Stress urinary incontinence (SUI) is the medical term for bladder leakage during physical activity or exertion. Many women who live with SUI can experience leakage during a variety of activities—from anything energetic, such as exercise, sexual intercourse, or lifting heavy objects to common, everyday actions, like laughing, coughing, or sneezing. Think of the muscles, tissues, nerves, and ligaments of your pelvic floor as a sling that provides support for your uterus, bladder, vagina, and rectum: these are muscles that most people don’t really think about until they weaken and you experience SUI events. Most adults can hold roughly 16 oz of urine in their bladder. But when you’re living with SUI, the muscles controlling your ability to hold your bladder have been compromised, leading to leakage. Though there are many causes of SUI, women are particularly at risk for developing SUI symptoms because the muscles of the pelvic floor can be weakened by menstruation, vaginal childbirth, and pelvic prolapse. Other common causes of SUI include injury to the urethral area, certain medications, or in men, pelvic or prostate surgery. Living with SUI can be both frustrating and embarrassing. Because of the sensitive nature of SUI, many people don’t pursue help from their doctors, or worse, doctors fail to provide realistic solutions to improve the quality of life. In fact—as we’ve blogged about before—for many years, the medical “go-to” solution for SUI was to suggest surgery in which hernia mesh would be implanted in the vaginal wall (link to TVM tort landing page here). In the years that followed, this caused terrible damage to thousands of women. In this post, we’ll be covering some basic exercises for women who face SUI, and show you that talking about SUI doesn’t have to be embarrassing. There are natural, non-surgical ways to improve the strength of your pelvic floor and see lasting improvement. This post will empower you with the knowledge you’ll need to feel in control of your SUI symptoms.
Research demonstrates that up to 70% of women living with SUI experienced significant improvement of their symptoms when incorporating regular pelvic floor exercises into their daily routine. Both yoga and Pilates are proven to improve SUI symptoms, with research showing a 70% decrease in the frequency of SUI events following a 6-week program. Here, we’ve shared five easy workouts that can build up the muscles of your pelvic floor. These workouts—Kegel exercises, yoga poses, and core-building moves—are easy ways to boost your pelvic floor muscle strength without cutting into your time. Most of these exercises take less than five minutes to perform, and some, like Kegel exercises, are discreet enough to be performed on the go or even at your desk, without anyone being the wiser. As you should before undertaking any new exercise routine, it’s important to consult with your doctor to make sure you’re physically ready to incorporate some new moves into your daily schedule. With pelvic floor muscle exercises, it’s especially important to work out the right muscles. There are several other methods of strengthening your pelvic floor—including biofeedback, electrical stimulation, and vaginal cones—which can help you properly identify and build up your pelvic floor muscles. Your doctor might want to have you meet with an incontinence specialist or physical therapist to choose an exercise routine that’s right for your body and your SUI symptoms. Whenever you start a new exercise routine, keep in mind that every person’s body (and SUI symptoms) are different, and that exercise is a cumulative process—it takes practice, effort, and time to see the results of your effort. Some people notice improvements within days; others may take weeks to see results. Ideally, after about three weeks of regular pelvic floor workouts, you’ll notice that your muscles feel stronger, you’ll be able to squeeze and hold your muscles longer before feeling tired, and you’ll experience fewer SUI events. Persistence is the key to long-term success, and it can take two to five months to experience the full benefits of these exercises. By then, these exercises will have become part of your daily routine, something you can maintain for the rest of your life.
Before you begin any pelvic floor exercises, empty your bladder and warm up with a few minutes of stretching. As you exercise, remember to breathe deeply and evenly, relaxing your body as you go. Make sure you’re focusing on the muscles of your pelvic floor, not just tightening the muscles of your stomach, chest, thighs, or buttocks. Remember that more isn’t always better—though you may feel that you can get faster results by increasing the frequency of your exercises or the number of reps, slow and steady wins this race. Overexerting already-weakened pelvic floor muscles could actually make your SUI symptoms worsen by increasing muscle fatigue. Remember to be as mindful of your body’s limitations as you are of its capabilities. If these exercises cause discomfort, you may be performing them incorrectly, which won’t produce the desired results.
The most common strengthening exercise to improve the strength of the pelvic floor is one you’ve probably already heard about in passing—Kegel exercises (“Kegels”). Kegels are a rehabilitation technique that’s used for toning and tightening weakened muscles of the pelvic floor. Kegels are sometimes jokingly called “the invisible workout”, because when performed correctly, it’s impossible for anyone to detect. Because Kegels are so discreet, you can perform them just about anywhere. First, and most importantly, you’ve got to find the right muscles. The easiest way to identify and isolate the muscles of your pelvic floor is to stop urination when you’re midstream, hold it for a beat, and then release the flow of urine again. If you can do this, then congratulations—you’ve located your pelvic floor muscles, and performed a Kegel! Once you know what muscles you’re working out (and what it feels like to flex these muscles), you can do Kegels in any position that’s comfortable to you, though many people like to start out from a reclined position at first. Now that you know how to perform a Kegel, focus on perfecting your technique and building your stamina. Try holding the contraction for at least five seconds, and then releasing the hold for another five seconds. Keep in mind that the releasing part of a Kegel is equally important. One “clench and relax” action constitutes one full Kegel. Once you can hold and release the Kegel for five seconds, try performing five Kegels in a row, gradually working your way up to more reps. For the best results, perform 10 reps three times daily. Once you’ve mastered your technique, you can start mixing things up, using slower or faster intervals as you contract and release.
The Bridge Exercise works triple-duty as a back bend, a core strength builder, and a balance pose that strengthens your pelvic floor muscles. This is an easy, fast exercise that’s suited for beginners as well as the more advanced, serving as an excellent supplement to Kegels. To effectively perform the Bridge, follow these steps.
The Garland Pose (also called Malasana) is a yoga pose suited for beginners and advanced alike. This exercise is beneficial because it lengthens the pelvic floor and allows for stronger contractions, improving circulation and blood flow into the pelvic area. To get started with the Garland Pose, follow these simple steps.
The Wall Squat is a beginner core strengthening move whose additional benefits include an increase in the isometric strength of the lower trunk, better flexibility, and improved balance. Wall Squats are also a great way to stretch out after a long period sitting at your desk, and since they’re fast, easy, and only require a wall, they’re something you can easily fit in during the workday. Here’s how to start incorporating Wall Squats into your strength-building routine.
The Cobbler’s Pose (Bound Angle Pose) is an easy yoga pose engaging your inner thigh muscles to stabilize the pelvic floor. When the inner thigh muscles are flexible, it’s easier to engage the muscles of the pelvic floor more deeply. Additionally, this pose opens up your lower back, which encourages your pelvic floor muscles to stretch and expand with each inhalation. Here’s how to get started with Cobbler’s Pose.
