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Why you should be doing Kegels

Wondering why you should be doing Kegels?

In my early days of being a pelvic floor PT, I was convinced I had the answer to all the woes of the pelvic floor. One word – Kegels. As I’ve developed professionally, I certainly realized Kegels have their place.

However, they do not have their place with all things related to the pelvic floor. There are specific instances when Kegels (also known as PC or pelvic floor muscle contractions) are the answer. I’m a firm believer in doing a Kegel program combined with a core strengthening program that will address the bigger picture. Here’s why you should be doing Kegels if you meet certain criteria:

  1. Most women that experience urinary incontinence

    1. A thorough physical exam can identify if postural dysfunction and weakness in your pelvic floor and what I call “pelvic floor accessory muscles” that are contributing to your incontinence.
    2. There are 3 primary types of urinary incontinence that physical therapy can treat:
      1. Stress Urinary Incontinence (SUI)
        1. Involuntary urine leakage with coughing, laughing, sneezing, exercise
      2. Urge Urinary Incontinence (UUI)
        1. Involuntary urine leakage associated with strong urge sensation and the inability to maintain continence on the way to the bathroom.
        2. Also associated with constant leakage (i.e. with walking, not necessarily associated with an urgency sensation)
      3. Mixed Urinary Incontinence (MUI)
        1. Having both stress urinary incontinence and urge urinary incontinence
    3. Stress Urinary Incontinence most often is accompanied with significant muscle weakness in the pelvic floor muscles, and often in the pelvic floor accessory muscles (such as the gluteal or adductor muscles). There may be poor posture associated as well that is inhibiting (preventing) proper pelvic floor muscle function.
    4. Urge Urinary Incontinence may or may not be associated with weakness in the pelvic floor muscles. These muscles need to be evaluated for trigger points and high tone that may be inhibiting normal muscle function.
    5. In Mixed urinary incontinence, both realms need to be evaluated and a treatment plan appropriate to the findings developed
  2. Women with pelvic organ prolapse

    1. his is when a pelvic organ (such as your bladder, uterus or rectum), drops (prolapses) from it’s normal place and pushes against the walls of your vagina, which can happen when your muscles get weak or stretched from childbirth or surgery (WebMD). This can also occur with constant or repetitive straining, such as what occurs with chronic constipation.
    2. It is often associated with discomfort and has a wide variety of presentations from from pain with sitting, dyspareunia (deep pain with intercourse), difficulty with voiding or bowel movements, pain with standing/walking/running or a report of a “pelvic pressure”.
    3. Depending on the level or grade of the prolapse, appropriate pelvic floor muscle strengthening alongside a pelvic floor muscle facilatory program can lend itself to significant improvements in the discomfort or pain associated with the prolapse. In part, because these muscles are acting to support the falling organs. However, sometimes ligament tearing is so significant or the prolapse so severe that surgery may be required to further reduce these symptoms.
  3. Women with diminished orgasm intensity

    1. Yes, stronger Kegels=better intensity orgasm, generally speaking. Yippee!!

Basically, if weakness contributing to a lack of support or a reduced ability to close around your openings to maintain continence is to blame, you should learn how to do your Kegels correctly NOW and begin a program that specifically addresses your contributing factors to weakness.

A trained pelvic floor physical therapist is the best person to evaluate all potential contributing musculoskeletal factors. At our offices, licensed physical therapists will go over a complete history or your condition. Once we have your background, a physical exam will begin that will address your posture and look at your muscle strength and flexibility of all the muscles that primarily influence your pelvic floor. Lastly, a pelvic floor muscle examination will determine your pelvic floor muscle strength and endurance, two important components of muscle function. We will also look at muscle coordination address any abnormal findings.

Classic stress urinary incontinence will typically take 6-8 visits to achieve 90-100% resolution of symptoms. These visits are often spread out over 3-6 months and is discussed on an individual basis. Urge incontinence has more variation, and can take as few as 4 visits up to 12 visits, again spread out over time. In all instances, we are able to spread out visits as a home exercise program is developed to address your specific areas of weakness and dysfunction.

However, just because you have incontinence, does not 100% guarantee that Kegels are the answer. In my upcoming article “Why You Should STOP Doing Kegels NOW”, I’ll go over why this magical muscle contraction is not all it’s cracked up to be.

What Our Patients Have to Say

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Testimonial by Ann V.

I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

Read more: Testimonial by Ann V.

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Rosanna R., age 35

Heather has affected my life in the MOST POSITIVE way and I am forever grateful. My husband refers to her as the "sex doctor" so you can only imagine how happy he is with my therapy outcome.

After the birth of my son I suffered from "Vaginismus", however, at the time I just thought I was broken. My "broken vagina" affected me physically but it was an emotional struggle as well. Many women in my life also suffered with pain from sex after their babies were born so I knew I wasn't alone. They told me they "just got used to it" but I couldn't see myself living that way.

Sex wasn't just painful, it was literally impossible - IT DIDNT FIT!

Read more: Testimonial by Rosanna R.,...

Testimonial by S.S., age 54

Heather is the best! I saw her today for terrible hip/groin pain. I was so impressed with the safety measures in place and felt completely safe . Thanks for the healing hands.

S.S., age 54

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

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