KEGEL EXERCISES
The pubococcygeus muscle is a supportive sling which helps to form the walls of the
vagina and to support the urethra and rectum. Having the muscle in good tone is
important. It helps the vagina resume its previous shape and feeling after childbirth and
aids in preventing the loss of urine with coughing or sneezing (stress incontinence) and in
urge incontinence (detrusor instability). In the area of sexual function, a good
pubococcygeus muscle is related to sexual feelings and the ability to have orgasm.
Improving the tone of the muscle may also be important in some cases of painful
intercourse.
Dr. Arnold Kegel developed a set of exercises, appropriately named Kegel exercises, for
improving the tone of this muscle. Your goal is to progressively strengthen the muscle
until it is strong enough to stop leakage, to help you control urges and to strengthen
vaginal muscles and tissues.
You will need to do them daily for the rest of your life. It is sometimes helpful to do the
exercises with something in your vagina such as a tampon or your fingers. This provides
something for the muscle to push against and gives you additional feedback.
HOW TO IDENTIFY THE CORRECT MUSCLE
We would be happy to assist you in the proper technique of Kegel exercises. The
following instructions are NOT REQUIRED of you, but merely suggestions which may
help you.
1. To find the muscle, place your finger into your vagina or rectum. Try to squeeze
around your finger. That is the muscle you want to exercise. This muscle is the same one
you use to hold back gas or a bowel movement, or if you are trying to stop urinating. Do
not be discouraged if you do not feel a strong squeeze. We want to first make sure you
are doing the exercises correctly. Your squeeze will become stronger as you do more
exercises.
2. Remember, it is very important that you not use your stomach, legs, or buttocks
muscles. The most common mistake is using too many muscles. To find out if you are
also contracting your stomach muscles, place your hand on your abdomen while you
squeeze your pelvic floor muscles.
If you feel your abdomen moving, you are using your stomach muscles. To find out if
you are using your buttocks muscles, place your hands under your buttocks. If you feel
movement when you squeeze your pelvic floor muscle, you are also using your buttocks
muscles. The same goes for the leg muscles. Try placing your hand underneath where the
hip joins the thigh and also on your inner thigh. If there is movement felt, you are more
than likely using an incorrect muscle there as well. If you continue to have difficulty with
this let us know. We will be more than happy to help you.
DOING THE EXERCISE
1. If your pelvic floor is very weak, it is best to do these exercises lying down at first.
The pelvic floor muscles have to work harder in sitting or standing positions. Maintain
normal breathing at all times.
2. Squeeze the muscle which you have already identified as the correct muscle. Hold for
a count of 5. Then relax for a count of 10. Remember, it is just as important to relax as it
is to contract this muscle. Always try to relax twice as long as you hold the squeeze.
Work u to holding the squeeze for 10 seconds, increasing your relax time to 20 seconds.
Do not be discouraged if you cannot do this at first. Just do the best you can and go from
there. You will get stronger in time. This muscle is not one we regularly use, so be patient
with yourself.
3. Begin by doing 50 Kegels each day. You do not have to do them all at one time. If you
have trouble remembering to do these, set some time aside each morning and set a
kitchen timer for 5-10 minutes each day, increasing it to twice daily. You will be
surprised how this will help you get into the routine. Over time, increase to 3 times a day,
if possible, eventually increasing the total number of daily exercises to 100.
4. Also work on a more rapid, repeated squeeze (about 10-20 repetitions). These do not
need to be held for any length of time and can be performed when coughing, sneezing of
lifting to help control leakage. They will also help reduce urgency.
WHEN WILL YOU NOTICE THE CHANGE?
You should notice a slight decrease in urinary incontinence (accidents) after about two
weeks of consistent, daily exercise. You will see an even bigger difference within one
month, however, it may take up to 6 months if your pelvic floor is very weakened.
Obviously, the more consistently you do these exercises, if done correctly, the more
benefit you will receive from them.
These exercises cannot harm you in any way. You may feel some muscle soreness as
your body adjusts to this new activity. Most people find them relaxing and easy to do. If
you get back or stomach pain after exercising, you are probably trying too hard and may
be using your stomach or back muscles. If this occurs, go back and try to find the correct
muscle. Remember, this exercise should be easy. If you experience headaches you may
be holding your breath. Try to remember to relax and make these as easy as possible. In
time, you will learn to practice effortlessly,. Eventually, these will become a part of your
lifestyle, like, brushing your teeth. Remember, though, in order to receive and maintain
maximum benefit from the exercises, it is important that you continue doing them on a
daily basis.