During the clinic, we often advise patients with lower urinary tract symptoms to “pay attention to exercising the perineal muscles”. However, due to the time constraint, it is not always clear and thorough. Generally speaking, people have been neglecting this important training method, thinking that the only way to solve the problem is to rely on drugs and surgery. This is a big misconception. Compared to all physical methods and conservative treatments, pelvic floor exercises are simple, inexpensive, cost-free, effective, and can be trained anytime, anywhere, whether sitting, standing, or lying.
Today, we are going to synthesize and sort out the knowledge of pelvic floor muscle training in order to help those who need training but cannot find the right method. It should be noted that the following methods are not only applicable to female patients, male friends can also refer to and learn from.
I. What is pelvic floor muscle training (PFMT)?
A: It is also called Kegel training method, which was initially invented to teach mothers-to-be or women in labor to train during the perinatal period for smooth delivery and postpartum recovery. Later, its use was greatly expanded and it was found to be very useful for the whole range of pelvic floor organ dysfunction related diseases: including urinary incontinence, defecation dysfunction, and various dysfunctions and dissatisfactions related to the female pelvic organs …… you get the idea.
Second, how effective?
A: Very! Very! Good!
If you have the following symptoms, please be sure to first try pelvic floor muscle exercises.
Urinary incontinence: leaking urine when sneezing, laughing or coughing
Urinary urgency: sometimes you don’t even have time to run to the bathroom before you have an overflow of urine
Fecal incontinence
Unsatisfactory sex life, chronic inability to achieve orgasm and pleasure
Male ejaculation weakness, too fast, poor level of control may also want to try
Third, talk about the medical principles, okay?
A: The pelvic floor muscles are a group of muscles at the bottom of the pelvic floor, supporting many organs, such as the female uterus, bladder, small intestine, rectum, etc., and the contraction of the pelvic floor muscles also maintain the normal function of these organs. Although this group of muscles has a very difficult task, it is very fragile. Things like obesity, pregnancy, childbirth, surgery, coughing, and aging …… are all killers of the pelvic floor muscles. However, we can train to make the muscles of the pelvic floor gradually heal and get stronger to fight against increased abdominal pressure.
Fourth, how to do the pelvic floor muscle exercises?
A: Remember the three steps: one seek, two shrink, three alternate.
Tell us more about it.
The first step is to find. You have to find the right pelvic floor muscles: first try to contract the muscles around the vagina (for men, between the root of the scrotum and the anus) and the rectum, and try to lift these muscles. Yes, it’s like the feeling you get when you try to hold back from peeing and farting at the same time.
If you find it difficult and can’t find it, there’s an easier way to stop suddenly in the middle of urination and feel which muscles are being moved? This is the pelvic floor muscles. If you’re not quite sure yet, women can stick their fingers into the vagina and when the control muscles are correct, you should feel the vagina contracting slightly.
Step two, contraction. You have to contract the muscle correctly: remember that the correct direction of movement of the muscle should be upward and inward, not downward to hold your breath. Early on in your training, it is especially important to pay attention to the correct method of training. Remember, we practice “internal”, you can put your hands on the abdomen and hips during training, to ensure that the stomach, thighs and hips remain stationary during the exercise.
A few more tips.
Empty your bladder before training
Don’t hold your breath, breathe normally. Talking and chatting should be unaffected when training correctly. But try to concentrate as much as possible and also try to count out loud.
Don’t contract the muscles of the belly, thighs and buttocks
Don’t pinch your legs
The third step, alternate. That means fast contractions and slow contractions, alternating.
Slow contractions help strengthen the pelvic floor muscles and can assist with urinary control. The specific method is: lift the pelvic floor muscles and count 10 seconds; 2. contract the pelvic floor muscles and count 10 seconds; 3. relax the muscles and count 10 seconds; 4. repeat this action 10 times. At the beginning, you may be able to hold on for 1 or 2 seconds at most, but don’t give up, continue to insist, and gradually you can contract for longer and longer.
Fast contractions help the pelvic floor muscles to resist sudden increases in abdominal pressure, such as coughing, sneezing or laughing. The quick contraction comes into play when urination is suddenly interrupted. The specific method is: quickly lift the pelvic floor muscles; contract for 1 second; relax the muscles and rest for 1 second; 4. Repeat 10 times.
V. What frequency of exercise should be maintained?
A: Anytime, anywhere, according to local conditions.
1. Do it anytime, anywhere: keep doing 3-6 sets of pelvic floor exercises every day as much as possible (1 complete set of pelvic floor exercises including a set of slow contractions and a set of fast contractions).
2. Do it according to local conditions: you can do a fast contraction before coughing, sneezing and laughing; you can also do a fast contraction when you get up from the chair, because the action of getting up will put pressure on the bladder and pelvic floor.
VI. How do I know if the exercise is effective?
A: You can test it by using the “interrupt-start” urination test. When you urinate, pass some of the urine first and then try to interrupt the urination. It is possible that you may not be able to brake at first, but even if you can slow down the flow of urine, it is a good start. You can test it every two weeks, and if you can collect and release it freely, then congratulations, the effect is manifest!
But please remember not to do this experiment frequently during urination, otherwise it will become a habit that will cause damage to the bladder’s forced urinary muscles.
Finally, a few more exhortations.
Be sure to be persistent, do not give up halfway.
The first 2 months may have little effect and you will not notice a change until 12-15 weeks later.
If you have done all of the above and after a few months you find that nothing is working, remember to see your doctor again for a definitive check for any other problems or for more aggressive treatment.