Why Kegels Aren’t Always the Answer to Incontinence
If you have urinary incontinence, or loss of bladder control, then you may have been told to do Kegel exercises. Kegel exercises, also called pelvic floor muscle training, are repeated pelvic floor muscle contractions to help strengthen the pelvic floor muscles. Unfortunately, this blanket recommendation to do Kegel exercises may not be the best answer for you. The key to stopping your leakage will depend on the type of incontinence that you have. Let’s take a look at the different types of urinary incontinence and see why Kegel exercises may or may not be helpful for your situation.
Stress Incontinence
Stress incontinence is when urine leaks with increased pressure on the bladder during coughing, sneezing, lifting something heavy, jumping, running, or other activities. Typically, Kegel exercises are very helpful in treating stress incontinence, however, they should be part of a comprehensive program only after the pelvic floor has been assessed by a pelvic health physical therapist or other qualified medical provider.
If you are experiencing stress incontinence, treatment should go beyond just treating the pelvic floor muscles. This includes addressing the surrounding muscles and joints that may be contributing to pelvic floor dysfunction. Examples are strengthening your hip muscles, modifying your jumping mechanics, or improving the flexibility of your hips to optimize pelvic floor function.
Urge Incontinence
This type of incontinence happens when you lose urine after having a sudden, intense urge to urinate. For example, when you’re rushing to the bathroom only to leak urine right before you get to the toilet. Urge incontinence occurs when the bladder muscle contracts at the wrong times, even when the bladder isn’t full. Some of the main treatments for urgency incontinence are avoiding bladder irritants like caffeinated, acidic, and carbonated beverages, and retraining the bladder which may or may not include Kegel exercises.
Mixed Incontinence
If you have a combination of both stress and urge incontinence, then you have what’s called mixed urinary incontinence. Typically, the urge incontinence needs to be addressed first, then the stress incontinence can be treated.
Overflow Incontinence
If the bladder doesn’t completely empty, you may experience frequent or constant dribbling of urine, which is called overflow incontinence. Since the cause of leakage is due to poor bladder functioning, performing Kegel exercises likely won’t help this type of incontinence. Determining why the bladder isn’t emptying completely is important if you have overflow incontinence, as this will help determine the type of treatment that you need.
Functional Incontinence
Having a physical or mental difficulty may make it hard to get to the toilet in time. If you have urinary leakage in these types of situations, this is considered functional incontinence. An example would be if you have trouble with using buttons or zippers and you can’t undo your pants quickly enough.
Yes, a strong and functional pelvic floor is helpful, but what needs to be done is problem-solving for strategies that can help you get to the toilet easier. You may benefit from working with an occupational therapist, a speech language pathologist, or a physical therapist to treat functional incontinence.
As you can see, Kegel exercises are not always the best for treating urinary incontinence. It all depends on the why of your urinary incontinence as well as how well your pelvic floor muscles are functioning. If you’re experiencing urinary incontinence, it’s always best to be assessed by a qualified medical provider. Pelvic health physical therapists are specially trained to assess and treat all types of urinary incontinence so you can have an individualized program and optimal results. Pelvic health physical therapy has been shown time and time again in the research to be beneficial in reducing or eliminating leakage. So what are you waiting for? Go get help!
