RARP scheduled, what to expect for day to day life recovery

June 16th RARP here...good info on MCC, as usual. Thanks!

I saw a pelvic floor specialist twice weekly for three weeks and she never mentioned overdoing it. I've mostly returned to doing several daily sets of 10 long and 10 short holds, and engaging when standing up from a seated position (when I remember) and at other various times. Based on previous threads, especially @survivor5280's plethora of helpful info, I've amassed a small treasure trove of catheter-week goodies.

1. Muscle fatigue
2. Hypotonic Pelvic Floor Muscles(PFM) , can spasm, can become too tight, painful, stuck,
3. Too many done incorrectly can shape poor functioning ( doing them incorrectly, not allowing them to relax completely can be like a learned behavior. we end up teaching our PFM the wrong way to function
To strengthen most muscles we need to exercise, break them down ( we really damage them ) then rebuild them ( a lot of this occurs when we sleep but this is why muscle growth requires rest periods. Muscles growth requires muscle rest.
Think of it this way. If I wanted to get really strong to the point that I could do 1,000 push ups with two grandchildren on my back (this will never happen). I would start with maybe just doing 10-20 push ups then increase maybe 5% every few days. If I tried to do it all in a week, I run the risk of tearing a muscle, never allowing my muscles to grow and likely causing damage.
You can definitely do too many Kegels. You can definitely strain too hard.
Personally, I have learned ( I am now four months into this) that on those days when I push things just a bit harder ( two sets of Kegels and core exercises but also a couple of walks and perhaps gardening or babysitting when I feel good and go for an extra walk or try more exercise, my pelvic floor muscles have ‘locked’ on me ( I can feel them, they are tight, I might need to sit in a recliner for 30-60 minutes to get them to relax again. Then on the same evening and sometimes throughout the night, I am leaking considerably (pelvic floor is tired) . This does not happen when I keep to a slightly more conservative pattern. It took me a while to learn this.

Relatedly, ‘form’ is also important. I had to learn (thanks to a really good pt and now biofeedback) that even though I do my Kegels religiously every day ( I have never missed a session) that While I was doing great at finding/isolating and engaging the right muscles, I was not doing so good at releasing/relaxing these muscles.

Lessons learned from me
1. Take the right dosage ( number and type of Kegels per set per day) from whoever you are working with
2. Work on form
3. Learning to relax PFM and resisting the urge to push too much makes sense
I hate incontinence.
There still needs to be more research and study on issues like this ( incontinence in men following prostrate surgery). It is acknowledged even in a recent NIH report, that there is no agreement on the number of Kegels to do each day. However, if you do a google search you may notice at least a range and several who warn patients against doing too many. (remember at the very minimum to train both slow muscles and fast muscles)

The good news is that research does support that Kegels help, efficacy is better for those that start prior to surgery, efficacy is better for those that get professional help ( trained PT ) and for those using biofeedback. Research does not seem to support electrical stimulation, emsella chair and other ‘short cuts’. This does not mean they do not work it just means there is a lack of evidence.

I copied the following from the National Library of Medicine. “. Inability to identify pelvic floor muscles or not exercising correctly may be the most common reason for poor outcomes with PFME. “

From https://pmc.ncbi.nlm.nih.gov/articles/PMC8743604/

Because the pelvic floor comprises skeletal muscles, it can experience the same type of injuries as other areas of your body, such as your biceps or hamstrings. As such, you can 100 percent overdo it with Kegels, just like you can overdo it at the gym lifting weights or running.

The pelvic floor can get too tight or short and develop muscle tension or spasm. This can be from doing too much activity or strengthening, performing Kegels incorrectly, or not training the muscle to lengthen or release after strengthening.

Rest phases are just as important as contractions, and if we don’t rest or train the muscle to move through its entire range of motion (lifting up and full release), we see muscle injury like we’d see in other parts of the body.

1. Muscle fatigue
2. Hypotonic Pelvic Floor Muscles, can spasm, can become too tight, painful, stuck,
3. Too many done incorrectly can shape poor functioning ( doing them incorrectly, not allowing them to relax completely can be like a learned behavior. we end up teaching our PFM the wrong way to function
To strengthen most muscles we need to exercise, break them down ( we really damage them ) then rebuild them ( a lot of this occurs when we sleep but this is why muscle growth requires rest periods. Muscles growth requires muscle rest.
Think of it this way. If I wanted to get really strong to the point that I could do 1,000 push ups with two grandchildren on my back (this will never happen). I would start with maybe just doing 10-20 push ups then increase maybe 5% every few days. If I tried to do it all in a week, I run the risk of tearing a muscle, never allowing my muscles to grow and likely causing damage.
You can definitely do too many Kegels. You can definitely strain too hard.
Personally, I have learned ( I am now four months into this) that on those days when I push things just a bit harder ( two sets of Kegels and core exercises but also a couple of walks and perhaps gardening or babysitting when I feel good and go for an extra walk or try more exercise, my pelvic floor muscles have ‘locked’ on me ( I can feel them, they are tight, I might need to sit in a recliner for 30-60 minutes to get them to relax again. Then on the same evening and sometimes throughout the night, I am leaking considerably (pelvic floor is tired) . This does not happen when I keep to a slightly more conservative pattern. It took me a while to learn this.

Relatedly, ‘form’ is also important. I had to learn (thanks to a really good pt and now biofeedback) that even though I do my Kegels religiously every day ( I have never missed a session) that While I was doing great at finding/isolating and engaging the right muscles, I was not doing so good at releasing/relaxing these muscles.

Lessons learned from me
1. Take the right dosage ( number and type of Kegels per set per day) from whoever you are working with
2. Work on form
3. Learning to relax PFM and resisting the urge to push too much makes sense
I hate incontinence.
There still needs to be more research and study on issues like this ( incontinence in men following prostrate surgery). It is acknowledged even in a recent NIH report, that there is no agreement on the number of Kegels to do each day. However, the good news is that research does support that Kegels help, efficacy is better for those that start prior to surgery, efficacy is better for those that get professional help ( trained PT ) and for those using biofeedback. Research does not seem to support electrical stimulation, emsella chair and other ‘short cuts’. This does not mean they do not work it just means there is a lack of evidence.

I copied the following from the National Library of Medicine. “. Inability to identify pelvic floor muscles or not exercising correctly may be the most common reason for poor outcomes with PFME. “

From https://pmc.ncbi.nlm.nih.gov/articles/PMC8743604/

sorry I do not mean to post this twice

I might have posted this on the wrong page before. I apologize if I am posting too much but I wanted to respond to your question just from my own personal experience.

How is overdoing defined?
1. Muscle fatigue
2. Hypotonic Pelvic Floor Muscles, can spasm, can become too tight, painful, stuck,
3. Too many done incorrectly can shape poor functioning ( doing them incorrectly, not allowing them to relax completely can be like a learned behavior. we end up teaching our PFM the wrong way to function
To strengthen most muscles we need to exercise, break them down ( we really damage them ) then rebuild them ( a lot of this occurs when we sleep but this is why muscle growth requires rest periods. Muscles growth requires muscle rest.
Think of it this way. If I wanted to get really strong to the point that I could do 1,000 push ups with two grandchildren on my back (this will never happen). I would start with maybe just doing 10-20 push ups then increase maybe 5% every few days. If I tried to do it all in a week, I run the risk of tearing a muscle, never allowing my muscles to grow and likely causing damage.
You can definitely do too many Kegels. You can definitely strain too hard.
Personally, I have learned ( I am now four months into this) that on those days when I push things just a bit harder ( two sets of Kegels and core exercises but also a couple of walks and perhaps gardening or babysitting when I feel good and go for an extra walk or try more exercise, my pelvic floor muscles have ‘locked’ on me ( I can feel them, they are tight, I might need to sit in a recliner for 30-60 minutes to get them to relax again. Then on the same evening and sometimes throughout the night, I am leaking considerably (pelvic floor is tired) . This does not happen when I keep to a slightly more conservative pattern. It took me a while to learn this.

Relatedly, ‘form’ is also important. I had to learn (thanks to a really good pt and now biofeedback) that even though I do my Kegels religiously every day ( I have never missed a session) that While I was doing great at finding/isolating and engaging the right muscles, I was not doing so good at releasing/relaxing these muscles.

Lessons learned from me
1. Take the right dosage ( number and type of Kegels per set per day) from whoever you are working with
2. Work on form
3. Learning to relax PFM and resisting the urge to push too much makes sense
I hate incontinence.
There still needs to be more research and study on issues like this ( incontinence in men following prostrate surgery). It is acknowledged even in a recent NIH report, that there is no agreement on the number of Kegels to do each day. However, the good news is that research does support that Kegels help, efficacy is better for those that start prior to surgery, efficacy is better for those that get professional help ( trained PT ) and for those using biofeedback. Research does not seem to support electrical stimulation, emsella chair and other ‘short cuts’. This does not mean they do not work it just means there is a lack of evidence.

I copied the following from the National Library of Medicine. “. Inability to identify pelvic floor muscles or not exercising correctly may be the most common reason for poor outcomes with PFME. “

From https://pmc.ncbi.nlm.nih.gov/articles/PMC8743604/

Was not specific but I will ask my physio when I start my consulting to see what he says. would be interesting to know if you can do too much. The amount suggested is not that much and takes only a little time so I can do more if leads to good outcomes.

Thanks for being on the list having a former surgeon chime in really helps