What the heck are Kegels? Arnold H. Kegel (1894–1981) was a gynecologist. He invented a device (a perineometer) that measured the pressure exerted by the vaginal muscles. He also taught his patients a systematic exercise program to strengthen their pelvic floor muscles. His name “Kegel” became the name for pelvic floor exercises.
Why would I want to do Kegels anyway? The pelvic floor muscles have 3 basic functions. Support: these muscles literally hold up your organs. Without good support from the pelvic muscles your organs can fall (YES, that really can happen- more about that in a later blog!) Sphincter: This is a fancy word that means the pelvic floor muscles create a circular band of muscles that can close the opening of the urethra, vagina or anus. Sexual: orgasm is rhythmic contraction of the pelvic floor muscles in response to specific stimulation in the vaginal area. So… strong fit pelvic floor muscles are essential for support of your pelvic organs, prevention of urinary leakage and sexual function. If any of this is of interest to you, read on!
How many Kegels will I have to do? Gaining strength takes longer than maintaining strength. The minimum number of daily repetitions to gain strength is 60 (30 repetitions twice per day). Once you have developed enough pelvic floor strength so that you aren’t leaking (and your organs aren’t dropping and you are happy in the bedroom), 10 repetitions of daily pelvic floor exercise is necessary to maintain the gain in strength that you have achieved.
How long will I have to do Kegel exercises? You will have to do the maintenance level of exercise as long as you don’t want to leak, keep your organs where they belong and be happy in the bedroom.
Where are my pelvic floor muscles? The pelvic floor muscles are located between the pubic bone in the front of your body and the coccyx (or tailbone) in the back. When these muscles contract they close the openings of the urethra, vagina and rectum and the muscles lift upward (it is the same feeling as stopping gas). Don’t think “squeeze” the muscles- think close and lift the muscles!
Do I have to do pelvic floor exercises on the floor?
The “floor” in pelvic floor exercises refers to the floor of the pelvis not the floor of your home. You can do pelvic floor exercises anywhere and at any time. It is a good idea to do the exercises while sitting and standing. Muscle strengthening needs to be specific to the task. This means if you want your muscles to be able to stop urine loss when you are standing, you need to strengthen them when you are standing. You may sneeze someday while you are standing up and you will want the muscles to “know” how to contract when you are standing.
How will I know if I am doing the exercises correctly? Take some time to make sure that you are doing the exercises correctly (even if you are positive that you are doing them correctly). When the pelvic floor muscles contract, they lift upward. Place your hand over your pelvic floor muscles (remember where the pelvic floor muscles are located- between the pubic bone and tail bone, the area of your pantiliner), when you exercise the pelvic floor muscles correctly, they will lift (slightly) off your hand. The most common mistake we see is that women bear down which pushes the muscles downward and creates pressure into the hand – this is the WRONG WAY. Lift up, lift up, lift up!!! You can also check that you are doing the exercises correctly by placing a clean finger into your vagina. When you contract the pelvic floor muscles correctly you will feel a tightening or a lift around your finger. If you feel that your finger is being pushed out- you are going the wrong way. Again, lift upward and inward!
Let’s be frank…. Pelvic floor exercises (or Kegel Exercises) aren’t that fun. You don’t get to buy new shoes, a new outfit or talk about the number of reps you did while standing around the water cooler (well you could but it is doubtful anyone is interested!). You just have to do them! They do work, you will get results but you have to be persistent! Don’t give up. Muscle strengthening takes time. You should see some results in several weeks but you should expect to maximize your results in 2-3 months. That may sound like a long time but you didn’t develop this problem overnight and it may take some time to correct it. So let’s get going!
The Practical PT’s guide to pelvic floor exercise for pragmatic women To get the best results, you need to specifically train the pelvic floor muscles to do their job- both holding and quick contractions. These are basic guidelines for an exercise program. Consult your medical provider before starting these or any exercise program. KEEP BREATHING NORMALLY AS YOU DO THESE EXERCISES.
Slow Holding Contractions · Contract and draw pelvic floor muscles up and in as if to stop urine or gas. You should feel the muscles around the vagina and the anal sphincter contract. · Hold for 3 seconds, try a little harder for 2 more seconds and then relax completely for 10 seconds. Increase the length of the hold gradually until you can hold the contraction for 10 seconds. You should always rest for 10 seconds after each contraction. Repeat this exercise 15 times. Don’t hold your breath when doing the exercise.
Quick Contractions · Contract your pelvic floor muscles quickly 3-5 times, remembering to pull upward and inward. · Repeat this cycle of 3-5 contractions, with a 10 second rest between cycles, repeat 15 times. Remember to breathe normally when doing the exercises You will need to practice both the slow holding contractions and the quick contractions 2 times per day. You need to do all 15 repetitions at one time- muscles need to get tired before they get stronger. I
If you have difficulty with these exercises, you may want to contact the American Physical Therapy Association (APTA) to find a women’s health physical therapist near you.
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