Regardless of the different causes of incontinence, there are definitely exercises that you need to do to either help get rid of incontinence, prevent it from getting worse while working on the cause, or slow down its progression. The right exercises will strengthen the pelvic floor, which is either the main reason for incontinence or a result of prolonged incontinence. Which exercises are crucial to everyone with incontinence is the subject of this blog.
Before we begin, I strongly recommend you visit my blogs on the different types of incontinence to better understand what your comprehensive options for treatment are.
What You Need to Know About Incontinence
- You need to know that if any medication is causing it, then the fix is to not take that medicine.
- Nutrition plays a role and there are irritants that should be avoided such as citrus, coffee, non-herbal tea, caffeinated drinks, spicy foods, and sweeteners. You should read my blog on incontinence and nutrition to also see what foods you should be eating more of.
- Regardless of the cause, working on your posture will eradicate, improve, and/or slow down the progression of your incontinence.
- Focusing on the floor, thinking incontinence will go away is a mistake. You can’t strengthen a floor when the walls are unstable.
- Internal manual work for the pelvic floor has a great value but is over-rated in most incontinence cases.
- Most breathing that is taught to patients with a weak pelvic floor is confusing and most patients don’t do them right.
- Kegel IS NOT for all types of incontinence but customized exercises to improve the posture ARE for all patients with incontinence.
- The best thing to do is to put aside the reasons (or excuses) behind your incontinence and be determined. Know that without you doing something about it, the only path ahead is the path of decline
- Do plenty of research to find the right practitioner that not only gets success treating patients but has a great track record for long-term success.
- Incontinence is one of the ‘chapters’ of the book: “Pelvic Floor Dysfunction’ and it is not necessarily the first “chapter” of this book either!! To understand the subtle and not-so-subtle signs of pelvic floor dysfunction, I recommend you read the blog I wrote on the very subject.
- You need to take an active role in your treatment and educating yourself on the basics is necessary.
- Use common sense to live your life and apply the principles of common sense in treating your incontinence.
What is the Best Exercise for Incontinence?
The number one exercise for all issues related to the pelvic floor is Breathing and if you think you know what I am talking about, you may want to watch this video to understand the most common mistakes made when teaching pelvic floor patients.
With proper breathing, we build a barrel that makes postural decline difficult and decreases the chances of injury due to dysfunctional movement.
What Other Exercises Are Good for Pelvic Floor Dysfunction?
Neutral spine on the back
Once you start practicing Biological breathing, the next step is to practice how to keep a neutral spine; that is, laying down on the floor, keeping the rib cage not pushed out, and engaging the pelvic diaphragm while maintaining the spine elongated and neutral. Here is a video on how to do that.
Neutral spine standing up
Once you know what neutral spine means and how to create it, the next is to duplicate that move standing up. That means with standing up, there is no tilting forward or backward of the pelvis, nor pushing the chest out or hunching back. The neck needs to stay back vs in front of the body which is commonly seen due to the over usage of electronic devices.
In my blog on functional movement self-assessment, I speak of the plumb line. Although that blog was written with active adults and athletes in mind, it applies to all of us and is a great reference to use.
Side View Plumbline
Development exercises for stability of the torso in movement
This is potentially a whole new subject to you. Let me explain, if all babies on this planet go through the same developmental stages of movement without being coached, going to a gym, or lifting any dumbbells, then we must be programmed to move that way. When studying babies, we see that they keep the torso stabilized while working out their arms and legs. Interestingly enough, we see the same concepts applied in professional athletes.
Pay close attention to how the neck and the rest of the back are in the neutral position while doing the push-up. Meanwhile, the legs are doing a side plank. The lower back is not twisted and is in the most perfect stabilized position. This baby is practicing stabilization while the muscles of the glutes on the side of the pelvis are getting stronger as walking is just around the corner.
Can you be this stable?
Here, you see Michael Jordan is applying the same principles of stabilizing his torso, keeping the neck and back in a neutral position while the arm (not the torso twisting) throws the ball. He is able to do this and do it well to be Michael Jordan.
When it comes to all exercises, the focus should be on stabilizing the torso while the legs and arms do the legs and arms job. The issue with incontinence is that when the pelvis tips forward, there is an increase in pressure in the front where the bladder resides. That by itself makes it difficult to hold urine, now add other factors on top of the postural decline and you can see how there is very little chance to hold the urine. This can be a simple sneeze, cough, laugh, or exercise.
There are many exercises that should be done but without the breathing and neutral spine, it is easy to mechanically duplicate the moves to get from point A to B, it is not the duplication of the moves that matters but how you get to point B that makes the difference. For a collection of those exercises, I recommend you visit my 2 channels:
If you are not sure where to begin, or which exercises are right for your pelvic floor dysfunction, contact me and refer to this blog when making your appointment.
Dr. Shakib
