What is the kegel exercise?
The kegel exercise was named for Dr. Arnold Kegel, who developed
this exercise for the pelvic floor muscles. Until the kegel
exercise was developed, women had to either put up with urinary
stress incontinence (the inability to prevent urination when
you laugh, cough, sneeze or jump) or risk surgery, which
was often not very effective against incontinence.
There are several ways to perform the kegel exercise, but
all concentrate on squeezing the pubococcygeus (pc) muscle
(also referred to as pelvic floor muscles) repeatedly to
increase strength to eliminate/avoid urinary incontinence
as well as achieve other added benefits.
Why should I do the kegel exercise
during and after pregnancy?
Strengthening your pelvic floor muscles with the kegel exercise
can help you:
- eliminate or avoid incontinence aggravated by the weight
of your baby pressing on your bladder during pregnancy
- make birth easier with fewer tears and episiotomies, less pain and swelling*
- increase circulation in the rectal area, helping your perineum heal from
an episiotomy or tearing and decreasing your chance of developing hemorrhoids
- avoid prolapse (falling out of place) of the uterus, bladder and other pelvic
organs after giving birth
- return to your normal activities after birth without fear of stress incontinence
when you laugh, sneeze, cough or jump
- increase sexual pleasure. Doing the kegel exercise is essential for toning
your vaginal muscles and resuming a normal sex-life with your partner after
birth
Postnatal incontinence affects roughly 30% of women and
hemorrhoids affect up to 50% of pregnant or recently pregnant
women. Both can be eliminated or avoided by performing the
kegel exercise daily.
*Learning to isolate and relax the
pelvic floor muscles with the kegel exercise makes
it easier to stretch the
perineum to help avoid episiotomy or tearing.
What are hemorrhoids?
Hemorrhoids are a form of varicose veins that are more common
during pregnancy due to increased pressure on the rectal veins.
They may occur for the first time or become more severe during
pregnancy. Bleeding, itching and pain in and around the anus
are some of the symptoms of hemorrhoids. If you notice rectal
bleeding during pregnancy, consult your doctor. Although hemorrhoids
are a likely cause, it is best to let a medical professional
rule out more serious conditions. Hemorrhoids may require
minor surgical treatment, but will generally disappear on
their own after delivery. Performing the Kegel exercise regularly
can help prevent hemorrhoid formation by increasing blood
flow to the rectal area.
How do I identify and isolate the pelvic
floor muscles to do the kegel exercise?
The most basic way to isolate your pubococcygeus (pc) muscle
is to try and stop the flow of urine while you are on the
toilet. If you can do this, even partially, you can locate
those muscles in the future and perform the same squeeze
(kegel exercise) when not in the bathroom.
If you cannot stop the flow of urine, try inserting a clean
finger into the vagina and attempting to squeeze it. If you
get any kind of muscular response, you are on the right track!
Try to do as many repetitions per day as possible, aiming
for 50-300. As your strength increases, you will be able
to feel a stronger squeeze.
If neither of these techniques works for you, do not despair.
You just need a little extra help. Your ob/gyn should be
able to assist you in finding these muscles and may recommend
using a EMG perineometer at home to assist you in performing
the kegel exercise.
When should I do the kegel exercise?
Once you have identified the pelvic floor muscles, you can
do the kegel exercise anytime, anywhere and no one will even
know that you are doing it!
If you experience fatigue and aching of the back and abdominal
muscles or nervous irritability following the exercises,
it is a sign that you are squeezing with your abdominal,
back, thigh and/or gluteus muscles as you attempt the exercise.
Try to relax all of your muscles and squeeze only the pelvic
floor.
How do I do the kegel exercise?
Here are several variations that you can try. Changing the
way in which you perform your exercises from time to time
will help you to get stronger.
1. Basic kegels. Squeeze and release the pelvic floor muscles
about 200 times per day. Basic kegels are great for addressing
the problems of stress incontinence (i.e. a sudden sneeze).
2. Sustained kegels. Contract the pelvic floor muscles and hold for a count
of ten. Repeat ten times. If you cannot hold them this long initially, hold
them as long as you can. Eventually, you will be able to do 10-second holds.
3. Elevator kegels. Visualize the muscles of your vagina as a building, with
the base of your pelvic floor as the bottom floor and the top floor at your
belly button. Slowly raise the elevator (tighten the muscles) from the bottom
floor to the top, give a slight hold and bring the elevator back down, slowly
relaxing your muscles from top to bottom.
4. Progressive kegels. Squeeze a little, hold for five counts. Squeeze harder,
hold for five. Squeeze as hard as possible, hold for five. Release a little,
hold for five. Release a little more hold for five. Release completely.
If I am already experiencing urinary
stress incontinence, how long will it take to notice improvement
with the kegel exercise?
Even if you are performing 200 repetitions of the kegel
exercise per day, it may take 6-8 weeks of faithful exercising
in order to improve urinary stress incontinence. Don't
give up; with time, you should see results.
How can I fit the kegel exercise
into my daily schedule?
The kegel exercise can be done anywhere, at any time. You
might like to do it whenever you are stopped at a light in
your car or whenever a commercial comes on TV. New mothers
can do it every time that they breastfeed or give their babies
a bottle. When you do the kegel exercise is up to you. You
can do it while other people are around and no one else will
know.
If you are pregnant or have recently given birth, doing
The Perfect Pregnancy Workout or The Perfect Postnatal Workout
makes it easy to do your kegel exercises while increasing
strength and muscle tone throughout your body. Both of these
workouts are geared specifically toward the new or expectant
mother, but they are also recommended for anyone who is new
to exercise, is conditioning her body against urinary stress
incontinence or would like to get back into shape after a
break.
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