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What are the Coordination exercises?

Coordinating squeeze and cough: This exercise is similar to the Squeeze & Relax with the addition of a cough during the squeeze. Contract your pelvic floor muscles and bring your knees together, while holding the contraction, give a cough. Hold the squeeze for 5-10 seconds, then relax the muscles for 10 seconds before repeating. If bringing your knees together, in addition to squeezing and coughing feels like too much, skip it. As you get stronger you can try adding two or more coughs. Coordinating squeeze and standing: This exercise is also similar to the Squeeze & Relax, but now you are adding a position change. While sitting, contract your pelvic floor muscles and as you stand up keep holding the squeeze. Hold for a total of 5-10 seconds, then relax the muscles for 10 seconds. Sit down and repeat. If you can't hold the squeeze the whole way as you stand up, try holding the squeeze at least part of the way. Coordinating squeeze and sitting: This exercise is essentially the coordinating squeeze and standing, in reverse. Stand with your feet shoulder width apart, contract your pelvic floor muscles and hold the squeeze as you sit down. Hold the squeeze for 5-10 seconds, relax for 10 seconds, then stand up and repeat. This activity is more challenging because the pelvic floor muscles naturally want to relax as you lower your body. If you can't keep your muscles contracted when you go from standing to sitting, practice holding the squeeze while only sitting partially. Advanced coordination: Practice keeping your pelvic floor muscles contracted while doing other activities like lifting, climbing stairs and squatting. Don't forget to breathe and relax your pelvic floor between contractions! Try to exhale while lifting to avoid holding your breath and straining.



What is the Squeeze Before you Sneeze exercise?

Whenever you feel a sneeze, cough or laugh coming on, squeeze and hold your pelvic floor muscles as tightly as you can until the sneeze or cough is over. This exercise adds additional support to prevent urine leakage during a sneeze, cough or laugh.



What is the Squeeze & Relax exercise?

The Squeeze & Relax involves tightening the pelvic floor muscles inward and upward as tightly as you can, holding the squeeze for 3-5 seconds and then relaxing for 10 seconds. You will do 10 repetitions of the squeezing, holding, and relaxing.
Don’t worry if you cannot hold for very long or cannot do 10 in a row. As you get stronger, you will be able to hold the squeeze longer and do more squeezes. Work up to your goals at your own pace, remember that as with any exercise program, you will get better with practice.



What is the Quick Flick?

To do the Quick Flick, you contract your pelvic floor muscles rapidly and then let go immediately and completely, bringing the muscles back down to a relaxed state. You will do 10 quick flicks in a row. Many women notice it takes longer to relax than contract when doing Quick Flicks. That's common and normal.



What is the Pelvic Floor Elevator?

With the Pelvic Floor Elevator you imagine that there is an elevator at the bottom of your pelvic floor. You start by closing the elevator doors and bringing the elevator up to the fifth floor, where you hold it for 3-5 seconds. Then you bring the elevator all the way up to the tenth floor and hold it again for 3-5 seconds. Then bring the elevator back down to the lobby, and then relax even further into the basement. Practice bringing this elevator up and down – lifting inward and upward and then relaxing outward and downward. This exercise helps to build endurance and teaches you how to vary the amount of tension in the pelvic floor muscles, building the necessary muscle control. When you first start practicing this exercise, you may want to do it on the toilet, in case you lose urine or pass gas when you completely relax the pelvic floor and bring the elevator to the basement. However, do not practice this exercise when you are on the toilet trying to empty your bladder or bowels, because the pelvic floor muscles should be relaxed when we are trying to empty.



How does fluid intake affect the bladder?

Everyone knows that the amount of fluid we drink impacts our bladder symptoms. What not everyone knows is that drinking too little fluid can be just as bad for bladder symptoms as drinking too much fluid can be.

If you drink too much fluid, you will notice that you go to the bathroom more often than other people - but that is probably because you are making more urine than they are. A sign that you may be drinking too much fluid is that your urine will look very clear, like water. You can cut back on fluid by drinking only when you are thirsty, and drinking smaller amounts than you normally would. If you have a history of kidney stones or frequent bladder infections, your doctor may recommend that you drink lots of fluid. If your doctor has recommended that you drink lots of fluid, don't cut back without talking to him or her.

If you drink too little fluid, you may also go to the bathroom more often than other people, but not because you are making more urine. If you are not drinking enough fluid, your urine will be very concentrated (dark yellow in color, with a strong smell). Concentrated urine irritates the bladder lining and makes the bladder feel full when there is less fluid in it. Even though it sounds crazy, drinking more fluids will actually help your bladder hold more urine, because the urine will not be so irritating.

Drinking too little fluid can also worsen constipation. Constipation fills the space in the pelvis with stool (poop) so that there is less space for the bladder to store urine. Increasing your fluids will help with constipation, and empty some of that space so that the bladder can store more urine.



How do types of fluids affect the bladder?

Certain fluids, such as caffeine, tea, artificial sweeteners, carbonated drinks, and alcohol, can irritate the bladder and make it more likely to leak. Pay attention to whether these drinks may your symptoms worse. If they do, avoiding these fluids as much as possible can improve bladder symptoms. Cutting back all at once is challenging so try to make little changes over time. For example, cut down from two cups of coffee to one, or try switching to decaffeinated, or half-decaffeinated, coffee.



How much urine should the bladder hold?

A comfortably full bladder should hold about 1 1/4 cups of urine (10 ounces). If you are curious about how much urine your bladder holds, you can measure it by peeing into a container when your bladder feels comfortably full (not painful, but you are ready to go to the toilet). Then mark the container and pour the urine into the toilet. Pour water from a measuring cup into the marked container to see how much urine was there. If your bladder holds much more than 10 ounces, you should try to urinate more frequently. Having too much urine in your bladder makes you more likely to leak, just like you are more likely to spill with a very full cup of water than you are with a cup that is half-full. Also, if the bladder muscle is always getting stretched, it can grow weaker with time. You might try setting a timer to remind you to go every 3 hours; if you are still voiding more than 10 ounces each time, set the timer to remind you to go every 2 hours. If your bladder holds much less than 10 ounces, you should try to gradually train it to hold more. Right now, your bladder is used to emptying when it holds less urine, and it probably feels full earlier than a healthy bladder would. You can teach your bladder to hold more urine by very gradually stretching out the time between trips to the toilet. If right now you go to the toilet every hour, try to wait an hour and fifteen minutes between trips. After a week or so, try to wait an hour and thirty minutes between trips. Over time, you will teach your bladder to feel comfortable with more urine inside it.



Soluble Fiber

Brings fluid into stools and creates a gel-like consistency that helps stool stick together.

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Can be found in grains, nuts, legumes, fruits and vegetables.

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Foods rich in this type of fiber include:

  • Beans (black, red, kidney, pinto, etc.)

  • Split peas

  • Lentils

  • Soybeans

  • Baked beans

Insoluble Fiber

Bulks up loose stools by soaking up excess fluid, promoting the movement of stool. ​

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Can be found in grains and in the skin of fruits and vegetables.

​

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Foods rich in this type of fiber include:

  • Skin of fruits and vegetables (apples, raisins, potatoes, etc.)

  • Kernel corn

  • Spinach, kale, bell peppers

  • Whole wheat, brown rice, buckwheat, quinoa, etc.

Soluble Fiber

Brings fluid into stools and creates a gel-like consistency that helps stool stick together.

​

Can be found in grains, nuts, legumes, fruits and vegetables.

​

​

Foods rich in this type of fiber include:

  • Beans (black, red, kidney, pinto, etc.)

  • Split peas

  • Lentils

  • Soybeans

  • Baked beans

Insoluble Fiber

Bulks up loose stools by soaking up excess fluid, promoting the movement of stool. ​

​

Can be found in grains and in the skin of fruits and vegetables.

​

​

Foods rich in this type of fiber include:

  • Skin of fruits and vegetables (apples, raisins, potatoes, etc.)

  • Kernel corn

  • Spinach, kale, bell peppers

  • Whole wheat, brown rice, buckwheat, quinoa, etc.

Food triggers: Sometimes specific foods can be the cause of uncomfortable bowel and bladder symptoms. We can do an experiment to see if this is the case: ​

First, remove the food item from your diet for one week. Really pay attention to your symptoms and note if you feel a difference.

  • If your bowel symptoms improve, that food (and other similar foods) may be a trigger, and we should continue to avoid it.

  • If our bowel symptoms do not change, that food is probably not a trigger, and we can put it back into our diet.

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To help with stool seepage after bowel movements, try the following before wiping:

  1. Place your feet hip-width apart, and place your hands at the outside of your knees.

  2. Push your knees out while resisting with your hands. While still pushing your knees out against your hands, squeeze the anal sphincter hard and hold for 10 seconds

  3. Relax for 10 seconds and move your hands to the inside of your knees

  4. Push your knees in while resisting with your hands. While still pushing your knees in against your hands, squeeze the anal sphincter hard and hold for 10 seconds

  5. Relax for 10 seconds

  6. Then, as you wipe, squeeze the sphincter hard, as if you are squeezing the remaining stool out onto the toilet paper. 

Information used with permission from Michigan Bowel Control Program Patient Education by University of Michigan Health System is licensed under a Creative Commons Attribution-Non-Commercial-ShareAlike 3.0 Unported License.

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Increase total fiber and fluid intake
Goal consistency,
maintain fiber amount
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Type 7
Increase total fiber intake to bulk up stools

When we concentrate we often tend to hold our breath, it is important to breathe comfortably and evenly before, during, and after the exercises. Take 2 minutes before you start your exercises to focus on breathing. Relax your body, making sure your pelvic floor muscles are also relaxed and that you are not holding in your abdominal muscles.

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This website was created by researchers at the University of Wisconsin in collaboration with the Department of Obstetrics and Gynecology and the College of Engineering. 

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