Few things feel less graceful than wetting your pants. Unfortunately, 10% of Americans of all ages and more than 35% over age 65 suffer from urinary incontinence, which ranges from leakage when sneezing to total loss of bladder control. Most people can prevent pelvic floor dysfunction and minimize incontinence issues with the right type of exercise. This article gives you the basics and several good resources. A future article, "The Problem with Kegels," will provide more detailed information and exercises.
The pelvic floor is a group of muscles slung between the tailbone, sit bones, and pubic bone. Although it’s the base of the torso, the word “floor” is misleading for several reasons. A floor is usually flat and hard, but the pelvic floor works best when it can flex up and down like a kite in the breeze. Also, the muscles are interconnected and overlapping, more complicated than a layer of tile.
You can think of the pelvic diaphragm as the bottom and the breathing diaphragm as the top of a cylinder. If the bottom is loose and weak, the contents of the abdomen aren’t well supported, the core muscles remain flaccid, and the bladder doesn’t have good control. On the other hand, if the pelvic diaphragm is tense, breathing is restricted, constipation is likely, and it’s hard to control the bladder during forceful motions like sneezing or jumping.
Exercising the pelvic floor will improve its tone and your bladder control. Fortunately, you can strengthen and relax the group of muscles during everyday activities: while waiting in line at the grocery store, watching TV, or sitting at a desk.
One simple exercise is to use your pelvic floor to start every exhale. Simply contract between your sit bones (think of drawing all four corners of the kite together) to start the out breath. It’s a very small movement, less than a quarter inch from each corner. Then remember to relax the pelvic floor completely at the top of your inhale.
My favorite book of pelvic floor exercises is Pelvic Power by Eric Franklin. His imagery makes subtle exercises easy and is never boring. On Amazon at http://www.amazon.com/Pelvic_Power_Exercises_Strength_Flexibility/dp/0871272598.
This Canadian Women’s Health Network has an excellent website with comprehensive information about urinary incontinence. Check it out at http://www.wowhealth.ca/myself/ui/index/html. You can also print their exercises at http://www.health.ca/pdf/kegel_en.pdf.