Kegels and Quick Flicks

Urinary incontinence (UI) is NOT something you have to live with, and is NOT something that goes away on it's own. In fact, UI usually worsens over time. Roughly 80% of those affected by urinary incontinence can be cured or improved.* Participation in a consistent program led by a trained pelvic health PT can lead to a successful decrease in urinary incontinence symptoms. Exercises now to strengthen the pelvic floor, can save you a lot of money down the road. Studies estimate that incontinence products cost an average of $500 per year.* UI is also one of the main reasons people are placed in assisted living facilities as they age.

There are a variety of pelvic floor exercises that a trained pelvic health PT can use to help lessen the symptoms of UI. Kegels and quick flicks are a couple of examples of ways to strengthen the pelvic floor. Before we get into what a quick flick is and how it's different than a Kegel, let's talk about the muscles in general.

Did you know that your skeletal  muscles consist of 2 different types of muscle fibers : fast twitch and slow twitch fibers? It’s important to understand the difference when it comes to training your muscles, including your pelvic floor muscles. Knowing and understanding what you are using your muscles for is important, especially  when its comes to training them. What are you using the muscle for? What is their role, function or job? 

When it comes to your pelvic floor musculature, what are some of their roles? 

1- To support the organs in the pelvic bowl such as the bladder, uterus & prostate

2- To aid in urination and defecation 

3- To aid in sexual function 

4- To control movements of the pelvis & hips (they are an important part of the deep core) 

Understanding the role the muscle plays in how the body moves is one of the first steps to learn how to effectively train it. What are their roles and what do you use them for? 

The average person has equal amounts of both slow and fast twitch muscle fibers. Slow and fast twitch muscle fibers have different metabolic characteristics. Muscles are the main site of energy consumption in the body.

Type 1 are the slow twitch, which generate energy via aerobic metabolism. Slow twitch fibers are used in long duration contractile activities, such as stabilizing the spine and postural control. They are resistant to fatigue. 

Type 2 are the fast twitch, which generate energy in an anaerobic manner for quick powerful contractions. Type 2 fibers are used in short duration power activities such as power lifting  and sprinting. They are very quick to fatigue, but have a very high force production. 

Even though most of our muscles have about a 50/50 split of fast twitch and slow twitch muscle fibers, your age, activity level, race and genetics also play a role in the breakdown of these 2  fiber types  in our bodies. As we age we lose lean muscle mass, with this loss comes a decrease in Type 2 muscle fibers and an increase in Type 1. Some people with a low level of activity might have a greater percentage of Type 1 muscle fibers, whereas an athlete that is a sprinter might have a higher percentage of Type 2 muscle fibers.

Now that we understand the difference between the 2 types of muscle fibers, let’s get back to how to train them, specifically as we talk about the pelvic floor. 

Let’s consider the different roles the pelvic floor musculature plays:  They are one of the four deep core stabilizers (along with the diaphragm, multifidus and transversus abdominis) that are responsible for stabilizing the spine and pelvis as we move our limbs. This is a low load, long duration type contraction which would be comparable to those Type 1 muscles fibers. But, the pelvic floor is also responsible for stopping the flow of urine when you are about to sneeze  or laugh, which might require a more powerful contraction over a short period of time. See the difference? 

To effectively train the pelvic floor musculature, you must incorporate different types of exercises to train the muscle in different ways. Long duration contractions for 10 seconds (Kegel) as well as short powerful contractions, called “quick flicks” holding for just 2 seconds are both important training methods based on the roles of the PFM. 

A home program might look like this to start: 

-10 second hold 10 second rest repeat 10 times 

-2 second hold 2 second rest repeat 20 times.  

(To start these exercises for the first time,  lie on your back with your knees bent- Try these exercises spaced out 3 times a day to start and increase from there as you improve).

A couple things to remember:

-It’s important to fully relax the pelvic floor in between contractions. 

-Remember to focus on using just the pelvic floor muscles and not the larger muscle groups in the surrounding area: such as the quads, adductors, and gluts.  -Do not hold your breath. Use the exhale to aid in contracting the pelvic floor. 

If you have any issues with urinary incontinence, or have any questions about whether you are performing a pelvic floor contraction effectively, you can schedule a free phone consultation today. If you have been trying pelvic floor exercises and have not seen any improvements, you may not be performing the exercises correctly or might not be performing the 'right' exercises. To schedule a consultation, email or call The R3finery today. 

1) ILL Department of Health, Women's Health, Facts about Incontinence www.idph.state.il.us

2) The "Costs" of Urinary Incontinence for Women, Subak, Brown... Diagnostic Aspects of Incontinence Study Group, Obstetrics and gynecology