Exercises Specifically for the Pelvic Floor
The second exercise, Type 2, is a quick contraction. The muscles are quickly tightened, lifted up, then released. This works the muscles that quickly shut off the flow of urine (like a faucet) to help prevent accidents.
Now, you are ready to begin:
1. Remember, it is important to exercise only the muscles of your pelvic floor (between your pubic bone and tailbone). Do not tense or contract the legs, buttocks, or belly.
2. You should contract the PFM as you blow out, or exhale, then continue to breathe normally as you do the exercises.
3. Remember to relax the body before and after the exercises.
4. In the beginning, it is best to do the exercises lying down so that there is little stress on the muscles. Bend your knees or elevate your legs on a pillow or stool so you are comfortable and your legs are relaxed.
Each of the exercises explained previously can be done with or without assistive devices. If you are using vaginal weights, it is easier for some women to walk around while doing Kegel exercise contractions.
Suggested Exercise Schedule
Most people try to perform too many exercises and sacrifice the quality of the exercises. It is important to remember to stop and rest when you are no longer performing each contraction properly. To improve muscle function you must challenge the muscles to work harder than they are used to. This is done by exercising the muscles on a regular basis. Start with a set of 10 repetitions of each type of exercise, and do them two to three times per day. It is recommended that you try to do a total of 30-80 repetitions per day. Progress at your own pace. The amount of time needed to show improvement varies from person to person. Increase the exercise periods and/or the number of exercise repetitions as you notice improvement.
Remember, you must continue challenging your PFM to see improvement. Your bladder and bowel control can begin to improve in three to four weeks. However, some people take three to six months to see improvement.
Pelvic muscle exercises require a lifetime commitment. Start your day with a set of pelvic muscle exercises. This is especially important if you have chosen to use vaginal weights. It is easiest to use weights in the morning, as later in the day your muscles tend to become tired.
• Always tighten the pelvic muscles before you lift, cough, or sneeze to help hold back the flow of urine. Remember, learn to squeeze before you sneeze.
• Tighten the muscles before you clear your throat or blow your nose.
• You can also use pelvic muscle exercises to help suppress a strong urge to urinate until you can locate an appropriate place to empty your bladder.
• Pelvic muscle exercises should be incorporated into a regular exercise program.
Assisted Pelvic Muscle Exercises
Various devices and techniques have been developed to help you locate, exercise, and rehabilitate the correct pelvic floor muscles. These include biofeedback training, electrical stimulation, and, for women, vaginal weight training.
As well as basic PFM exercises, Dr. Arnold Kegel also pioneered the biofeedback approach to rehabilitate and exercise the pelvic floor muscles. PFM exercises performed with biofeedback equipment has been demonstrated to be a highly effective treatment procedure for incontinence, because it helps to isolate PFM activity and gives an immediate audio or visual indication of successful exercises. Muscle contraction exercises performed without biofeedback assistance sometimes leads to contractions of other muscles, like the abdominals, and may cause undue fatigue and pressure on the bladder.
These different training aids have also been known to add discipline to a Kegel program – helping people to stick with a routine. Talk to your healthcare provider about these and other ways to assist your pelvic muscle strengthening program.
Working With Your Healthcare Provider
Because these muscles are out of sight, they are frequently out of mind and difficult to isolate. If you have any questions or difficulties, be sure to discuss them with your healthcare provider. If you are considering Kegel exercises, it is wise to get proper instructions from a health professional before you invest the time in the program.
In addition to the techniques mentioned previously, bladder retraining, medications, and surgery are also used to treat incontinence. Sometimes a combination of all or some of these therapies is most helpful in managing and improving your incontinence.