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This article is a transcribed edited summary of a video Bob and Brad recorded in January of 2021. For the original video go to https://www.youtube.com/watch?v=l2aIKP-aWWQ&t=107s
Bob: Today we're going to show you some easy exercises to help hemorrhoids. Yes, believe it. This helps hemorrhoids and I'm going to actually sacrifice myself here, Brad. I'm going to admit that I had hemorrhoids, and this has helped my hemorrhoids.
Brad: Say no more, Bob.
Bob: Now I'm going to just go and warn you right away. The language is going to be a little bit graphic at times on here. We're not using blasphemy. We're just using descriptive words. So we're going to be talking about the genitalia and stuff like that.
Brad: It's all professional.
Bob: It's all professional, yeah. So what we're talking about here is Kegel's exercises. Arnold Kegel. He invented this in the fifties and it was really done mostly for urinary incontinence but I saw a bunch of articles, Brad that it does help hemorrhoids. It gets more blood flow to the area. But in my case, I'm going to get a little graphic here but it firms things up so things don't droop as much.
Brad: Around the anus.
Bob: Well yes, because you're strengthening the muscle of the pelvic floor.
Brad: Sure.
Bob: And the pelvic floor is made up of the superficial level and a deep level. But when you do this exercise you're strengthening both levels.
Brad: Sure. The pelvic floor, I envision them kind of flat like a pancake or like a diaphragm. And it literally is the pelvis floor that keeps things supported so that your visceral organs stay where the need to be.
Bob: Exactly. It's like a netting down there. And you know, it's horizontal just like the diaphragm. In fact, I think it's called, there's a name where they call it something like the diaphragm.
Brad: The bottom diaphragm?
Bob: Yeah, something like that. Seriously.
Brad: Inferior diaphragm?
Bob: Well, if not, we just made that up. So if you want to strengthen these or we're going to give you hints on how to do it. What you're going to feel is like a gentle gathering of the pelvic floor muscles. You're going to contract and lift them up. You should feel like you're including the anal sphincter. Like that should be moving up. With ladies and men too, in fact, we're going to talk about this later, you want to feel like the perineal body is lifting up. The perineal body. What is it, Brad? You want me to tell them?
Brad: Yeah, go ahead.
Bob: It's the area between the anus and the vagina for women and the anus and the scrotum for men. So it's really, we'll talk to it later how you can actually palpate that and feel it moving up.
Brad: So I'm assuming this is preferred in the seated position.
Bob: You could do it lying down. You could do it seated. In fact, it's a good thing to progress. Like start lying down. Then you could even do it in a quadruped position.
Brad: On your hands and hands and knees.
Bob: Hand and knees. You could do it in a seated position and they should do it standing. The whole thing with this, you should continue to breathe normally while you're doing this. People should not be able to tell that you're doing this. Brad and I could be doing it right now and you'd have no idea.
Brad: Assuming you've practiced it.
Bob: Practice, and you know what you're doing. With men, you may actually feel the base of your penis lift up and possibly your testicles as well. You know, we'll get into all the cuing that goes on. What you shouldn’t feel is you shouldn’t feel other muscles contracted, like the glutes.
Brad: You should or you should not?
Bob: Should not. They should not. You're trying to focus on the pelvic floor. You shouldn't feel the inner thigh. You shouldn't feel the abdominal muscles contract.
Brad: So if you're straining and tightening everything?
Bob: Yeah. You know and I've seen some other channels where they were actually promoting that. And I was like, you know, I don't think that's right.
Brad: That's not along with this?
Bob: Kegel's, yeah.
Brad: It came out of a book or two books, you said?
Bob: I've read a couple of books on it.
Brad: Sure.
Bob: Don't hold your breath. You should be able to talk. Don't tense, anything up in your face either, your eyebrows or shoulders, biceps.
Brad: It's just one of those things on isolating muscles. I mean, we do this with people, with your abdominal muscles try to isolate that for pelvic position. A lot of these areas of the body are very difficult to isolate or it's just not a normal thing. It's not like moving a finger, you know?
Bob: Yeah, I think that's a good point to be made, Brad. You can voluntarily control the pelvic floor muscles. But it's also got an added automatic component to it. It's going to automatically work at times when you're lifting or you're carrying something, you know.
Brad: I compare it to your breathing muscles. I mean, you can voluntary control your diaphragm and your breathing. But at the same time you don't have to think about it and you continue to breathe.
Bob: It's going to keep going. Hopefully, thankfully. So these are the common cues, and this is probably the most important part of this, is for women, you're going to squeeze and lift the pelvic floor. They tell you, you want to tighten up like you would like to stop the stream of urine. But they don't want you doing that. They don't want you to just start going and then stop.
Brad: Not literally?
Bob: Not literally because you could develop a urinary tract infection and it can mess with your reflexes, I guess a little bit, your urinary reflexes. So yeah, you want the feeling like you're stopping urine but not actually doing it. And another cue is you can make it feel like you're lifting and holding something in your vagina. You can also squeeze, like you're trying to hold in gas, which Brad and I know quite well. You know you're afraid to let one go, you're among company so you tighten up.
Brad: Flatulence, Bob.
Bob: Flatulence. There you go.
Brad: I got to put some professionalism in there.
Bob: That's right. So the other thing you can do, and you can't see this on a podcast, but you can actually take your sit bones. That's the bones that you're sitting on. You can feel right when you're palpating.
Brad: Or if you're sitting on a hard surface…
Bob: Like bleachers.
Brad: Yeah, you rock back and forth, you'll feel those sit point bones are making contact.
Bob: Yeah, now with those sit bones, what you want to feel is like you're pulling them together. That also helps raise it up. So now this is interesting, Brad, they only had one cue for men and they did a study on this. They had a bunch of cues for men, but the one that worked was this one. So you're supposed to shorten your penis.
Brad: Bring it in like a turtle.
Bob: There you go. Like a scared turtle.
Brad: I think most guys could relate.
Bob: So, it's funny. People, men really seem to latch onto that and it worked for me.
Brad: So the whole idea is we're contracting those muscles and you said, it's going to increase blood flow for the hemorrhoid.
Bob: So they can heal better. The other thing, a lot of people with hemorrhoids they sit on the toilet too long. You know what I mean? And everything starts to get slack. This is year after year. Do you know what I mean?
Brad: So you shouldn't be reading or looking at your cell phone.
Bob: You really shouldn't. You really shouldn't.
Brad: Get on there, get your business done, and go.
Bob: That's what you're supposed to do. Otherwise you’re just stretching things out. You know, you're letting things sag. And so this helps tighten things up here. So... What are you laughing at now? So we're trying to keep this as serious subject because you know, hemorrhoids are an issue.
Brad: Oh right. I've never had them.
Bob: Well I had them, and it's not fun. Let me tell you, so.
Brad: You know, this is one of those things that there are therapists who have taken courses on this and become certified, and they have actually some tools that are specifically made for this.
Bob: Yeah. Feedback tools. So if you are having trouble, seek out a therapist that has expertise in this area. Some of the larger hospitals generally have someone dedicated towards that.
But I think what we're doing here, I think for some people, it's going to help.
Bob: Oh! My wife picked up right on it. I mean, she was able to do it right away. In fact, she hardly even listened to me, I think. Because she was doing it. But this is how you can actually feel it, Brad. If you want to try to feel it. You can actually take a piece of toilet paper, small piece and put it by your anal sphincter, do the exercise, and it actually kind of picks it up a little bit. So, I mean you got to put your finger on the anal sphincter.
Brad: Sure. Oh. Yeah.
Bob: All right, Brad, keep serious here now. Next one, the perineal body, which we already recommended. I think this is the best cue of all, Brad. So again, the perineal body. It's the area between the anus and vagina or the anus and the scrotum. Put your hands there. Obviously you do this in private. You could be lying on your back and you put your hands there for feedback and if you're doing it right you're just going to feel it gently lifted inward.
Brad: Feel some motion going inward.
Bob: Up, yep.
Brad: I can see where lying down would be a good place to start that.
Bob: And men, one more one, you might actually see the penis lift up a little bit when you're doing this. If you're doing it right.
Brad: Not if you got your pants on.
Bob: Not if you got your pants on. No. You know, you'd have to check it out. You know, one of those things where, and don't send us any phone videos of this stuff. All right. So repetitions, you start off probably like eight to 12 reps. You're going to hold it for 10 seconds.
Brad: Boy, that is a long hold. That's work. I mean, especially to get started.
Bob: Yeah.
Brad: But that's what they recommend.
Bob: It's not really hard to hold it. I didn't think so. Yeah. You can do that three times a day. Eventually, they said you want to work up until like a hundred reps in a day.
Brad: So how many reps? Hold it for 10 and do it 10 times?
Bob: Yeah. Eventually, over the day. And the other thing is, it is a fast twitch and a slow twitch muscle. So you can do the hold one, that's slow twitch. But if you want to do fast twitch, you can actually tighten and then relax, tighten, relax just for a second.
Brad: So did they give any statistics on people who do this on success rate? Because I mean, you don't have to do this for the rest of your life, do you?
Bob: No, no, but I'm sure you know for women and incontinence and for men and incontinence you might have to do it in the rest of your life. It's not like it's a big burden, Brad.
Brad: Sure, once you get used to it, but I mean a hundred times a day, or do you get to relax often?
Bob: Yeah. I don't know on that. I find it can be very helpful with urinary incontinence. It can be the difference between you having trouble and not having trouble. I mean, there's a reason it's been around since the fifties. I mean, it works. Give it a try!
Brad: Good luck.
Bob: Thanks everybody.
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