Kegel, or pelvic muscle exercises are done to strengthen the muscles that support
the bladder, urethra and vagina. Often the pelvic floor muscles are weak which
contributes to problems with losing urine. Learning how to “activate” or contract these
muscles properly can help prevent urine loss from occurring. It takes time and effort to
strengthen these muscles. This means that it may take several weeks to months before
you will see an improvement.
How to Identify the Correct Muscles
To find the muscles you need to exercise, place your index finger into your vagina
and try to lift your finger upward with the muscles of your vagina. Alternatively,
imagine that you have a tampon in your vagina that is falling out and you must tighten
you muscles in order to hold it in.
Do not be discouraged if you do not feel a strong lift at first. We want to first
make sure you are doing the exercises correctly. Your muscles will become stronger as
you do more exercises. Remember, it is very important that you never use your stomach,
legs or buttocks muscles or hold your breath when you contract your muscles. The most
common mistake is using too many muscles.
Doing the Exercise
Pelvic exercises can be done in many different ways. We will give you instructions on
how to do two types of exercises.
1. LIFT the pelvic floor muscles and hold for a count of 5 seconds. Then relax for a
count of 10 seconds. This is called a holding contraction. Repeat this lift five times
hourly during your waking hours.
2. Next, activate the pelvic muscles and hold for 1 to 2 seconds in an on and off
sequence three times. This is called a flick contraction. Perform these types of
exercises after you have finished performing the holding contractions.
3. Do not be discouraged if you cannot hold the lift for more than a few seconds at a
time initially or if your efforts is very weak. This is quite typical. This muscle is not
one that we regularly use, so be patient with yourself. With practice, your ability to
hold a contraction will improve.
4. Start by practicing these exercises lying down. Maintain normal breathing at all
times. When you feel more comfortable with them, you can do them in a sitting andeventually a standing position.
5. If your muscles get tired during your initial practice sessions, continue to do the
holding contraction for 5 seconds and do three contractions at a time. Gradually, as
you gain endurance, you will be able to do this five times an hour.
6. You should also perform a pelvic muscle contraction during sneezing, coughing,
lifting or bending to help prevent urine leakage. Start the contraction immediately
prior to exertion, and hold it steady throughout the exertion. Although you may not
be able to prevent urine loss completely, you may greatly reduce the amount of
leakage.
7. If you feel a strong urge to empty your bladder, relax and begin contracting slowly –
do a holding contraction for 5 seconds, relax for 5 seconds and repeat 4 more times.
Your first few efforts may increase the urge momentarily, but eventually it will
decrease the urge. Then, if you need to empty your bladder, walk calmly at a normal
pace to the bathroom.
