Hab-it Exercises Forums Ask Tasha! bladder discomfort with standing/sitting kegels

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  • #75803
    Kathleen
    Guest

    Hi Tasha,
    A little background–I am a 50-year-old mother of two teenagers. After having my kids in my mid 30s, I developed minor issues with stress incontinence, but only ever leaked when I ran or jumped for more than several minutes, which wasn’t much of an issue until 2.5 years ago when I lost 30 pounds and starting running and weightlifting. My doctor told me to use Impressa when I ran and do more kegels. That worked for about 2 years, but I have also been fighting chronic constipation for most of my life (and only recently learned that one shouldn’t have to push to have a bowel movement), and last winter while pushing particularly hard, I felt a thud and discovered I had developed a stage 2 cyctocele and rectocele.

    I quit running and doing ab workouts (I had an 8-pack at the time), quit wearing my belt and low-rise juniors pants, and bought all new pants with elastic waistbands. I also found and bought your Hab-it downloads and started doing those along with walking and elliptical workouts. I was seeing great progress and was hoping to start higher impact training, when I developed severe bladder infection symptoms. I went to the doctor, but the results for the uti test were negative. I realized that the symptoms coming on and worsening seemed to coincide with kegels, so I stopped doing kegels, found Brianna’s site and started doing stretching and relaxation. That helped those symptoms, but without kegels my prolapse issues worsened, so I tried to add kegels back into my routine, but the bladder infection symptoms returned-frequency, lower abdominal pain, feeling like I still need to go while still on the toilet even though nothing is there. I got a referral to a pelvic floor PT and she did massage and told me to resume kegels but only laying down and to include relaxation and stretching afterwards. I was able to get back to doing them laying down, but I still can’t move to sitting or standing without the bladder infection symptoms immediately returning and she doesn’t know why. I recently saw a surgeon who didn’t note anything beside the stage 2 cystocele and rectocele. He even did an incontinence exam with a catheter and confirmed that I am fully emptying my bladder and didn’t leak at all during his tests.

    Have you run across this before? Do you have any idea why this might be happening? Even before I started working out and working on my abs, I’ve always kept my abs sort of flexed and kept my tummy flat when standing, but I kept a good arch in my back. I’ve tried to experiment with letting my belly go all out and keeping it flexed and neither seems to make a big difference in the abdominal/bladder discomfort.

    Thank you for all you do for women! You and your site are an invaluable resource.
    Kathleen

    #76122
    Tasha
    Keymaster

    Kathleen,
    It sounds like you consistently have pelvic floor spasms with Kegels, so listen to your body and stop them! You seem very focused on Kegels being the key to your success. Recognize the co-contraction of your pelvic floor with your adductors, deep hip rotators, TA, multifidi. Focus on working all the other muscles of your pelvic basket and you will have better results!

    Read through my Pelvic Floor Muscle Spasms topic within the Education section. You should focus on all the muscles of your pelvic basket and work Briannes relaxation methods following your workouts and you will be on the right track.

    Also, read through Pelvic Basket Muscles topic. You may have to focus on quieting your RA and allowing your TA to fire first.

    Lots of work to do – just not Kegels!

    Tasha

    #76259
    Kathleen
    Member

    Tasha, thank you for your reply. I am in an unfortunate position of being pulled opposite directions by your program and that of my PT. I have been doing your Hab-it workouts for a while now and do feel like they’ve really helped, and I do notice those co-contractions. However, my PT is only focused on my pelvic floor. She wants me doing 3 sets a day of 20 quick flicks and 10 long (10 second) holds. As it is I only do her workout once a day (lying down) and have been substituting your videos–minus the kegels–for the other two workouts. She knows about the symptoms I get when I try to move to sitting or standing kegels and has agreed for me to continue doing the kegels lying down, but she thought I needed to progress in some way so she asked me to extend the long holds to 20 seconds. I tried that and told her that I could do it but only once a day. So at least now we’re on the same page. She knows I am doing your workouts, which she doesn’t have a problem with, but she doesn’t talk about them.

    On a positive note, she has helped me with my posture. It is pretty good generally, but I was noticing that when I stood for a long time cooking or baking I felt like I was internally “sitting” on my pelvic floor. I asked her about it and she took a closer look at the alignment of my ankle, knee, hip, and shoulder and asked me to lift my rib cage and bring my shoulders forward just a bit–and I immediately noticed my pelvic floor engage and pelvic basket lift a bit! So I’ve been really focusing on remembering to maintain that posture.

    One question I have about your video is that in the hip abduction exercises you say to pause or hold at the top, but then during the first set you are saying “squeeze” at the top. Should we be simply holding at the top or should we be adding an extra flexing of the glutes? Also, if I can flex my glute while holding my leg up am I doing the lift wrong?

    Thanks again,
    Kathleen

    #76636
    Tasha
    Keymaster

    Kathleen,
    Sounds like some good open communication with your PT which is great! In the sidelying exercise, my reminder to “squeeze” is so that you squeeze your gluteus medius for a 2 count (your outside glute muscle). Focusing your brain on which muscle to squeeze actually helps you recruit more muscle fibers – it will give that warm burn as you progress through the exercise if you are “squeezing” correctly. So it is a squeeze and a hold up top in this exercise that does the trick. Hope that makes sense!

    Tasha

    #76646
    Kathleen
    Member

    Tasha,

    Yes, thanks, that clears things up a bit. I was adding an extra flex of the gluteus maximus while holding at the top of the lift so it appears that is not what you were going for. How can I make sure I’m squeezing the gluteus medius instead? Would that be like imagining that you are pushing against someone trying to push your leg back down as you lift it?

    I read in another thread that you don’t recommend pessaries because they interfere with the natural firing of the muscles. I know what you mean about some of them. When I told my ob/gyn that I was hoping to still run, she recommended the gellhorn just for running. I tried it for a run and then tried doing my kegels while still wearing it-not a good idea! Boy did that hurt! That made me rethink using the gellhorn at all. So I simply quit running. But I’m thinking that doesn’t apply to all pessary shapes, right? Tampons can work like a pessary, but tampons don’t interfere with the firing of our pelvic floor and basket muscles, do they? Have you looked at the IncoStress pessary? https://www.incostress.co.uk/ It is shaped like a tampon and is supposed to help with, rather than interfere with, pelvic muscle training. Thoughts?

    Thanks!
    Kathleen

    #77542
    Tasha
    Keymaster

    Kathleen,
    If you are sidelying and lifting your leg toward the ceiling, it would be hard for you to squeeze your glute max (which moves your leg straight back) and not your glute medius (which moves your leg out to the side and slightly back). So no worries, lead with your heel, lifting your straight leg toward the ceiling and you are targeting the gluteus medius. Pause at the top so the movement is slow and deliberate and you are on track.

    Go for it on the tampon shaped pessary. If your body will hold that in without effect that is great. Typically pessaries sit above the the pubic bone and use this shelf to stay in place. Depending on the weight of the one you are describing, it may work more like a sea sponge that fills the vaginal canal but isn’t a hard structure that would put cross fiber pressure on the vaginal muscles.

    Tasha

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