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health and wellness

Whose Kegel Is It Anyway?

By Riva Preil

Okay, folks: it’s time for a game of free word association. What is the first thing that comes to mind when I say the word “Kegelâ€? If your response was “womenâ€, “pregnancyâ€, or “incontinenceâ€, you would be in very good company. However, if your response was “male†or “prostatectomy,†you receive extra credit. That is because KEGELS ARE NOT JUST FOR WOMEN: men can benefit from Kegels, or pelvic floor muscle strengthening exercises, as well.

Research has already proven that Kegels facilitate restoration of strength and continence in males post -prostatectomy, and that even one session of biofeedback pre-surgery with proper instruction of home exercises resulted in quicker recovery with decreased incontinent severity. Recently, a study was performed to help delineate clearer pre-op guidelines and recommendations. The study was published in The International Journal of Urology, and it consisted of a control group (132 males) and an experimental group (152 males). The men in the control group were given verbal instructions by their surgeon on how to perform Kegels daily prior to the surgery. On the other hand, the experimental group met with a physical therapist who educated them on pelvic floor anatomy, instructed them on proper performance of Kegels in various functional positions and activities (ex. coughing and squatting), and educated patients on how to avoid abdominal substitution. This was achieved by using transabdominal ultrasound. The males in the experimental group were encouraged to perform a home exercise program of 10 repetitions of 10 second endurance contractions in supine, sitting, and standing positions. All males received the same pelvic floor physical therapy treatments following the surgery. The researchers concluded that males who received P.T. guided pelvic floor training prior to surgery recovered 28% faster than those in the control group. In other words, investing the time and energy to participate in a pelvic floor strengthening program prior to surgery resulted in faster return to continence post-surgery. Take advantage of the research! If you or someone you know is scheduled to undergo prostate surgery, please call us at Beyond Basics Physical Therapy to give us the opportunity to assist your healing process. We would be honored to help!

—FAQ

Frequently Asked Questions

Pelvic Floor Disorders and Treatment

What is pelvic floor dysfunction and why does it happen?

Pelvic floor dysfunction is extremely common and occurs when the muscles, tissues, or nerves of the pelvic floor are weakened, tightened, or injured by trauma, chronic strain, or overuse. Pelvic floor disorders can result from traumatic injury such as a fall, from sporting activity, surgery, or childbirth. They can also happen from more chronic issues, such as infection or chronic inflammation such as endometriosis. Pelvic floor disorders can be a consequence of poor alignment or posture, overuse, or improper movement. The pelvic floor muscles surround the urethra, rectum, vagina and prostate; therefore, if there is a dysfunction in these muscles it can result in urinary, bowel, or sexual dysfunction in people of all ages.

Who should I see to get a proper diagnosis?

Many healthcare providers don’t assess – or don’t know how to assess – the pelvic floor muscles and nerves, so it’s important to get a proper diagnosis from a practitioner who specializes in pelvic floor dysfunction and pelvic pain. Too often patients tell us that they’ve been to 10 different doctors and healthcare providers and their symptoms have not improved, or have worsened. Find a specialist right away and get on the path to healing as quickly as possible.

Why do healthcare providers miss (or misdiagnose) pelvic floor dysfunction?

Long story short, the medical practice is divided into areas of the body: Urology. Orthopedics. Gynecology. But the body itself doesn’t have walls; every system interacts with everything else. Sometimes providers are so laser-focused on what they treat that they miss the whole picture. 

As more and more research emphasizes the importance of physical therapy as part of a complete treatment regimen, more and more physicians are learning how to recognize and treat pelvic floor disorder. In the meantime, if you’re not getting relief from your current treatment, make an appointment with a pelvic floor specialist to learn more.

How does pelvic floor dysfunction affect sex?

Pelvic floor muscles have a huge impact on sex. Muscles that are shortened or tight and are unable to elongate will not allow for good blood flow into the genitals. This can result in pain, weaker erections, diminished sensation, inability to orgasm, and even decreased lubrication. Pelvic floor PT can help with these issues by enhancing blood flow and improving muscle function. 

How can pelvic floor dysfunction cause bloating?

Pelvic floor dysfunction, a condition characterized by the inability to correctly relax and coordinate pelvic floor muscles, can significantly contribute to bloating due to its impact on gastrointestinal functions. When these muscles are not functioning properly, it can impact the ease of emptying and make it difficult for your body to pass stool and gas through the intestines. This obstruction leads to an accumulation of waste and gas in the gastrointestinal tract, causing bloating and abdominal discomfort.

Is it true there’s internal massage?

There can be. We do perform internal soft tissue mobilization of the pelvic muscles that are inside your pelvis and are accessible only through the vagina or rectum. We never do internal treatment without your consent and understanding.

What makes someone a pelvic floor PT vs a regular PT?

All pelvic PTs get additional training in pelvic floor internal treatment through continuing education and at our clinic. 

We pride ourselves on the level of training we provide, not just at the beginning but throughout the time our therapists spend at Beyond Basics. We know that learning is a life-long process.  We also provide additional training in physiology of the GI system and urinary system as well as sexual health and function and nutritional training. Most PT programs and schools do not provide the depth and breadth of knowledge that we provide all our PTs at Beyond Basics.

Get help now from a pelvic floor therapist.

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