Contrary to what you may have been told – Kegels can improve the function of the pelvic floor – if done correctly.
What is the pelvic floor?
The pelvic floor is a set of muscles that spread across the bottom of the pelvic cavity like a sling or hammock. The pelvic floor has 3 openings that pass through it, the urethra, the vagina, and the rectum. The functions of the pelvic floor include:
- Supporting the lower organs, specifically the uterus, bladder and intestines.
- Helping to provide sphincter control for the bladder and bowel.
- Withstanding increases in pressure that occur in the abdomen, such as coughing, sneezing, laughing, straining and lifting to prevent leakage of urine or stool.
- Enhancing the sexual response.
What happens if I have a weak or spastic pelvic floor?
If your pelvic floor is weak or spastic, you may experience involuntary leakage of urine or fecal matter and/or straining with voiding or elimination, pelvic organ prolapse (one of the pelvic organs falls out of place) such as the bladder, urethra, uterus, rectum, intestine or vagina, or pain during intercourse.
What causes pelvic floor weakness or spasticity?
The most common causes of pelvic floor instability include:
- Pregnancy-related changes in the body including lax ligaments and stretching or possible tears causing damage during delivery
- Repeated straining during bowel movements, with chronic cough or with heavy lifting
- Changes in hormone levels that lead to decrease tone and muscle tautness
- Surgeries or other traumas
How can I help my pelvic floor?
- Avoid heaving straining during bowel movements
- Increase daily intake of fiber and fluid
- Squeeze pelvic floor muscles before sneezing or coughing
- Avoid repetitive heavy lifting
- Perform pelvic floor exercises daily
What are the benefits of strengthening the pelvic floor?
- Maintenance of strength, tone, and elasticity of the pelvic floor muscles. This helps support the abdominal and pelvic organs against gravity
- Helps with bowel and bladder control
- Improves sexual response for both you and your partner
What are pelvic floor exercises?
Pelvic floor exercises (Kegels) strengthen muscles to help with bladder and bowel leakage, constipation and pelvic and rectal pain. An important component of pelvic floor exercises is muscle isolation, or only contracting one area at a time (e.g. only contracting the pelvic floor, not the abdomen). Because the pelvic floor muscles are voluntary, you can control them and learn to isolate your pelvic floor muscles from the other muscles in your body.
How do I start doing pelvic floor (Kegels) exercises?
Slow Contractions: In the beginning, when you are first learning, find a position where you can squeeze just your pelvic floor muscles. Sitting on a hard surface or lying down with your knees bent is a good place to start.
- Contract your pelvic floor muscles as though you do not want to pass gas
- Hold the contraction for 1-2 seconds
- Relax all the way for 2 seconds
- Repeat twice per day (once in the morning, once at night) for 20 repetitions
Once you can hold the contraction for two seconds, increase the hold to three seconds, alternating it with a three second rest. Continue increasing the hold and rest times until you can hold the contraction for 10 seconds and rest for 10 seconds.
- Perform lying down; when successful in this position, then…
- Perform sitting; when successful in this position, then…
- Perform standing
Quick Flicks: In addition to slow contractions, it is important to perform quick contractions, or quick flicks. These contractions focus on your fast twitch muscle fibers that “catch” your urine when you cough, sneeze or laugh.
- Squeeze your pelvic floor for 1 second
- Rest for 5 seconds
- 25 repetitions, once per day (e.g. lunchtime)
Your program for success:
|Exercise||Repetitions||Time of Day|
|10 second squeeze w/10 second rest||20||Morning|
|1 second squeeze w/5 second rest||25||Noon|
|10 second squeeze w/10 second rest||20||Bedtime|
Exercise Tips: To get the most out of your exercises:
- be sure you only use your pelvic floor muscles and not your buttocks, thighs or stomach. If you are doing the exercise correctly, no other muscle movement should be noticed or felt.
- Remember to breathe normally and mentally focus on tightening and relaxing the pelvic floor muscle.
- You may notice when you are trying to hold the contraction, your muscle may “let go”; simply contract again.
What if I try the Kegels but do not get relief from my symptoms?
If you try the above instructions and still cannot get proper contraction of the muscle, Pelvic Floor Rehabilitation Therapy can help. Using surface EMG and special computer equipment that measures and displays muscle activity, our highly trained therapists can help patients decrease the sudden urge to urinate, decrease leaks and lessen certain types of pelvic pain.
If you have questions about correctly performing these pelvic floor exercises, or you would like to learn more about pelvic floor rehabilitation, call OptimaLiving Therapy & Wellness Center @ 623-777-3113 to schedule a consultation today.