Fit Forever with Kathy!

Dr. Julie Reil & Kathy Smith: Don’t Ignore Your Pelvic Floor

by Kathy Smith

Kathy Smith: Julie, welcome to the show.  

Julie Reil: Thank you, Kathy. Thank you for just having a heart for education for women. Because every woman out there eventually does have to think and address some issues that happen with aging and the pelvic floor. I think every time we have an opportunity to discuss this is a natural part of aging and that there are some things you can be proactive with, I think it’s just another step forward for us. 

Kathy Smith: Let’s just dive in. What prompted your interest in this particular part of a woman’s body? Had you seen, have you been told, do people come in? When I was visiting you in Montana–and by the way we had a lovely visit. It’s been a while now. Maybe a couple of years ago. It was just so much fun to spend time with you in Montana and to see you in your clinic and to hear some of the stories about how women’s lives, even though sometimes we think about it as just the sexual part of our bodies, so many other things are going on down there. As it ages, it really can cause problems. What prompted your interest? 

Julie Reil: My board certifications are in family medicine and also in obstetrics. So, delivering babies for 10 years, of course, firsthand you’re seeing women through the process of childbirth which is probably the number one way that the pelvic floor loses tone of course. Then, also seeing women in their maturing years and helping them through menopause, which is the second basically insult or hit against the body in the pelvic floor area.  

So, childbirth is easy to understand because the area stretches. You don’t get complete rebound. Sometimes there’s extensive tearing in other extenuating circumstances. Menopause is kind of a little-known facts, so whether you’ve had babies or not, once your body is no longer making its own estrogen and you’re officially menopause, you now have 50% less thickness and tone of your entire pelvic floor. That entire hammock of muscles is thin as well as the connective tissue and skin thins out.  

So, your aging scenario going into your golden years is really quite tenuous. So, you’re at a lot of risk for not just urinary incontinence but loss of vaginal wall tone, loss of anal and rectal tone so that is responsible for holding gas and stool and, then the fourth function of the pelvic floor is low back pain and posture. So, all of those actually are important for just everyday life. 

Kathy Smith: Give us a little anatomy lesson when we’re talking about the pelvic floor.  

Julie Reil: It’s very much like a hammock. The front of the hammock is your pubic bone. The back of the hammock is your tailbone. So, in between there is some side attachments to the pelvic wall to your sitz bones and the very center of your hammock is basically that perineal body or the muscle that either is torn or gets cut. But it’s compromised no matter what when you give birth naturally. So, the very center of your hammock of that nice group of muscles that are anchored is already sitting lower and has less support after just one baby – one natural birth. 

So, ultimately, toning those muscles, toning the side wall supports and all the anchoring structures of that entire hammock becomes our goal. So, how do we basically keep those muscles in shape? How do we get them back in shape, for instance, after you have a childbirth? 

Kathy Smith: Of course, we’re taught at every Lamaze class, every Bradly Cat class that you go to and every workout that you go to now about Kegels. Talk to me about – because I know you have a point of view on Kegels and how to do them and their efficacy. 

Julie Reil: Again, Kegels can be helpful, but they’re not always helpful. First of all, if you have urge incontinence, which means you’re getting up in the middle of the night to use the bathroom or all day long you’re going back and forth to the bathroom, so you have urgent or frequent urges, Kegels can make that worse.  

So, you have to know that Kegels are specifically for people that are having more trouble with leaking urine when they sneeze or cough or do exercise. That’s called stress incontinence, which means basically the seal isn’t as tight as it used to be and you can leak and pressure can overcome that.  

Kegels can be helpful, so really you need to be directed towards the right exercise for you. Then, there’s been some advancements of Kegels which are basically some very basic exercises put together by Dr. Arnold Kegel in 1961.  

Now, there’s a program called Beyond Kegels. There are some other things out there that are basically optimizing the things that you know about, Kathy which is what types of muscles are we working on? Are these big muscles? Are these tiny, intrinsic muscles? Yes, they’re tiny muscles. Are they slow twitch? Are they fast twitch? Yes, they’re a little bit of both.  

So, the more advanced toning programs are really helping people to optimize their position, optimize the way they do their exercises to get the most out of them. Then, also, educating women that this is not like working out in the gym. These muscles are very unique and basically when people say, ‘I’ve tried Kegels. It didn’t work.’ Most likely, they haven’t tried something that’s tailored for them, because most everybody thinks a simple Kegel is just squeeze those muscles and you’re out of there. But there’s a lot more that needs to go on in order to effectively tone your pelvic floor. 

Kathy Smith: Let’s talk about it and maybe we can give the listeners one thing to try, because typically you’re told if you want to understand a Kegel, try when you’re urinating, stopping the flow of urine and those muscles that you’re using to do that are the ones you’re trying to tighten. 

Julie Reil: Yes, it’s similar to that, but we don’t recommend you do them during urination. But, yes, you’re right, those are the same muscles that will stop the flow of urine. 

Kathy Smith: I know that when I was doing my Moving Through Menopause book and video, I taught different exercises like the flutter or the elevator exercise where you would imagine that you’re in an elevator and if you imagine your vagina and going up the wall, it would be first floor, second floor, third floor. You get to the penthouse, you hold and then release one at a time.  

Another one is that you just, instead of long squeezes, it would be almost like flutter kicks like squeeze, release, squeeze, release. So, things like that. But what’s interesting when we were together and you were showing me some of the postures, maybe just explain the one of where you lift your hips up and perhaps place them on a pillow or place them in a position so you change the position of your lower body. Explain why that’s effective. 

Julie Reil: Ultimately, who needs Kegels the most, really, are women who had a baby. Those muscles are no longer nice and tight. They don’t communicate and they’re not as effective as they used to be, so you’re trying to accomplish some toning of muscles, but you’re challenged because you’re not starting off with the ideal that you used to have before having babies is those muscles are a little bit stretched apart, almost like fabric that is no longer completely in tone.  

So, what’s interesting is people who need the Kegels also have typically given birth vaginally, so sitting up and doing a Kegel or sitting at a stop sign and saying, ‘Oh, every time I stop in my car, I just do my Kegels.’ First and foremost, this is not the position to do them in because everything sits lower in the abdomen and the pelvis once you’ve given birth even once. So, you want to be in a neutral, laying down position. Ideally, if there’s something you can prop under your lower back, that elevates the hips a little bit, now, you even have less gravity working against you. 

So, sitting up, no. Laying down, better. That’s kind of a neutral. But, then, a little bit of a prop underneath the lower back where the hips kind of almost curve forward. I don’t know what you call that but if you were just doing a little bit of a flexing of the hips forward that is a very nice position because, now, you’ll eliminate gravity and even save tissues that are sitting lower, and you can really work through those full range of motion of what you’re trying to accomplish with your pelvic floor. That’s one position. 

Kathy Smith: Ok. Did you have another one you wanted to share?  

Julie Reil: I was going to say if you were to do one thing besides that position, it would be to do a combination like you mentioned, Kathy, of kind of a long-held isometric, like I’m going to pretend there’s a marble in the vagina. I’m going to squeeze around that marble and I’m going to pull it up towards my belly button and I hold, hold, hold. Count slowly to five and hold it. I call that more of an isometric, like a long-held contraction. Then, rest and do the same thing but do what you mentioned – the flutters – where you lift the marble up, you let it go, you lift the marble up, you let it go.  

So, for most people that have tried to do Kegels in the past, they usually do them in one way. And I think most people do it in kind of a long-held fashion. I’m not sure. But when they do the combination which, then, is allowing you to work both the slow twitch and the fast twitch muscles down there, which are basically there’s 40% of one and 60% of the other – almost half and half – you’re going to be toning the muscles more effectively and getting more out of your exercises if you do that combo.  

Kathy Smith:  I love those combos…and you’re right, it’s so important to switch up your kegel exercisses to work both the fast twitch and slow twitch muscles! Just like any other muscle in the body, the PC (pubococcygius) muscle, which is the muscle you work while kegeling,  needs regular exercise to remain firm. And having a strong pelvic floor is extremely important because when done correctly, “Kegeling” can alleviate up to 90 percent of stress incontinence. And of course, it’s going to heighten pleasure and sensitivity during intercourse! What are some other ways women can be proactive about keeping their pelvic floor strong?  

Julie Reil: It certainly wouldn’t hurt. Exactly. First and foremost, you’ve got your four functions of your pelvic floor. So, urination and having bowel movements or stooling, that’s a necessary part of life every day. And it also has issues of dignity. So, that’s so important that we, as we’re aging and living longer, that we maintain and be able to have the pelvic health that we can. Because it does affect your cardiovascular fitness and activities you do, for instance. So, if you can keep those muscles strong and not be someone who’s leaking urine or unable to control gas or stool, which happens as people get into their 60s and beyond, that’s really important.  

But vaginal wall tone becomes quite important, not only structurally so that you’re not having things sagging and falling out and that discomfort, but to be able to basically enjoy sex more and, then, be able to, I guess, be a little bit more proactive too, because this is an area where if you use it and continue to be able to use it, even through the drying, aging scenario for a pelvic floor is that you have less thickness of the skin. You also have less moisture.  

So, that’s a little bit of the flower that withers away and dries up. So, you have to be proactive to make sure your flower doesn’t wither away and dry up. There’s some things you can do medically, but the tone is probably the cornerstone of it all. Then, using some other strategies to keep things – the mucus glands active and working. So, you had said once, I think, in a question, ‘Is this an area where if you don’t use it, you will lose it?’ There is some truth to that. This is ideally an area where you need to continue to use it, which becomes a challenge when you don’t have a partner. But there are ways that you can keep the area working and keep it from thinning so dramatically. 

Kathy Smith: Exactly…if you don’t use it, you lose it! But if you don’t have a partner, you don’t have to feel left out! There’s all kinds of techniques that will help you everything stay active and toned…including vibrators. It’s nothing to be ashamed of…One out of every three people that go into nursing facilities go in because of incontinence. At one point, if you cannot maintain and hold your urine and your bowels, then life becomes very difficult and it’s not just something that happens in very old age. Women in their 30s start to leak when they jumprope or jog. And a lot of women suffer in silence. It affects their relationships, their self esteem, their sex lives. It’s an important thing to address. So, that’s why it’s never too early to start being proactive. 

Julie Reil: Absolutely. And, again, so in the last 10 years, it’s a thrill to know that I think because of our wonderful, younger generation – these millenniums – they will talk about things. They’re taking the taboo out of a lot of subjects, and women in their 50s, 60s, 70s, 80s, 90s–I treat women in their 90s–they’re realizing they’re not alone. This is actually a fairly normal part of giving birth as well as aging and they can be proactive.  

It’s a very personal subject. It involves matters of dignity, truly. But to empower women to realize, well, there really are some things you can do. It may not be in your mainstream medical doctor’s office yet, but there’s some treatments and there’s combining exercises with, say, bioidentical estrogen cream, used very conservatively. There’s a lot of things where if you do the stuff over the long run, if you started in your 40s, 50s, continue on, your preservation of your pelvic floor and its function will be so much better, of course, than if you just let things go.  

Kathy Smith: Yeah, optimizing that. 

Julie Reil: These young women are saying, ‘Tell me what to do.’ It’s important to them. They don’t want to lose their, let’s say, sexual abilities, their attractiveness but, also, their functional issues and their dignity. They’re looking around, going, ‘Whoa, that could happen to me.’  

I love the fact that people are becoming proactive, and I love that fact that 90-year olds come in. Ninety-year olds are interested in not getting up and down and peeing all night, not having leaking but more than that, they want to feel as young and beautiful down there as they do anywhere else in their body. 

Kathy Smith: Yeah, it makes so much sense. 

Julie Reil: Yes, it’s beautiful.  

Kathy Smith:  And it turns out that engaging in intercourse and other sexual activities that stretch the vagina can actually preserve elasticity by preventing contracting and over-tightening of the tissue in the area. But yet, around 50-60% of women report problems with vaginal dryness. What’s happening in a woman’s body and hormone levels that cause this dryness, and how can we prevent that atrophy…especially during or after menopause?  

Julie Reil: Naturally, in terms of vaginal dryness, what’s happening structurally, physiologically is your pelvic floor is very dependent upon estrogen. When you no longer make your own estrogen and, say, you are officially in menopause, which means you haven’t had a period for 12 months, you are basically already – because of the lack of estrogen influence on those tissues – at least 50 percent thinner than when you were having your menstrual cycle. So, that means the skin, the connective tissue in the muscle are all thinning out. They’re becoming weaker. So, estrogen naturally supports the thickness, the turgor and the elasticity. So, it’s a big deal when you go into menopause.  

If you take systemic hormone replacement, there’s some improvement, but typically people will still have atrophy and they will still have vaginal dryness as well as some difficulty with the stretch of intercourse. That might be felt during intercourse or what we call afterburn. It seems like it’s going fine but, then, when you’re all done, it’s really uncomfortable because those tissues did not stretch well.  

Your strategies really do come down, ideally, ultimately that if you can replace a little bit of that estrogen topically. One of the best things that happened for women, in my opinion, in 2010, the American College of Oncologists, the cancer doctors, issued a position statement reassuring women that use of an estrogen cream on your pelvic floor, on your vaginal walls is not putting you at risk of systemic cancers and long-term risk of heart disease and stroke and things that we know that come from taking systemic hormones over the long term.  

There’s a couple of reasons for that. First of all, you don’t need much in terms of the dose. Second of all, you only dose it three times a week and it’s typically just a little wheel of cream. I have my patients just rub it in like you would a lotion. Interestingly is, that little bit makes a huge difference to preserve some thickness, some elasticity and how to guard against the ultimate withering away and drying up of the flower. You want to preserve the thickness and the blood supply and the stretchability of that area. So, estrogen is your number one thing.  

So, is there natural forms of estrogen? Personally, I like to prescribe Estriol, which is compounded. It has to be prescribed, but it is 100% bioidentical to what’s in the human body. It’s only one subtype of estrogen, but it’s about 85% specific for the pelvic floor. So, you don’t have people talking about breast tenderness, a kind of systemic effect of the hormone, because it’s really just being used three times a week, about 1 ML, which is a small dosing. It takes care topically, or locally, what you need, but it’s not going throughout your whole system. Does that make sense? 

Kathy Smith: It does. Totally. With the product, then, it’s going to help with dryness, with thickness and a little bit of the elasticity and the shape? 

Julie Reil: The tissues that are essentially estrogen dependent, we’re talking the entire hammock of your pelvic floor is skin-connected tissue, and those fine intrinsic muscles all respond a little bit to that estrogen. So, it’s not just like the very surface of the skin becomes less wrinkly. No, it’s actually giving a small, functional improvement.  

It doesn’t suddenly make you re-toned, but we’re talking about the marathon, not the sprint here. So, if you go into menopause – on average 50, 55 – and you’re going to live another 45, 50 years, you’ve got a lot of years where you really want to prevent, which would be the ultimate–which is kind of the withering away of those tissues. When I examine women in their elder years who haven’t had any estrogen, it’s as thin as wet tissue paper. So, you’re talking about an area that really becomes somewhat non-functional. 

Kathy Smith: Because it can tear so easily. 

Julie Reil: Yeah, with hardly any pressure. Imagine sitting in a wet pad, then, having that pliable, fragile tissue. It really behooves us to just become aware of how we can use every possible strategy to make this area preserved and maintained as well as possible. 

Kathy Smith: Right. And also, it’s interesting to note that when estrogen leaves the body, so does important bacteria that lives in the vagina. This changes the pH, and makes the area more acidic and vulnerable to infection. Because of this, combined with the loss of elasticity, little tiny tears form making the vagina more susceptible to infections. And not the infections of the yeast infections we used to get when we were younger but more so, even more bacterial infections. 

Julie Reil: Absolutely. And bladder infections, for sure. 

Kathy Smith: And bladder infections. So, yeah, it really is something to pay attention to. Well, then, for one of the things that–I know in your introduction, I talked about it–but it’s a procedure called Genityte. I know it’s a procedure that helps with the pelvic floor. It helps with all the things we’re talking about.  

Can you talk a little bit – because I know these things are popping up across the country and there’s different claims that are being made for different procedures – can you talk about Genityte? But, also, just in a broader view of a lot of claims that are being made for products out there of how they can tighten, shift, change and which ones work and which ones don’t. 

Julie Reil: Ok, well, good. Essentially, what is out there are different, let’s say, machines or mechanical ways to potentially add a little more tone to the vaginal walls. CO2 laser can be used, radio frequency, electricity. I don’t think ultrasound’s been used successfully.  

What I use in a Genityte procedure is infrared light. It’s light, not heat and it’s a very gentle approach. Because it can go directly in and around the clitoris, the anus, very, very sensitive, highly innervated areas, we’re able to accomplish toning of the entire pelvic floor – pubic bone all the way back to the tailbone and everything in between including the vaginal walls. What I love about Genityte is the four functions of the pelvic floor – urination, having babies, the vaginal wall tone which is our sexual function too, having bowel movements or passing gas and stooling as well as lower back pain and posture are all improved. Therefore, the ability to Kegel, to use those muscles and to return better structural tone by exercising them, all that, then, becomes possible.  

Other than that, the things that are out there are using pretty intense heat or electricity or radio frequency, that can only be used in the vaginal walls where you don’t have a lot of nerve supply; otherwise, you would literally damage nerves to the clitoris or to the anus in which people would never tolerate and, certainly, we can’t risk.  

I think the best of the best things out there because Genityte was something developed right here where I practice myself. The other things have kind of just come as a little bit of a spinoff, if you will. I think the best things that can be accomplished, you just have to work one on one with your physician in terms of what’s safe for you. What you don’t want to risk, of course, with any of those thing is that something might get worse.  

There is a difference between urgent incontinence and there’s a difference between stress incontinence and, then, there’s a difference between vaginal wall prolapse. The person doing the procedure needs to be a physician, and they need to know how to actively diagnose and, then, steer you in the right direction.  

There are some home product, which you might be referring to as well. There’s something now that can help you, let’s say, optimize your Kegeling ability and it connects to your iPhone. I think it costs only about $150. It’s essentially a biofeedback device. It’s used by the physical therapists, and it can give you feedback as to how well you’re squeezing those muscles. I think that’s kind of exciting. It’s something you can actively do along with your Kegeling program at home and give you a sense of are you making strides, are the muscles getting stronger, are you registering, on your biofeedback scale, a higher score? 

Kathy Smith: Is that called a dilator? Just for the audience, what would they look for? I’ve read about them. I’m actually going to order one. That’s a great idea. I read about them.  

Julie Reil: They came out in Europe first, but I know the physician in Vancouver has been using it, meaning recommending it to patients and feeling like it’s a little bit of a step up. Certainly, it’s affordable, which is nice. The other units I’ve seen that are available to order off the internet in the U.S. look more like a vibrator. You insert it. But they’re a little bit bulky and, then, they don’t have the blue tooth. So, what I like about the one he was talking about–I think it’s called eFIT or something. I’m going to look it up and see if I can find it on my phone. 

Kathy Smith: We’ll track it down and we’ll put it in the liner notes here.  

Julie Reil: Yes, because of the affordability, first of all, I think that’s amazing. And, then, the fact that most everybody has an iPhone now or some kind of a blue tooth device, so it just seems like it would be easy to use and, then, have some immediate feedback as to how you’re doing. 

Kathy Smith: So, I guess the message is start with a program to strengthen the pelvic floor, to strengthen the muscles of the vaginal wall. Think about the dryness element of where you are on the spectrum and whether you need a little bit of estrogen cream.  You might also try vaginal moisturizers, which are called “face cream” for the vagina. They work by binding vaginal cells and holding water.  

Then, if things are to the point where you’re finding you’re embarrassed because you can’t hold your urine or your bowels, then the idea is instead of just going out and getting the Depends or getting a pad or something to stop the leakage  – or to not even stop it but to catch the leakage – the idea is to now start to go to a doctor, to perhaps go to even your website, which is ShilohMedicalClinic.com or subscribe to Women’s Voices Magazine, and start to get more information about what are some of these techniques that you can do now to really help with the strengthening of this area. Because it’s a fascinating brave new world, and I encourage everybody to listen up, not be embarrassed about it and perhaps start the dialogue with your girlfriends or even with yourself or with your doctor.  

Julie Reil: Right. 

Kathy Smith: Any last parting words before I have to let you go? 

Julie Reil: No. Once again, Kathy, I just applaud you because you are so proactive for women. You’re broaching topics here, I think, everybody needs to hear about. But the common denominator is these are really embarrassing topics, and I think people are often not reaching out for the help they need because of the embarrassment. So, everything that we can do to encourage each other as women and let them know there are other things.  

Doctors like myself, I’m nothing wonderful but I certainly have a heart for women. Because of my women’s health category, I’m just one of many out there who are trying to make life better. I just want to thank you again for what you do for women. I think just continuing to be a resource for women as to what’s coming out, what’s coming down the pike. I think there’s a lot of interesting things out there and everything has to be taken with a grain of salt. I think looking at things critically, talking with your doctor, making sure things are safe, number one. Then, beyond that, just being proactive for yourself and your own health is what it’s all about these days. 

Kathy Smith: So well put. On another note or just to add to that, I would love to track down the Kegel exercises you’ve mentioned. We’ll also put all those in the liner notes just so people know where they have access to find these newer techniques. 

Julie Reil: Absolutely. The website that you can research is called PhoenixCoreSolutions.com. This is a physical therapist from Missoula, Montana who did this research a good 30 years ago. A very successful program called Beyond Kegels and little things like the wedge to prop under your lower back is all available on here site and the books and what not. She is an interesting woman who basically has done very well as a physical therapist and she said, “In my younger years, I said I’m going to make a million dollars.” Well, then, after she made a million dollars, her next goal was to help a million women.  

That’s what Beyond Kegels has been about. It has been just kind of her giving back to women. I think it’s the best program out there and the easiest to do. She has research to back it up and I would say have hundreds of patients to also credential that it’s something that is realistic, you can do it at home, it works and it can fit into anybody’s everyday life. And you only do it three times a week, which is another helpful thing, so it’s not laborious to do this. 

Kathy Smith: It sounds like a remarkable woman. Once again, it’s great. I’m going to have to fly out to Montana. I need a Dr. Reil fix, so I’ll have to come see you. Thank you so much. 

 

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

What Type of Incontinence Do You Have?

by Kathy Smith

Screen Shot 2016-07-25 at 1.41.21 PM

Written by Ashlee Davis and originally published on Health

If you have urinary incontinence, you have a tendency to accidentally leak urine. Paying attention to when and where you have bladder problems can help figure out which type of incontinence you have

1 – Standing up

If you leak urine after simply standing up from a sitting position you may have stress incontinence. This type of incontinence isn’t due to emotional stress, but rather physical stress—meaning increased pressure in the body or straining can force urine past the neck of the bladder and out through the urethra.

Stress incontinence is more common in women than in men, and is typically caused by factors that weaken the bladder muscles, such as aging, childbirth, excess weight, and surgery—particularly hysterectomy in women and prostate surgery in men.

2 – Sudden urge

If you feel the need to urinate frequently and often have a sudden, urgent, and uncontrollable need to urinate, you may have overactive bladder, which can cause you to have urge incontinence. The feeling can occur even when the bladder contains only a small amount of urine.

Urge incontinence typically occurs when the bladder contracts at inappropriate times, and these bladder spasms result in incontinence. Bladder contractions can be the result of damage to the nerves or muscles of the bladder.

3 – Laughing, sneezing, coughing

Urine leakage when you laugh, sneeze, or cough is a common symptom of stress incontinence. Depending on the severity of the problem, you may leak small to large amounts of urine when this pressure on the abdomen occurs.

Doing Kegel exercises can help you tone the pelvic floor muscles, which hold in urine, and tame your incontinence.

When done correctly, “Kegeling” can alleviate up to 90 percent of stress incontinence and heighten pleasure and sensitivity during intercourse. Click here for 4 NEW ways to do kegels!

4 – Running water

This is not a myth. Some people have an increased urinary urgency—which can trigger incontinence—when they hear the sound of running water. Other noises or daily rituals can also cause problems for people with urge incontinence.

“Running water or thoughts of approaching home—as one waits for the garage door to open or unlocks the door—can actually exacerbate the symptoms of overactive bladder,” Dr. Shah says.

5 – Exercise

Leaking urine when lifting weights or performing other exercises is another sign of stress incontinence. “Anytime you exert yourself, increase pressure on the abdomen, and leak urine, that would be considered stress incontinence,” Dr. Shah says.

Exercising with a full bladder makes you even more vulnerable, so try to schedule bathroom trips before and during your workout. If this still doesn’t give you a handle on your incontinence, talk to your doctor before giving up on exercise.

6 – Can’t hold it

People who experience urge incontinence have a hard time reaching the bathroom.

“They know they have to go, but feel they don’t have enough time to get there,” says Dr. Shah. “They can’t stop the bladder, and their underwear is wet before they get to the bathroom or they are dripping on the floor.”

Anxiety can worsen urge incontinence, as can having uncontrolled diabetes and taking diuretics, which are blood pressure-lowering drugs that work by clearing your body of water and salt.

7 – Sex

Women with incontinence can also experience urine leakage while having sex, Dr. Shah says. Since this discharge is caused by pressure on the abdomen and bladder, it’s a sign of stress incontinence.

You can reduce your chance of leakage by going to the bathroom before sex, avoiding fluids an hour before sex, and trying certain positions (such as being on top).

8 – Mixed symptoms

It’s common for a woman to have mixed incontinence, or a combination of stress and urge incontinence, especially after menopause.

“Sometimes it’s clear-cut, but it’s not uncommon for patients to have both components,” Dr. Shah says. However, one type of incontinence is usually more severe or annoying than the other.

“One should see an expert to determine which conditions are present and then decide which therapy would be best,” Dr. Shah says.

9 – Amount of urine

Volume of leakage alone doesn’t necessarily tell you what type of incontinence you have, Dr. Shah says.

The amount leaked completely depends on the severity of the condition. Although people with stress incontinence are thought to leak less than people with urge incontinence, they can still release quite a bit if their condition is severe.

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

By Collage Video | | goals, health, Healthy, Kathy Smith, Weekly Blog | 0 comments | Read more

Chocolate Cherry Protein Shake

Yields 1-2 servings

Ingredients
1 scoop chocolate protein powder
1 cup spinach or kale
1 cup frozen cherries (pitted)
1 Tbsp chia seeds
1/2 cup blackberries
2 Tbsp plain Greek or Icelandic yogurt
1/2 cup ice

Blend all ingredients together.

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

By Collage Video | | Kathy Smith, Recipe, Weekly Blog, womens fitness, womens wellness | 0 comments | Read more

Spicy Garlic Stir-Fry Recipe

by Kathy Smith

Spicy Garlic Stir-Fry Recipe

The weekend is almost here, but that’s no excuse to forget your diet and healthy habits! You can still eat meals that are delicious and healthy while burning muscle and shrinking fat. I love my Spicy Garlic Stir-Fry recipe because it’s packed with nutrients and each of the spicy garlic sauce is fantastic!

Use these proportions to create your own signature stir-fry dishes!

Stir-Fry Ingredients:
4 tablespoons olive oil, divided
1 pound vegetables, cut into 1-inch pieces (use a mixture, such as broccoli, mushrooms and bell peppers)
1 pound meat/poultry/seafood, cut into 1-inch pieces
1 tablespoon minced fresh ginger
1-2 cloves garlic, minced

Spicy Garlic Sauce Ingredients:
1 t cornstarch
1/2 C low-fat/low-sodium chicken broth
1 1/2 T low-sodium soy sauce
1 1/2 t chili garlic sauce
1 T ketchup
1 T dry sherry or red wine

Heat wok or large skillet over high heat. Add 2 tablespoons of the oil and heat util almost smoking. Add the vegetables and stir-fry 3 to 5 minutes. Removed from wok. Add 1 to 2 tablespoons more oil to the wok as needed; add meat and cook for 2 to 3 minutes. Add the ginger and garlic; cook and stir until the meat is almost done. Return veggies to wok and cook 1 minute to heat through.

In a separate pan, begin the sauce by combining 1 tablespoon water and 1 teaspoon cornstarch in a small saucepan. Stir in chicken broth, soy sauce, chili garlic sauce, ketchup and dry sherry or red wine. Cook and stir until thickened (3 to 4 minutes). Stir in with your stir-fry. Enjoy!

Serves 4.

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

By Collage Video | | Kathy Smith, Recipe, Weekly Blog | 0 comments | Read more

Don’t Resist The Resistance Bands!

by Kathy Smith

What’s long, can stretch from head to toe, and will help you look fab in your summer tanks? That’s right…a resistance band!  You already know that they’re one of the best ways to increase your strength, because they’re inexpensive, small enough to travel with, and they make it easy to target specific muscle groups.

But what you might not know is that unlike dumbbells, tubes also provide what’s called linear variable resistance. Basically, this means that as you increase a move’s range of motion, the tension of the elastic also intensifies.
Imagine you’re doing a bicep curl. As you curl your arms up to a ninety-degree angle, the resistance provided by the tube gets stronger. Because the tube is made out of elastic, it provides more workload as it stretches. This can’t be done with dumbbells or other forms of free-weights.
Another reason linear variable resistance is so beneficial is because the elastic tubing better mimics the way a muscle’s strength changes throughout a movement. Until a certain point, most muscles increase in strength over the range of motion. For example, during a bicep curl, the muscle is weakest at the beginning, and at the halfway point the muscle is the most strong.

When you perform a bicep curl with a dumbbell, you’re limited to how much tension you can use based off of how strong your muscle is at the weakest point. This hinders the strongest part of your muscles from receiving adequate training.

But, try this same bicep curl with a tube, and the workload increases as the strength of your muscle increases.
Moral of the story…don’t resist the resistance tube!

To get started, try this 5-minute video designed to strengthen your lower body with a tube!

 

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

Mint Julep Green Juice

by Kathy Smith

Ingredients:

1 stalk celery
1 handful mint leaves
2-3 handfuls spinach
1 apple

Juice all ingredients and enjoy!

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

By Collage Video | | Healthy, healthy aging, healthy lifestyle, Kathy Smith, Recipe | 0 comments | Read more

Green Queen Juice

by Kathy Smith

Green smoothie with heart of seeds

Ingredients

  • 1 crown broccoli
  • 1 green apple
  • 1 bunch green grapes
  • 2 handfuls spinach
  • 2 large leaves of collard greens

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

By Collage Video | | Kathy Smith, live long, live strong, Recipe, Weekly Blog | 0 comments | Read more

HOW THEY LIVED TO 100 (IT’S NOT WHAT YOU THINK)!

by Kathy Smith

Courtesy of BrainTap Technologies

While you’d think most centenarians — people who’ve lived 100 years or longer — would offer up lots of do’s and don’ts or diet and exercise regimens, their longevity secrets, it turns out, have little to do with most of the usual healthy-living recommendations. In fact, many spent a lifetime ignoring the advice of health experts. They didn’t avoid smoking or lose weight, yet most centenarians say they feel on average 20 years younger than their chronological age.

Centenarians, it seems, age more slowly than the rest of the population. Sardinia, a region of Italy, has the most centenarians per capita – 6 centenarians for every 3,000 people – 10 times more than in the US where the ratio is 1 per 5,000.

But, the statistics for 100+ year olds may surprise you. For example:

  • 37% were smokers for an average of 31 years
  • 37% were overweight; 8% were obese
  • 20% never exercised at all; 44% only moderately

Yet, these centenarians have lower rates of heart disease, high blood pressure, and stroke. Psychiatric illnesses, such as depression, are almost nonexistent.

But Why?

According to research and interviews with centenarians themselves, the primary difference between them and the rest of us comes down to six key ingredients…

  • Zest for life
  • Strong family and social ties
  • Optimism
  • Sense of humor
  • Eating real food
  • Hard work

Centenarians tend to be exceptionally good at expressing love, nurturing others, working hard, being involved in their communities, and flat-out refusing to stress about the small stuff—or most anything for that matter.

Happiness, say centenarians, is the key to a long life, and research backs them up. In fact, happy people tend to live about 35 percent longer. Positive thoughts and attitudes seem to somehow strengthen the immune system, boost positive emotions, and decrease pain and inflammation.

Sadly, though, life expectancy worldwide is now on the decline. At least half the US population is struggling with chronic illness. Many centenarians think the 21st century lifestyle is to blame. Modern conveniences and technologies have left us stressed-out, unhappy, unhealthy, chronically tired, and disconnected from each other.

They say that if you want to live to 100 and enjoy the happy, healthy lifestyle they had, you must be proactive every day and that managing stress is vital. Most importantly, they all agree that the keys to living to 100 are available to everyone, everywhere. And, as you can see, they’re not complicated.

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

Tropical Dream Protein Shake Recipe

by Kathy Smith

Ingredients:
  • 8 oz unsweetened coconut milk
  • 1 serving vanilla protein powder
  • 1/2 Cup frozen pineapple or mango
  • 1 Tbsp coconut oil
  • 1 handful dark, leafy greens

Blend all ingredients together and enjoy 

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

Tomato and Pomegranate Salad Recipe

by Kathy Smith

Here is a dish featured in the New York Times that melds the best flavors of summer into a robust salad. Serve it alongside grilled chicken, preferably in the back yard, summer nipping at the heels.

Screen Shot 2016-06-24 at 10.51.50 AM

INGREDIENTS

  • 2 pints mixed small or cherry tomatoes, of varying colors
  • 2 teaspoons za’atar
  • 3 ½ tablespoons extra-virgin olive oil
  • Seeds from 1 pomegranate
  • ½ yellow bell pepper, seeds removed and very thinly sliced
  • ½ small red onion, peeled and very thinly sliced
  • ⅓ cup loosely packed fresh basil leaves, torn into pieces
  • ⅓ cup loosely packed fresh mint leaves, torn into pieces
  • 1 ½ teaspoons freshly squeezed lemon juice
  • Flaky sea salt
  • 3 ½ ounces manouri or feta cheese, broken into small chunks

PREPARATION

  1. Halve or quarter the tomatoes so that they are all roughly the same size, and place them in a large mixing bowl.
  2. Mix the za’atar with 1 1/2 tablespoons of olive oil, and set aside.
  3. To the bowl with tomatoes, add the pomegranate seeds, sliced pepper and onion, the herbs, lemon juice, the remaining 2 tablespoons of oil and 1 teaspoon of salt.
  4. Gently mix the salad, then transfer it to a large shallow bowl or serving platter, and dot it with the cheese.
  5. Drizzle the za’atar mixture over the salad and serve.

Kathy Smith, New York Times bestselling author, has stood at the forefront of the fitness and health industries for over 30 years. The numbers speak for themselves: Kathy has sold more than 20 million exercise DVDs - landing her in the Video Hall of Fame - and $500 million in Kathy Smith products. With her revolutionary approach to fitness, Smith has touched millions of people, inspiring them to move, live, and love.

Stay in Touch

Information

210 W. Parkway, Suite 7, Pompton Plains, NJ 07444 ● © Collage Video ● Exercise Video Specialists ● Fitness Videos and Workout Videos ● 1-800-819-7111 / 201-464-4921 ● CustomerCare@CollageVideo.com

From Our Blog

  • Collage welcomes instructors Brook Benten & Aimee Nicotera to the shop!

    Exciting news! We're welcoming two highly qualified instructors that will help you crush your fitness goals, shake up your routine, and offer a new source of motivation!   Brook Benten, B.S. in Exercise and Sport Science from Texas State University. Masters of... read more

  • Two More Happy Yoga DVDs Coming to Collage Video

    Happy Yoga from Sarah Starr is designed to bring you the beauty of Mother Nature as you receive yoga's rejuvenating benefits, including flexibility, toning, clarity and balance. Want to learn more about Sarah? Visit her instructor profile here. These titles... read more

  • What is Callanetics? Is it for me?

    Some people swear by it. Some people have never heard of it. It’s Callanetics. Callanetics became a revolutionary method of exercise and gained international recognition for its speedy body-shaping results. Some of the noise behind Callanetics may have softened over... read more