Archive for August, 2015

Kegel Exercises To PREVENT Pelvic Floor Dysfunction

August 29, 2015

Andrew Siegel MD   8/29/15


“Prepare and prevent, not repair and repent.”

Restoring function of injured muscles is a well-established principle in sports medicine, orthopedics, plastic surgery and physical medicine and rehabilitation. The premise is simple: a traumatized or injured muscle is treated with rehab and training to accelerate tissue healing and restore working order. Many of the “baby boomers” demographic (age 51-69)—striving to retain their fitness and youth through exercise and “weekend warrior” activities that promote cardiac health but at the same time, musculoskeletal injuries—understand this concept well.

Dr. Arnold Kegel applied this principle to the female pelvic floor muscles to improve muscle strength and function in women after childbirth. Obstetrical “trauma” (9 months of pregnancy, tough labor and delivery of a 9 lb. baby) can cause pelvic floor dysfunction—urinary and bowel control issues, looseness of the vagina and its support tissues with descent of the bladder, uterus and rectum, and altered sexual function.

This principle has also been applied to men with pelvic floor muscle issues to improve urinary, bowel, erectile and ejaculatory health. Obviously, men do not suffer the acute pelvic floor muscle trauma of childbirth that women do, but they can develop pelvic floor muscle dysfunction from aging, weight gain, pelvic surgery (radical prostatectomy, colon surgery, etc.), a sedentary lifestyle, disuse atrophy, participation in saddle sports including cycling, etc.

An Ounce Of Prevention Is Worth A Pound Of Cure

Why not a radically different approach and instead of fixing pelvic floor dysfunction, try to prevent it? Unfortunately, we have a “reactive” oriented medical culture in the USA that does not emphasize prevention, but “repair.”  Another hurdle is that many people prefer having broken things fixed as opposed to making the effort to avoid breaking them in the first place.

So, if obstetrical trauma to the pelvic floor often brings on pelvic floor muscle dysfunction and its urinary, gynecological, bowel and sexual consequences, why not consider starting pelvic floor muscle training well before pregnancy, perhaps at the time of the first gynecological visit? And if aging, surgery and other factors contribute to male pelvic floor muscle dysfunction and its urinary, bowel and sexual consequences, why wait for the system to malfunction? Why not strengthen and tone the pelvic floor muscles when a man is young and healthy to prevent the predictable age-related decline?

Did You Know? The concept of pelvic floor muscle training BEFORE radical prostatectomy for treatment of prostate cancer is rapidly gaining traction and implementation. Instead of waiting to “rehab” the pelvic muscles after the fact, the concept is to “prehab” them. 

Many of us apply wellness principles through regular exercise—aerobic pursuits for cardiovascular health and strength training to maintain muscle tone, integrity and function—so why neglect the pelvic floor? We work out in the gym not only to achieve better fitness, but also to maintain fitness and prevent age-related losses in strength, flexibility, endurance, etc.

Preventive Pelvic Health Paradigm

Why passively accept the seemingly inevitable, when one can be proactive instead of reactive and can address the future problem before it becomes a problem? Why wait until function becomes dysfunction? Whether male or female, the new paradigm is preventive pelvic health. The goal is to avoid, delay, or minimize the decline in pelvic function that accompanies aging and that is accelerated by pelvic muscle trauma and injury, surgery, obesity and disuse atrophy.

Bottom Line: You have the ability to positively influence your health destiny. Instead of being reactive and waiting for your pelvic health to go south, be proactive to ensure your continuing urinary, bowel and sexual health. If you wait for the onset of a dysfunction to motivate you to action, it may possibly be too late. Think about integrating a preventive pelvic floor muscle program into your exercise regimen. Much like a vaccine, it will help to prevent a disease that you hopefully will never get.

Wishing you the best of health,

2014-04-23 20:16:29

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Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: Available in e-book (Kindle, iBooks, Nook, Kobo) and paperback:  In the works is The Kegel Fix: Recharging Female Sexual, Pelvic and Urinary Health.

Co-founder of Private Gym, a comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training program.  Built upon the foundational work of Dr. Arnold Kegel, Private Gym empowers men to increase pelvic floor muscle strength, tone, power, and endurance: or available on Amazon.