The answer is maybe. With some of the cases we see, we start to see some muscle weaknesses and things like that. Kegels can be helpful, but by the time people start possessing some of the disorders we are discussing here, we can actually do a bit better than Kegels. We have a great team here. Kegels are a tough muscle to isolate. They are very deep. That is why we use a lot of physical therapy to understand that you actually aren't isolating those muscles when you think you are. There are many more precise techniques like physical therapy and biofeedback that can actually show you how to isolate the right muscles to make it a much better result.
With pelvic floor exercises or Kegels, same thing, for people with extremely advanced prolapse for example where everything is out, pelvic floor muscle rehab is not going to make that go back up. But where we find pelvic floor rehab really useful is for people with more mild symptoms. We can sometimes eliminate symptoms with physical therapy. Also for people with pelvic floor disorders, and even those who have had pelvic floor surgery, you can only benefit in terms of preventing reoccurrence by doing pelvic floor rehab. The best evidence for pelvic floor rehab in the urogynecology world is for stress urinary incontinence, and also can help with overactive bladders. We see as much as 70 percent symptom improvement in motivated people who do them correctly and regularly. The trick with pelvic floor exercises is really getting into a therapist and learning to do them correctly. By large, the majority of women who try to demonstrate Kegel exercises aren't really isolating the right muscles.
There is some thought that people should be doing pelvic floor exercises even before they have babies, and even in some European countries women are automatically sent to pelvic floor rehab after they have babies. So I would say in terms of prevention number one is getting back into a pelvic floor physical therapist after giving birth. Some of the risk factors for pelvic floor disorders are modifiable and some are not. So again, you can't fight your genes. You can't fight your connective tissues or things like that but the things that are modifiable are obesity, smoking as it contributes to cough, controlling allergies. Some risk factors are modifiable and some are not. Physical therapy is covered by insurance. If you know you have a weak pelvic floor there is no reason to wait. Ask your obstetrician for a referral today.