This article includes two case reports from a male and female and recounts the health improvements in their pelvic area after doing kettlebell exercises.
Specifically, the article deals with positive changes regarding stress incontinence, vaginal dryness, hemorrhoids, and erectile dysfunction. Next, I explain how kettlebell swings improved their health.
A kettlebell (KB) looks like a cannonball with a handle. Typically, it is generally made of metal. For the unfamiliar, this is an example of a kettlebell swing. Pay attention to the movement of the hips and the breathing.
The case reports
The first is a woman in her early 60s. She started doing kettlebell swings using a 15 lb KB. I advised doing ten sets of 10 repetitions each for 100 total.
Gradually, as the weeks passed and her confidence increased, she could swing 25 lbs. As her physician, she confided that her stress incontinence, external hemorrhoids, and vaginal dryness improved. She wondered what had happened.
In the second case, a 57-year-old male had erectile dysfunction. Previously. he has been doing weight training and body-weight exercises. He started doing kettlebell swings using 25 lb weights and gradually progressed to 55 lb KB swings and 45-lb kettlebell snatches.
One day, he told me his erectile dysfunction and cardiovascular endurance had improved, and he wanted to know why.
The following is my explanation to them.
Stress Incontinence
Stress incontinence is when urine leaks after coughing, sneezing, laughing, or heavy lifting. That’s because those activities increase the pressure inside the abdomen and overcome the strength of the pelvic floor muscles. It can happen to both sexes.
Pelvic muscles surround the sphincters of the anus and the urethra, where the urine comes out and contributes to the sphincters’ strength.
In the video above, forceful exhalation thru the mouth is done when the kettlebell is at the highest position. At the same time, the abdominal and buttock, and thigh muscles are contracted.
While tensing the abdominal muscles, the muscles of the pelvic floor muscles also contract. Repetitive contraction increases the muscle fiber size and strength of the pelvic floor. Recruitment of other dormant muscle fibers also happens and improves the tone of the pelvic floor surrounding the sphincters that control urination.
It is quite possible that vaginal and rectal prolapse can also improve since they are also due to weakened pelvic floor muscles.
Similarly, urge incontinence from an overactive urinary bladder may also improve.
Blood supply improvement
The upward movement of the kettlebell is not from the arms but the energy transmitted from the forceful extension or straightening of the hips. The arms function only to guide the direction of the kettlebell.
The movement is similar to the trebuchet’s mechanism, which is a catapult type. In the kettlebell swing, the power comes from the hips, and that is similar to the sudden release of energy from the counterweight of the trebuchet.
The hand does the work of the sling. Of course, you shouldn’t let go of the kettlebell.
The repetitive hip movement and muscular contractions during the kettlebell swing increase and improve the pelvic area’s arterial and venous blood flow.
The vigorous flow of blood due to increased muscle increases shear stress in the blood vessels, promotes autophagy, and improves atherosclerosis.
Let’s unpack shear stress and autophagy.
Shear stress is the pulsatile movement of flowing blood inside the blood vessels—the pulsatile flow results from the expansion and contraction of the heart muscles. The paper by Vion et al. demonstrated that blood vessels with high shear stress promote autophagy.[1]
In contrast, blood vessels with low shear stress, which is seen in a sedentary lifestyle, have lower autophagy levels and more atherosclerosis.[1]
Autophagy is when defective and diseased cells are broken into amino acids, fatty acids, and sugars and recycled into new cells.
In the case of the endothelium, the inner lining of the blood vessels, the atherosclerotic deposits on them also undergo autophagy, and the endothelium becomes healthy again.
My previous articles show that exercise by itself can promote autophagy. Exercise alone can induce autophagy.
Normally, the endothelium constantly works to maintain the smoothness of the blood vessel lumen to prevent and dissolve blood clots and the formation of atherosclerosis. Read: The Magical Endothelium
Hemorrhoids
Hemorrhoids are enlarged veins. They enlarge due to a local obstruction such as a small clot, anatomical change, recurring higher pressure inside the abdomen from constipation, or the veins become lax due to sluggish blood flow.
During exercise, there is an increase in arterial flow has to be drained, and the shear stress in the veins improves the quality and capacity of the veins to drain the hemorrhoids, making them smaller.
Vaginal dryness
Vaginal dryness is due to a decrease in estrogen levels and is commonly experienced by post-menopausal women. It can also happen to younger women.
Vaginal moisture is essential for sexual and reproductive health. It also prevents urinary tract infections. Two glands are responsible for vaginal moisture and lubrication.
They are the Skene’s and the Bartholin’s glands. Most likely, the increase in the blood flow in the pelvic area also benefits the arteries supplying those glands to improve their function and resume normal secretions.
Erectile dysfunction
Contrary to what some people know, there is no bone inside the penis, even if there is a medical condition called “penile fracture.”
The “boner” or penile erection comes from the temporary accumulation of blood inside the specialized veins inside the penis.
Aging is an important factor contributing to erectile dysfunction. As men age, cardiovascular diseases, hypertension, and other co-morbidities play an increasingly significant role in this condition.[2]
These health problems also affect the pelvic and penile blood vessels that produce an erection because they have the same underlying vascular problem. Having vascular erectile dysfunction puts a man at a higher risk for myocardial infarction.
It is essential to point out that the nervous and gastrointestinal systems improve in addition to the blood vessels, glands, and skeletal muscles.
That’s because the nerves are also supplied by arteries and benefit from improved blood flow. Physical activity also reawakens neural connections that have become dormant.
The body puts efficiency and conservation of resources at a premium. If the body senses that you don’t use a particular organ, like a skeletal muscle and its nerve supply, it decreases the nutrient and blood supply to it, causing it to get smaller and weaker. Use it or lose it applies to the human body.
Physical exercise stimulates intestinal movement. And with proper fluid intake prevents constipation and improves hemorrhoids.
The whole body benefits
The changes in the blood vessels are not limited to the pelvic area. The shear stress and the promotion of autophagy extend to the vascular supply of other organs, including the coronary arteries and internal carotids that supply the brain – thus preventing heart attacks and strokes: the top and the fifth cause of death in the US.
What I presented are the immediate and noticeable health enhancements. When doing kettlebell exercises, other benefits may not be readily identified but are also vital for health, like lower blood pressure, blood sugar, a decrease in body fat, lower triglycerides, and an increase in high-density lipoproteins (HDL).
My recommendation to the two patients is to continue their exercises and to challenge themselves with a gradual increase in the kettlebell weights.
What makes the kettlebell different?
The repetitive and forceful straightening of the hips is what is different. The degree of hip flexion is also unique. It is rare to see their combination in other physical activities except for rowing and the butterfly stroke in swimming. Both are not as easily accessible as the kettlebell.
Kettlebells are inexpensive and only need a small non-dedicated space. When doing kettlebells, you can pause between sets, and once you can speak a short sentence without catching your breath, you can go to the next set.
Start with light kettlebells and talk to your doctor before starting an exercise program.
You can view the complete instruction by Pavel Tsatsouline on how to do the kettlebell swing at this link. You can buy his kettlebell book here.
Both patients gave consent to use their experiences to make this case report.
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References:
- Vion AC et al. Autophagy is required for endothelial cell alignment and atheroprotection under physiological blood flow. Proc Natl Acad Sci U S A. 2017 Oct 10;114(41): E8675-E8684. doi: 10.1073/pnas.1702223114. Epub 2017 Sep 25. PMID: 28973855; PMCID: PMC5642679.
Image credit: Trebuchet By I, Luc Viatour, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=299752
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I just got two five pound kettleballs. The video is great in showing how to do this. I hear the book is more into wrong pictures than the right way to do this. Thanks!