Urinary Incontinence Truths: Why doing KEGELs is NOT the solution...
UI is a VERY prevalent issue affecting millions of individuals, particularly women, worldwide. It’s nuts to spit out this stat but one in THREE women that will have incontinence at some point in their lifetimes. WTH! It's a concern that goes beyond simple solutions, challenging the notion that kegel exercises are the ultimate solution for all types of incontinence. In this blog, we'll explore why kegels might not be the answer to our prayers and why a more comprehensive approach is necessary for managing urinary incontinence.
Contrary to popular belief & (sadly) contrary to what some modern day Doctors may still be prescribing… performing KEGELs (or pelvic floor muscle contractions) are oftentimes NOT the solution to urinary incontinence (UI). Here’s what I’ve found over the years of treating hundreds of women and a handful of men with UI.
1. UI is a Whole Body Problem:
Contrary to popular belief, urinary incontinence is not solely a pelvic floor issue. The pelvic floor muscles (PFM) are undoubtedly crucial, but they do not operate in isolation. UI is a complex interplay of various factors involving muscles, nerves, breathing mechanics, jaw function, fascia & connective tissues, lifestyle factors, diet, bowel health and even the surrounding organs. The idea that kegels alone can address the multifaceted nature of UI oversimplifies the problem.
2. Different Types of Incontinence Require Different Treatments:
There's no one-size-fits-all solution for urinary incontinence because there isn't just one type of incontinence. Stress incontinence, urge incontinence, overflow incontinence, functional incontinence, neurological incontinence and mixed incontinence are just a few examples. Each type necessitates a tailored approach for effective management. Kegels, focusing primarily on strengthening pelvic muscles, may not be the answer for all types of incontinence.
3. I mean… My Profession (Pelvic Health Physiotherapy) Must Exist for a Reason:
If kegel exercises were the be-all-end-all solution, the field of pelvic health physical therapy wouldn't be thriving. Pelvic health PTs specialize in addressing the complexities of urinary incontinence, employing a holistic approach that goes beyond kegels. These professionals recognize that effective treatment involves understanding the patient's unique circumstances, considering the whole body, and employing a range of therapeutic techniques. I can tell you right now that the treatment from one individual can look DRAMATICALLY different from another. For example, one of my clients with UI may initially need 2-3 sessions of myofascial work on their Right Shoulder, whereas another client with UI may require toileting education and constipation management techniques. It is up to the physiotherapist to ask a really thorough subjective interview and use their clinical judgement on what treatments would be of MOST HELP to the individual!
4. Weakness is Not the Only Issue with the PFM:
While kegels aim to strengthen the pelvic floor muscles, weakness is just one aspect of the problem. Coordination, flexibility, and endurance are equally critical. Overemphasizing strength without addressing these other components can lead to an imbalance that may even exacerbate rather than alleviate incontinence issues. I think by now we’ve all heard of the tight, overactive pelvic floor muscle. By doing more and more endless kegels, we are not doing any service to an existingly overactive pelvic floor. It is important to assess what exactly is the ROOT SOURCE(s) of the UI to get to a better understanding of how to manage the unwanted leaks!
5. Other Contributing Factors Worsen UI:
Several lifestyle factors contribute to urinary incontinence, and kegels alone can't mitigate their impact. Issues like constipation, chronic stress, prolonged sitting, and the aftermath of childbirth can all play a significant role in exacerbating UI. A comprehensive approach should involve addressing these contributing factors alongside targeted pelvic floor exercises. This may even mean recruiting a team of different healthcare practitioners.
While kegel exercises may offer benefits for certain individuals, they are not a one-stop solution for the complex issue of urinary incontinence. A more holistic approach, considering the entire body and individualized treatment plans, is crucial for effective management. Consulting with pelvic health professionals, adopting lifestyle changes, and understanding the diverse factors at play can pave the way to a more comprehensive and successful approach to urinary incontinence. Let’s get it Pelvic Pro!
*This Blog & its key concepts has been written by Jane Bai, with content generated with assistance from ChatGPT, a language model developed by OpenAI.