What to Expect at Your Physical Therapy Visit: Part 2

After the initial education about why and how to perform pelvic floor exercises (aka Kegels), there is always the question of what next? How long until these exercises work? Are there other exercises? Do I have to do this forever?

Your physical therapist (PT) should continue to guide you to the answers to these questions. Let’s dive in and talk about some of the next steps and questions.

Recovery timeline

How long until these exercises work? (Or, when am I gonna be dry?) The worst part about this question is that the answer can vary from person to person because there are so many factors involved. Your PT should discuss your case with you and all the variables that come into play, such as your ability to recruit the pelvic floor, the type of surgery or treatment you have undergone, and your lifestyle, hobbies, and work.

It does take time to build muscle strength, so patience and dedication go a long way toward getting better. PTs are great at motivating you to stick to the program as well as guiding you to seek other care if the exercises are not working.

Establishing an exercise routine

Are there other exercises I should do? Your PT will definitely help you here. We know that dedicated, isolated Kegels help to speed improvement in bladder control. We also know that incorporating other muscle groups into the program may help some people.

Your PT should talk to you about your lifestyle and your activity goals. If you are an accountant who just wants to make it through the workday without leaking, then go home and walk the dogs for exercise, we will show you the best exercises to achieve those goals. If you are a welder who lifts heavy weights for fun, well, we may have a different program for you.

Often, just doing the Kegels in different positions is all the modification you need. So, yes, there may be other exercises for you to do, but we may want you to stick with Kegels because you can reach your goals by doing just Kegels.

Long-term outlook

Do I have to do Kegels forever? Simple answer: Yes. You should plan to practice Kegels routinely.

Longer answer: Still yes, but with the understanding that we don’t really know whether each person who achieves continence (dry underwear) needs to continue the exercise program or not. I have seen some patients who were dry for years and started leaking later on. Starting back on Kegels helped some of them.

I often tell my patients that exercising the pelvic floor is just like going to the gym. You have to keep doing it if you want to continue to reap the benefits.

Building a care team that works for you

I hope that these articles give you an idea of what to expect with physical therapy for post-prostatectomy incontinence. As with any healthcare provider, you should expect compassionate care aimed at your individual needs. Communicate with your PT about your goals, and I believe you will find a valuable partner in care.