Friday, April 17, 2009

Learn How to Kegel

by John Sunyecz, M.D., F.A.C.O.G.

Kegel exercises help tone and strengthen the pelvic floor muscles. These muscles are important for proper tone of the bladder, urethra, vagina, uterus and rectum. Kegel exercises should be done by all women, but especially after the delivery of an infant, as a treatment for urinary incontinence and pelvic relaxation that often comes with the aging process, and for improving sexual relations by improving pelvic floor control.
Multiple studies have been done with Kegel exercises showing success for urinary incontinence. A study in the Journal of Gerontology (J Gerontol 1993 Jul;48(4):M167-74) by Burns PA, et al showed that "biofeedback and pelvic muscle exercises are efficacious for sphincteric incompetence in older women. Benefits are maintained and improvement continues for at least 6 months post-intervention. These therapies may be useful before considering invasive treatment." A recent study by Cammu H, et al in the British Journal of Urology (BJU Int 2000 Apr;85(6):655-8) showed that pelvic floor exercises for urine incontinence, when successfully performed, had a 66% chance of favorable results for at least 10 years.
Unfortunately, women are poorly informed about the benefits of these exercises. Through proper teaching and continued practice, women can learn the correct technique. For optimal benefit, you need to perform Kegel exercises daily. The best part of these exercises is that they are free, painless, and can be done at any time of the day.
The proper technique relies upon finding the proper muscle group. Ask your physician about identifying this muscle group during your next gynecologic exam. Alternatively, you can find this muscle by inserting your finger into the vagina and squeezing around it. If you feel pressure around your finger, you have found the correct muscle. This is also the muscle used to voluntarily stop your stream of urine.
Try to isolate this muscle (the levator group of muscles) while relaxing your legs, back, and abdominal muscles. Practice will make perfect. Initially, do these exercises while lying down or sitting comfortably. When comfortable with the technique, you can do these while driving, watching television, during meals, etc. To avoid confusing the bladder muscle, do not perform repetitively while urinating.
The correct number of exercises per day is variable. Evidence suggests that at least 50 repetitions are helpful. A repetition consists of squeezing the levator muscle for 5 seconds and relaxing for 5 seconds. Performing 10 repetitions five times a day will achieve the minimum 50 repetitions. You should be able to build up to holding the levator muscle for 10 seconds with practice. Do not expect miracles over night. Most women find improvement in urine incontinence and sexual relations after 4-6 weeks of therapy.
One of the most important aspects of these exercises (like any form of exercise) is persistence and a daily routine. Try to pick activities during the day to remind you of the exercises. Upon awakening, with morning tea, driving to work, at lunch, driving home from work, watching television, and before bed are common times for women to perform these exercises. Keep a calendar and monitor your improvement.
With a little persistence and patience, these exercises can be very effective.