2. Keep active and moving even when you have pain. Gentle=walking and stretching will prevent stiffness. Also try to avoid long periods of bed rest as this is counterproductive.
3. Always lift and carry objects close to your body, bend your knees and your hips not your back and never twist and bend at the same time.
4. Try to maintain a healthy diet and lifestyle as this will helpprevent back pain. Quit smoking as it increases your chances of developing back pain.
5. Use painkillers when pain occurs to allow you to carry on being active. If pain is persistent see your GP as they may be able to prescribe stronger painkillers or investigate further.
6. Consider your work environment. If you work in an office look at your workspace and ways to adapt it to help you manage your back pain. If your work is more manual in nature try to be aware of and work according to health and safety procedures such as manual handling or loading procedures.
7. Try to carry loads in a rucksack and avoid carrying single sling bags.
8. Always try to maintain good posture. Avoid slumping in your chair, hunching over your desk and walking around with your shoulders hunched up.
9. Always use a chair with a back rest and sit with your feet flat on the floor or on a foot rest. Don’t forget to change your sitting position every few minutes.
10. If you do suffer from back pain caused or made worse by being at work, talk to your employer or HR department.They may be able to help you come up with adaptations to your work environment, patterns and activities in order to help you better manage your back pain.
Source: http://www.backcare.org.uk/
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By Saanichton Physiotherapy
22 Oct, 2015
Back Pain, Fitness, Hip Pain, Manual Therapy, Osteoarthritis, Physiotherapy, Posture, Preventative Therapy
Back injury, Back Pain, back pain relief, Back Pain treatment, disc injury
It’s estimated that as many as 75% of us will have some form of back or neck pain at some point in our lifetime. The good news is that most of us will recover without the need for surgery—and conservative care such as physical therapy usually gets better results than surgery. Degenerative disk disease (DDD) is one cause of back and neck pain. Usually the result of the natural aging process, degenerative disk disease
What Is Degenerative Disk Disease?
Your spine is made up of 33 vertebrae that are stacked on top of one another. Between each of these vertebrae is a rubbery piece of cartilage called an “intervertebral disk.” Imagine the disk as a tire, with gelatin filling the hole in the tire. The tire is called the “annulus,” and the gelatin is called the “nucleus.” When we’re young—under 30 years of age—the disk is made mostly of gelatin. As we age, and sometimes with injury or excessive wear and tear, we start to lose some of that gelatin, and the volume of the disk decreases, resulting in less space between the vertebrae. The disk becomes flatter and less flexible, leaving less space between each set of vertebrae. Sometimes bone spurs form in response to this degeneration of the disk, making the spine stiff. When the rough surfaces of the vertebral joints rub together, pain and inflammation may result. Nerves may become irritated or compressed.
Disk degeneration might occur throughout several regions of the spine, or it might be limited to one disk. When it’s part of the natural aging process, the degeneration does not always lead to pain. For some people, however, it can cause a great deal of pain and disability.
You are more likely to develop DDD if you:
•Smoke
•Are obese
•Do heavy physical work
•Don’t get very much exercise
How Does it Feel?
You might have mild to intense neck and back pain—or no pain at all:
•A degenerative disk in the neck can cause pain in the arm, shoulder,or neck
•A degenerative disk in the low back might cause pain in the back, buttocks, or legs
The pain is often made worse by sitting, bending, and reaching. It may be worse first thing in the morning and after staying in any one position for a long time.
In severe cases, when DDD results in pressure on the nerves, it can lead to numbness, tingling, and even weakness in the arms or legs.
How Is It Diagnosed?
Your physical therapist will conduct a thorough evaluation that includes a review of your medical history and will use screening tools to determine the likelihood of DDD. For example, the therapist may:
•Ask you very specific questions about the location and behavior of your pain, weakness, and other symptoms
•Ask you to fill out a body diagram to indicate specific areas of pain, numbness, and tingling
•Perform tests of muscle strength and sensation to determine the severity of the pressure on your nerves
•Examine your posture and observe how you walk and perform other activities
•Measure the range of motion of your spine and your arms and legs
•Use manual therapy to evaluate the mobility of the joints and muscles in your spine
•Test the strength of important muscle groups
If you have muscle weakness and loss of sensation or very severe pain, special diagnostic tests, such as x-rays, may be needed. Physical therapists work closely with physicians and other health care providers to make certain that an accurate diagnosis is made and the appropriate treatment is provided.
Research shows that in all but the most extreme cases (usually involving muscle weakness or high levels of pain), conservative care, such as physical therapy, has better results than surgery.
After the evaluation, if your therapist suspects you have DDD and there are no major medical problems, treatment can begin right away.
How Can a Physical Therapist Help?
Your physical therapist’s overall purpose is to help you continue to participate in your daily activities and life roles. The therapist will design a treatment program based on both the findings of the evaluation and your personal goals. The treatment program likely will be a combination of exercises.
Relieve Pain and Increase Movement
Your therapist will design:
•Stretching and flexibility exercises to improve mobility in the joints and muscles of your spine and your extremities—improving motion in a joint is often the key to pain relief
•Strengthening exercises—strong trunk muscles provide support for your spinal joints, and strong arm and leg muscles help take some of the workload off your spinal joints
•Aerobic exercise, which has been shown to be helpful in relieving pain, promoting a healthy body weight, and improving overall strength and mobility—all important factors in managing DDD
This might sound like a lot of exercise, but don’t worry: research shows that the more exercise you can handle, the quicker you’ll get rid of your pain and other symptoms.
Your physical therapist also might decide to use a combination of treatments:
•Manual therapy to improve the mobility of stiff joints and tight muscles that may be contributing to your symptoms
•Posture and movement education to show you how to make small changes in how you sit, stand, bend, and lift—even in how you sleep—to help relieve your pain and help you manage your condition on your own
•Special pain treatments—such as ice, electrical stimulation, or a short course of traction—for pain that is severe and not relieved by exercise or manual therapy
Once your pain is gone, it will be important for you to continue your new posture and movement habits to keep your back healthy.
Can this Injury or Condition be Prevented?
DDD usually is a natural result of aging. Research has not yet shown how to prevent it—but you can make choices that lessen its impact on your life and slow its progression. Many physical therapy clinics conduct regular educational seminars to help people in the community learn to take care of their backs and necks. These seminars often are free and provide demonstrations along with written information about exercises for the back and neck, instruction on proper lifting and sitting postures, and other tips to keep your back healthy.
Your physical therapist can help you develop a fitness program that takes into account your DDD. There are some exercises that are better than others for people with DDD, and your therapist will educate you about them. For instance:
•Exercising in water can often be a great way to stay physically active when other forms of exercise are painful.
•Exercises involving lots of twisting and bending need to be avoided in some individuals.
•Weight training exercises, though very important, need to be done with proper form to avoid stress to the back and neck.Real Life Experiences
Jim W. is a 52-year-old construction worker who has been diagnosed with DDD. This is not the first time he has had pain, but it’s the first time the pain is bad enough for him to seek treatment. His neighbor recommended a physical therapist in his community who had helped her with her back problem.
Jim’s pain initially was in his low back, but now the pain is spreading down the back of his thigh and into his knee. He has some numbness and tingling but no weakness. His pain is worse with sitting and bending. He is currently unable to sit for more than 10 minutes without experiencing both back and leg pain. Except for the physical work he does on the job, Jim gets no regular exercise. He is 20 pounds overweight.
Jim’s physical therapist performs a thorough evaluation and asks him many questions about his health, his pain, and his lifestyle. She uses tests to determine the severity of his condition and evaluates the strength of his muscles and the mobility of the joints of his back.
During Jim’s first treatment session, the physical therapist:
•Explains some of the reasons for his problem and discusses the importance of special exercises to relieve his pain
•Shows him how to manage his pain by making simple changes in how he performs his daily activities, such the best muscles to use for lifting on the job
•Performs a manual therapy technique to his low back, which completely relieves his back and leg pain
•Gives Jim special exercises to do at home and encourages him to begin a walking program
Jim follows the advice of his physical therapist and, after only 3 weeks, he is free of symptoms. He is committed to a program of regular exercise and activity and has made an appointment to return to his physical therapist in 6 weeks to review his exercise program and make sure that he is staying on track with his program.
This story was based on a real-life case. Your case may be different. Your physical therapist will tailor a treatment program to your specific case
Source: moveforwardpt.com
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