Pelvic floor exercises, or Kegels, strengthen the muscles of the pelvic floor.
These muscles contract and relax to help control the opening and closing of the
bladder. There are two types of muscle fibers in the pelvic floor. The “fast” twitch
muscles help to prevent leakage of urine with coughing, sneezing or laughing. The
“slow” twitch fibers help to keep the sphincter or valve closed at the end of your
urethra or the opening to the outside of your body. You need to exercise both of
these muscle groups to control urinary leakage.
The pelvic floor muscles create a type of “hammock” that supports the
pelvic organs, such as the bladder and uterus. If the “hammock” is weak, the
support is not there and leakage of urine may result when there is pressure put on
the bladder. This increased pressure can occur suddenly with coughing, sneezing,
laughing or exercising. By strengthening this muscle group, the “hammock” is
stronger and the bladder does not descend and leak urine with the increased
pressure.
Pelvic floor exercises must be done every day to maintain effectiveness. If
you stop, the muscles will weaken again, much the same as if you stop exercising
any muscle in your body. Often, patients will not see much improvement for 3 to 4
months so you need to be faithful to doing the exercises and patient!
These exercises are easy to do once you learn them properly. In fact, you
can do these exercises anywhere and no one will know that you are doing them!
So, do the exercises when driving the car, in line at the store or stopped at red
lights. Develop a routine that you will be able to stick with. Soon the exercises
will become second nature and you will be able to contract the muscles as a reflex
whenever a “stress” occurs such as sneezing, coughing or laughing, lifting or
bending.
Begin by locating the muscles to be exercised:
1. As you begin urinating, try to stop the flow of urine. This small
upward, lifting inward movement is the pelvic floor muscle. Do not
exercise these muscles by stopping and starting urination. Only
do this to help identify the muscle.
Another way of identifying the muscle is to imagine that you are in a
room full of friends at a party and feel like you are going to pass gas.
Try squeezing the anus/rectal area as if trying not to pass gas.
This should create a feeling of upward and inward motion as above.
You should not bear down while exercising these muscles. Also you
should not be holding your breath. Your buttocks, abdomen and leg
muscles should not be moving. If you are doing any of these, you are
probably trying too hard and not exercising the correct muscle, If
you continue to have problems, contact us at (334-262-4418).
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In the beginning, your muscles may be weak arid you may not be able to
hold the contractions for longer than 2-4 seconds. It takes a lot of time to
build up this endurance. For example, if you have never run a race before,
you certainly would not be able to run the Boston Marathon! The same
applies here; your pelvic floor muscles need time to build up endurance
and strength.
You need to relax the muscles for twice the amount of time that you
contract them. For example, if you contract the muscles for 3 seconds,
relax them for 6 seconds. This is one set. You should do as many sets as
you can until you cannot maintain the contraction for the amount of time
set aside. This means that your muscles are getting tired. Please rest at this
point. You should then add two to this number and try that amount the next
time you exercise, Over-exercising the muscle when it is tired does not
help you at all and may cause some discomfort.
