[...] depending on the severity of the incontinence and any additional contributing factors (for example, prolapse or pelvic pain), the total duration of their therapy may require more than 6 weeks to completely eliminate their symptoms. Don't forget the valuable input of a Women's Health Physical Therapist, which can assist you with finding other potential causes of incontinence and provide a more directed treatment plan.
Perinatal Wellness Postpartum Urinary Incontinence By Heather Jeffcoat, DPT There is a typical history I encounter in my practice— Sample Kegel Progression “I’ve had two kids and now whenever I laugh or sneeze, I Week 1: Hold 1 second (“Quick Flick”). Perform 2 sets of 5, experience urine leakage”. But it’s normal, right? I always 3 times per day. tell my clients that the problem may have arisen because of Week 2: Increase to 2 sets of 10, 2 times per day. childbirth, and maybe all of their friends giggle about this Week 3: Increase to 2 sets of 15, 1 time per day. unfortunate consequence of having a beautiful and perfect Week 4: Continue with Week 3 routine, add 3 second holds baby. But it is not NORMAL—there is something you can do (“Long Holds”), 2 sets of 5. (other than surgery or medication) to get your pelvic floor Continue to increase 3 second holds per Week 2 & 3 pro- muscle function back to normal. And it’s more than doing tocol. Once, up to 2 sets of 15, increase hold times to 5 seconds just “Kegels”. and reduce repetitions to 2 sets of 5 again. Continue to gradu- I’ve had many women tell me over the years, “I do ally increase repetitions. Your client’s goal will be to perform “Kegels”, but they don’t work”. A study published in The “Long Holds” for 10 seconds, at least 2 sets of 10 daily. American Journal of Obstetrics and Gynecology (Bump, et al There are additional exercises that assist with reducing 1991) looked at the performance of Kegel exercises after brief symptoms of incontinence. These exercises work by utiliz- verbal instruction. The results showed that 51% of women ing muscles that have a synergistic effect to the pelvic floor were performing a Kegel incorrectly at this level of teaching. muscles (Carriere, 2006). Worse yet, 25% of women were performing them in such a way that could actually worsen their incontinence. This study Pillow Squeeze with Pelvic Curl highlights the principal that if an exercise is not performed Instruct your client to lie as pictured in (A) with a pillow properly, it will not work and has the potential to worsen the or ball between her knees. Have her take a deep breathe in, problem. then exhale as she imprints her spine into the floor followed The first item to consider is, does your client perform a by elevating her hips as pictured in (B). Cue her to inhale to Kegel properly? This is an essential first step in reducing or prepare then exhale as she reverses this movement back to eliminating incontinence. Here is a helpful trick your clients the start position. can try at home: Take a mirror to visualize the perineal area. A When performing a Kegel, they should only see the anus and vaginal opening lift and cl
Pages to are hidden for
"Postpartum Urinary Incontinence"Please download to view full document