KEGEL EXERCISES

Doing ”Kegel” exercises to strengthen the pelvic floor is a simple way to prevent and treat many unpleasant conditions… 

• Stress incontinence
There are muscle fibers which form a sphincter mechanism around the base of the bladder enabling the bladder to retain urine even when it is full. When the muscle is voluntarily relaxed urine is allowed to be released, while voluntary contraction stops the flow. If the integrity of these muscle fibers is compromised from being traumatized, stretched, or torn during childbirth, such things as sneezing, coughing, or laughing can result in a dribble or even a gush of urine which cannot be controlled. This is known as stress incontinence. The exercises increase muscle volume that will increase the degree that the urethra closes against downward pressure. This will increase your ability to consciously contract the pelvic floor when necessary (as with a sneeze, cough, or lifting). The overall health of the pelvic muscles is improved due to an increase in blood flow to the area.

• Tonify muscles of the pelvic floor following childbirth
There are muscles known as the pelvic floor or pelvic sling which support the organs in the pelvis. They often become stretched during childbirth. Maintaining muscle tone helps hold the organs in place.

• Aid in repair of cystocele or rectocele
A cystocele is the term used when the bladder herniates or pouches out into the vagina following tissue injury. A rectocele is a similar condition involving the rectum rather than the bladder. The exercises may actually change the shape of the vagina and decrease degree of organ prolapse.

• Increase sexual pleasure and strengthen orgasm
Kegel exercises have been advocated for the improvement of sexual relations between couples because they improve the ability of the vaginal sphincter to contract. The vaginal sphincter is responsible for the clasping action of the vagina around the penis during intercourse as well as being a muscle involved in the orgasm.

HOW TO DO KEGELS
Kegels can be done anywhere and anytime - - standing, sitting or lying down. The action of the exercise is to contract the muscle in the pelvic region.

• Quick Squeeze and Release Exercise
It will feel as though you are trying to draw the vagina and the anus up into the pelvis. Hold for a couple of seconds. Repeat 50 to 100 times a day. They can be divided into several sets to be done throughout the day, or done all at once. In addition, whenever voiding, the flow of urine should be stopped and started several times. This will strengthen the muscle at the neck of the bladder thereby preventing the leakage of urine. Avoid the use of the stomach, leg or buttocks muscles. Do not hold your breath.

• Slow Holding Exercise
Another variation of the exercise is to tighten or contract the muscles you identified previously in a gradual manner, a small amount at a time to the tightest possible. Hold the maximal contraction for up to 10 seconds. (Initially you may not be able to hold the muscle contracted for the full count. As your muscle becomes stronger, you will gradually be able to increase the count.) Now slowly relax the muscle for a count of 5-10 seconds. It is just as important to relax and give the muscle a rest.
• Advanced Variation
After you have gained control, try tightening the muscles from front to back slowly, including the anus, and hold for up to 10 seconds. Remember to release them slowly as well.

WHEN WILL I NOTICE THE CHANGE?
After two weeks, the pelvic muscles will become stronger.
After four to six weeks of consistent daily exercise, you will notice fewer urinary accidents.
After three to six months you will see even more improvement.

Resources
1. Nygaard et al. “Efficacy of pelvic floor muscle exercises in women with stress, urge and mixed urinary incontinence”. Am J Obstetric Gynecology; Jan 1996: 120.
2. Wyman et al. “Comparative efficacy of behavioral interventions in the management of female urinary incontinence. Am J Obstetric Gynecology; Oct 1998: 999.

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