You should have been told at some point in your radical prostate treatment to perform Kegel ( pelvic muscle ) exercises.
So what are they and what’s the point?
The surgery or radiotherapy you have received will have severely damaged tissues adjacent to your prostate and weakened the muscles on your pelvic floor that influence continence and potency You will be incontinent and impotent in some measure for some time, perhaps permanently. You can improve recovery times and/or reduce the effects of this trauma by carrying out pelvic floor exercises.
These are designed to strengthen these muscles, to provide support for your bladder and penile muscles to control continence and erections. The Squeezy app is recommended to impose a regular discipline on you to carry out the exercises at timed intervals and to record your progress.
Kegel Categories
There are 3 main categories of exercise, reflected in the squeezy app exercise routine.
The first is a clench and 10 second hold, followed by a 10 second controlled release. This is designed to provide strength to the muscles to enable long hold times.
Muscles are strengthened, be it biceps, abs or pelvics, by forcing micro tears in the muscle tissue which then heal during rest period, so it’s important to allow sufficient time between session for this to happen. The tears happen when muscles are over-stretched by loading, in this case, clenching hard. Slow relaxation allows the muscles to recover.
The second exercise is one or two seconds clench and the same time relax. This is to train the fast-twitch fibres of the muscles. The purpose of this is to deal with sudden stress incontinence when for example you sneeze, cough, change direction or get up suddenly and so on. This is the most frequent manifestation of post treatment incontinence that we experience.
The third exercise is a half-squeeze for a long (30 second or so ) duration. This is to encourage stamina in the muscles so you can contract your muscles for long periods.
Like all muscle-building, this takes time. You won’t see much progress for 2 or 3 months initially, then things should improve slowly as you continue.
The Knack
But there is no point in just strengthening if you don’t also apply it. So the fourth element is what is known as ‘the Knack’. This is training your body (and brain) to automatically invoke one of the above exercises according to circumstances. This is also the most difficult bit because it takes constant concentration .
So for example, if you feel a sneeze coming on you should simultaneously do the fast clench, if you get up from sitting, perhaps take a moment to start the slow clench and when you are just walking along, you may need to constantly half-squeeze.
In general, when you are sitting, lying or resting with your legs raised, gravity works for you and you don’t need to do anything, but it will be different for each individual.
Learning and using the Knack takes a long time, but you will improve and one day you will realise that you are doing it without thinking. As long as you keep the exercise regime going ( for the rest of your life) you may well find that you have conquered incontinence.
So, that’s the point of Kegels. It’s not easy but there is an achievable goal for most men. Using a pelvic floor physiotherapist specialist is worthwhile if you can afford it, for both progress measurement and encouragement. Good luck.!
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