Andrew Siegel MD 11/19/14
I’ll be in Miami for a few days at the SMSNA (Sexual Medical Society of North America) meeting, so will upload this blog earlier than usual.
FUNCTIONAL PELVIC FITNESS
It’s one thing to work out your muscles in order to make them stronger, better toned and more durable, but it’s another dimension when you can put that effort to practical use over the course of your day. Since the pelvic floor muscles are muscles of function rather than form, muscles for “go” rather than “show,” they can be put into service when applied to common real life situations.
Urinary and Bowel Urgency (for both sexes)
Chances are that at one time or another you have experienced a sudden and urgent desire to use the bathroom when none was nowhere in sight. This often occurs as a result of an involuntary bladder or bowel contraction, when the bladder or bowel squeezes without your permission, sometimes on the basis of triggers that induce a conditioned response (classic triggers are hand washing, placing a key in the door to your home, rising from sitting, exposure to running water, entering the shower, cold or rainy weather, getting closer and closer to the bathroom, etc.). By recognizing the occurrence of the involuntary contraction and by actively squeezing your pelvic floor muscles using a “rapid flex” technique—rapidly pulsing the pelvic muscles 3-5 times—the urgency can be relieved (and the leakage that can sometimes occur can often be prevented). This works equally as well for bowel urgency as it does for urinary urgency.
Going a step beyond inhibiting urgency after it occurs is preventing it from occurring before it occurs. In order to do so, it is important to recognize any triggers that may induce your urgency. Immediately prior to exposure to a trigger, rapid flexes of the pelvic floor muscles can thwart the involuntary contraction before it even arises.
Dribbling After Urinating (for men)
An “after-dribble” of urine is more annoying than serious and is often a sign of weakening pelvic floor muscles, for which strengthening exercises have proven an effective remedy. Squeezing the pelvic floor muscles is the body’s natural way of expelling the contents of the urinary channel. When contracted, the bulbocavernosus muscle—the body’s urethral “stripper”—compresses the deep portion of the urethra, pushing the urine out. The 1909 Gray’s Anatomy aptly labeled this muscle the “ejaculator urine.”
By actively squeezing your pelvic floor muscles immediately after urinating by using a “basic flex” technique—powerfully pulsing the pelvic floor muscles 3-5 times for 1-2 seconds per contraction—the last few drops of urine will be directed into the toilet and not your pants.
Stress Urinary Incontinence (for both sexes)
Stress incontinence is urinary leakage provoked by sudden increases in abdominal pressure, triggered by sneezing, coughing, bending, lifting, exercising, positional change, etc. It is a common condition in women, often resulting from the pelvic trauma of childbirth, weakening the pelvic muscles and connective tissues that support the urinary channel. Although less common in men, it can occur following radical prostatectomy for prostate cancer and sometimes after prostate surgery done for benign conditions.
In order to help control stress incontinence, you need to be attentive to the triggers that provoke it. By actively squeezing the pelvic floor muscles immediately prior to the trigger exposure, the incontinence can be improved or eliminated. For example, if standing up provokes the incontinence, do a brisk pelvic floor muscle contraction using a “long, hard flex”—contracting the pelvic floor muscles powerfully for 3-5 seconds when transitioning from sitting to standing. This long, hard flex is a means of bracing the pelvic floor muscles immediately prior to an activity that incites the problem and can be a highly effective means of managing the stress incontinence. When practiced diligently, it becomes an automatic behavior.
Weak pelvic floor muscles seem to play a role in hindering your ability to delay ejaculation. Pelvic floor muscle exercises are a promising treatment option for premature ejaculation, as they will increase the strength, tone, power, and endurance of the pelvic muscles, which can help short-circuit the premature ejaculation. Numerous scientific studies have demonstrated the effectiveness of pelvic floor muscle training in the management of premature ejaculation.
To apply your pelvic muscle facility to the real life situation you need to recognize the imminent ejaculation, slow the pace of intercourse, pause the pelvic thrusting and perform a “hold”—a pelvic floor muscle contraction lasting about 10 seconds or so, until the point that the ejaculatory urgency disappears. By actively deploying your pelvic floor muscles by using this sustained contraction of the pelvic floor muscles, the ejaculation can often be forestalled and intercourse resumed.
Bottom Line: Pelvic floor muscle training has numerous practical benefits, from the bedroom to the bathroom. Learn more about the specifics of these exercises—rapid flexes, basic flexes, long hard flexes and holds, through the Private Gym pelvic floor muscle training program, a comprehensive, interactive, follow-along exercise program that strengthens the muscles that support sexual and urinary health. (www.PrivateGym.com)
Wishing you the best of health,
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Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: http://www.MalePelvicFitness.com
Private Gym: http://www.PrivateGym.com – now available on Amazon
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