♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- Together we are the famous physical therapists
on the internet.
- In our opinion ofcourse Bob.
- Today we're gonna show you how to cure
urinary incontinence with kegels exercises.
- Kegels?
- Is it kagels or kegels?
- Well, depends on what country you're from I think.
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we're talking today.
- Yeah, podcast away Bob they won't be able to see.
- They won't be able to see this.
We're giving away a feet glide.
Which is a device, very lightweight
that you can actually work your legs
in a seated position and also lying down.
- Yes, do you want me? - We won't show that.
- Yeah. You can take it to bed
with you and work it, it does different angles.
It weighs 5.1 pounds.
You can pick it up and do what you want with it.
Hang it up in the closet.
- All right, kegel exercises.
Now I've been asked
by a family member a long time ago
to show her how to do these.
And I really didn't have much experience with them.
And so now I've read a couple
of books on it and I've been doing them myself.
- Yeah.
- And I'll talk about that some other time.
- Self help books I suppose. - Yeah.
So, what is urinary incontinence?
It's involuntary loss of urine.
- It's embarrassing.
- Yeah, it's embarrassing, you could be laughing,
you could be getting off the floor,
you might be jumping. - Right.
- Really common among the young women, even in sports.
- Sure.
- Trampoline obviously and as you know,
you gotta rush to the bathroom
and you don't get, if you don't make it so.
I had a family member
an older family member that really had trouble with this.
And it really socially isolated him.
I mean, it's not really a laughing matter at all.
- No it isn't.
- It causes depression and loneliness and you know
it's gonna impact your social life.
Your, you don't want to date someone
because you're afraid of it.
- Right.
Your spouse may not want to be with you.
- Right. Right, right.
- Maybe they do, but it's awkward.
- So a lot more common in women,
some reports, I saw one out of three women over
one out of three women have it.
And over 65, one out of two women.
- Yeah. - So that's very common.
Actually, believe it or not,
one out of 20 men also have it,
but my wife made the observation.
She goes, you go into the store
and there is all these male Depend diapers there.
- Which are made for-- - Incontinence.
- Right.
- So it may be a bigger problem that we're in..
- I think men just wont admit it
- Men won't admit it.
They'll, let it go.
- Not me though, I wouldn't.
- Yeah. All right.
So what we're talking about here
for kegels are kegels exercises is we're trying
to strengthen the muscles on the bottom of the pelvic floor.
So it's attached actually, the pelvic floor is attached
to the sit bone here, oh not the sit bone, I'm sorry.
- Coccyx. - Coccyx tailbone,
and up to the pubis.
So it's right in this area here where my hand is.
- It is, that's why they call it the pelvic floor.
It's literally on the bottom of the pelvis.
- Right, it supports everything,
- Right?
- It supports all those structures down there.
If you've got two layers of muscles
a superficial deep layer,
but you don't have to worry about that
because when you can't work them separately
if you're working one you're working on both.
So it was developed by Dr. Arnold Kegel in the fifties,
very popular now.
- 1950s. - 1950s, right?
So the pelvic floor, you can control voluntarily
but it is also, which is an intentional muscle contraction
but is also an automatic type
of muscle that's working when you're not
even thinking about it.
- Right, it'll automatically contract
and take care of business. - Yeah.
So like when you're lifting something
or carrying something it's kicking in so
that you don't go to the bathroom while you're.
- Yep, it closes those sphincters off and you're sealed.
- So, what should happen
when you feel a pelvic floor contracture?
You know, you're gonna have like a gathering
of the pelvic floor muscles
and it's gonna contract and lift up a little bit.
That muscle is actually going to lift up.
And also we gonna apologize ahead of time here.
We're going to use some graphic language here.
I mean, it's appropriate. - We'll be professional
- Yeah. But your anal sphincter it should also be lifting
up now with the ladies and the men too.
You're gonna feel the perennial body lift up.
Now the perennial body is the area between the vagina
and the anus.
And for the men, that's between the what will I say,
testicles and yeah, scrotum.
- Scrotum.
- How about scrotum and the anus.
So that you and you we'll talk about that.
That you can actually feel that with your hand,
you won't do it in public,
but you know, when you're trying to learn them
- So you wanna feel that movement
and you wanna be able to do it
and command your vision or your mind is telling you
and you feel like you have good control.
- Yep, you should continue to breath normal.
People should not be able to know
that you're even doing it.
My wife and I are joking that we've been doing these
and you could be talking to each other and doing it.
I mean, we could be doing it right now.
So what should not happen when you're
doing the pelvic floor Brad is you don't want
to contract outside muscles.
I've seen this on some other channels.
Like you don't want to tighten up the glutes
the inner thigh or the abdominals.
You don't.
I mean, the muscle that you want was working down there.
- You wanna isolate. - Isolate it so.
Don't hold your breath.
You should be able to talk, don't tense your eyebrows
or your shoulders, your body parts, you know, or yeah.
- I would think that this is gonna require initially
some practice by yourself, - Practice by yourself
get used to it and becomes easier.
- And if you have trouble, there's therapists that
specialize in this area, we had a couple of therapists
that's all they did.
- Right. Sure.
- So these are the common cues
and these are the ones that tend to help.
We'll talk about it for women and for men.
So women, they tell you to squeeze lift the pelvic floor.
They've told you the contract like you're trying
to stop the stream of urine from happening,
but they don't recommend doing that
because it can actually result
in a urinary tract infections.
And you can, I guess you can screw up your urinary reflex.
So you don't wanna actually start going
to the bathroom and then stop it.
- Oh, sure.
- Yeah. You want to think about how that feels
and then apply it.
You can, I mean, again
I'm gonna get a little graphic here, Brad
but you're supposed to imagine lifting
and holding something in your vagina.
- Sure.
- That's another one, you're supposed to squeeze
like you're trying to hold in gas.
- Yep.
- Oh, I think we've all done that.
So, or imagine pulling your sit bones together.
So these are the sit bones.
I first misstated at first, that's these two bones.
They're the bones you can feel when you're sitting down.
- If you're on a hard surface, you can feel those bones.
- Yeah. You're supposed to feel like
you're pulling those together.
- Sure.
- And that'll help lift that area up.
Now for men, this is kind of interesting.
They did a study on this Brad
and they had all these cues and the best cue that worked
for men was you're supposed to feel
like you're shortening your penis.
Don't make a joke.
- It's like a turtle. - Like a turtle right.
- Guys understand that.
- Yeah. But if he, it's funny, when I do that
it feels like, one it works,
and at two, it's easy cue to understand.
So I don't know why but
- I bet your wife knows when you're practicing that.
- Yeah. (laughing)
- I mean, she knows you.
- Stop, okay for positioning, you can lie
on your back with your propped up on a pillow
or you can have your knees up.
You can be in a quadrupedal position Brad.
Yeah.
And if you don't start that way
you might want to progress that way
to doing it that way, to do it sitting,
to do it standing so you can do it
apply it to all.
- So you would start lying on your back.
- I'll start lying down, yes.
That's what I would do. - Okay. Very okay.
- So this is how you can feel it, I think--
- How many repetitions?
- They got different ways of doing this.
One, you can like eight to 12 reps spread
and do a ten second hold.
- For a - Yeah.
So hold for 10 seconds.
Do another one, do eight to 12 of those.
- And then rest for 10 or?
- Then you can do it like three times a day.
- So you're gonna hold it for the contraction
and then rest for whatever, - Yeah, whatever.
- And then do it again.
- There's also, and they said, you want to get
up to like a hundred reps a day.
- So not in a row. - Not in a row.
And there's also, it's a slow Twitch
and a fast Twitch muscle fiber.
- Oh really?
- So you can actually do somewhere you do one second hold,
one second release, one second hold one second release.
- Sure.
- So you wanna, can't throw both of them in there Brad.
So, these are the ways to feel it.
This is a little bit, I don't know
if you want to say grotesque, but one way you can tell
whether or not it's working is you could take a small piece
of tissue paper and put it over your anal sphincter.
And if you're doing it right, it's actually
gonna kinda suck that paper up a little bit.
- Really? - Yeah.
Like it's going to grab onto it and pull it up.
- Well, it's like therapists, you know, when we talk
about doing, working your gluten muscles, it's very common.
Since I started therapy back
in the eighties as the teacher would say, well
pretend you got a quarter between your butt cheeks
and you're trying to squeeze that quarter
so it doesn't fall out.
And it's like, boy that, - It works.
- Patients really respond to it.
And they do it right.
- You won't want to do that now
because you're not trying to move the butt cheeks.
But this is the one that I thought worked the best for me.
And for people, it seemed like.
So again, the perennial body is that area between the vagina
and anus or the scrotum and the anus.
- Right.
- That area right there.
If you put your hand on that again
you won't want to do it in public,
but you just put your hand there when you do it,
you'll feel it lift up. - Sure.
- I think that's the best cue you have.
It seems like it works really well.
- Basically biofeedback here.
You're feeling what's going on with the muscles.
- Speaking of biofeedback and we can laugh 'cause we're men.
You can actually see your penis lift a little bit
if you're doing it right so.
- I have to laugh.
- We should have seen it.
I should have said, see if you can not laugh
and see if you're not doing it again,
We're laughing but we know this is a serious problem.
We really do - You gotta have fun
with life, don't you Bob?
- I know. 'Cause it's a terrible thing.
So you wouldn't be doing this
after surgery unless you're doctor has okayed that.
And you shouldn't, you don't do it
with a urinary catheter either.
- Sure. - Don't do it in place.
So that's it, Brad.
I know we're not experts on this
but it's definitely, it's helped me
with some issues and we'll talk about that in another video.
So, - So very good, Bob.
- All right, thanks for watching.
(upbeat music)