Kegel exercises for pelvic floor- What, When & How?

The pelvic floor muscles are the muscles that form the base of the pelvis and support the pelvic organs like the urinary bladder, uterus, cervix, vagina & bowel. These muscles hang like a hammock between the pelvic bones holding the organs together. 

With the passage of time & physical strain on the pelvic floor, these muscles become weaker & floppy leading to involuntary leakage of urine & stools  (incontinence) or pelvic organ prolapse.

Kegel exercise is a squeeze and release exercise that can help strengthen your pelvic muscles and prevent these complications.  

You do not require any large equipment or personal trainer to perform this exercise. All you need is to locate the right muscles in your pelvis, understand the technique and start practicing! You can perform this exercise anytime during the day, while working on your laptop, standing in a queue, or at home.

Kegel exercises are meant to improve the tone & function of the pelvic floor muscles which might have become weaker due to multiple factors. Different factors that lead to a weakening of the pelvic muscles include: 

• Age – As the age advances, the pelvic floor muscles become weaker.
• Childbirth and pregnancy put immense strain on pelvic muscles and they develop minute tears/cuts and  become weaker.
• Surgery like cesarean section.
• Reduction in estrogen levels leads to loss of muscular tone & vitality.
• Weight gain puts increased strain on abdominal & pelvic muscles.
• Strenuous physical activity like running, weight lifting also puts additional strain on pelvic muscles.
• Prolonged cough or constipation on a frequent basis.
• Individuals with brain and nerve disorders may have poor muscular tone & weaker support of the pelvic floor. 

When pelvic muscles become weaker, the pelvic organs lower down into the vagina under the effect of gravity and this leads to distortion of the normal anatomy of the urinary tract & intestinal tract. 

Consequently, you may experience leakage of urine or stools on physical activity and also while sneezing/laughing/coughing or jumping. 

Besides, the pelvic organ prolapse leads to the descent of the uterus/cervix and vaginal tissues which interferes with sexual pleasure by decreasing vaginal sensitivity. 

In extreme cases, the prolapse may even make it difficult for a person to pass urine or stools when they wish to do so while causing involuntary leakage at other times.

How to do Kegel exercises?

The initial and crucial step of the Kegel exercise is to be able to locate the correct muscle and this can be a little tricky. Don’t worry, we’re here to help you find the right muscles.

• A women can place a finger inside her vagina and tighten the vaginal muscles surrounding the finger as if trying to grip the finger by the vaginal tissue. When you feel the tightening, you have located the right muscles.
• For beginners, another way to locate the muscles is while urinating. In this technique, you have to hold your urine mid-stream. This means that you will stop the flow of urine temporarily by tightening the muscles that control the urine flow. However, this method should not be used often because incomplete bladder emptying increases the risk of urinary tract infections. 
• Biofeedback training can also help in the identification and isolation of the pelvic floor muscles in cases of people with nerve disorders. Here, a doctor introduces a small probe into the vagina or applies adhesive electrodes to the outside of the vagina or anus during the examination. You'll be prompted to perform a Kegel exercise. The length of time you were able to hold the contraction and if you contracted the correct muscles will be displayed on a monitor.

Steps to do the Kegel exercise

• Ensure to empty your bladder before performing Kegel exercise.
• For a beginner level, find a place to sit or lie down. 
• Relax and breathe through your nose. 
• As you breathe out from your mouth squeeze your pelvic floor muscles. 
• Tighten your pelvic muscles for 3 sec then relax them for 3 sec. Repeat this about 10 times. 
• Once you get a hang of it, perform the whole set at least  3 times a day. Once you have progressed you can perform it while traveling, eating, watching a movie or doing almost anything at all. 

Benefits of Kegel exercise 

• Kegel exercise helps to improve sexual sensitivity by improving the vaginal muscles. It helps to ease painful sexual intercourse.
• Improves sexual arousal by increasing the blood circulation to the vagina and increasing lubrication. 
• It helps in managing incontinence and urinary/stool leakage issues. Incontinence starts to resolve within 12 weeks of your Kegel exercise routine, provided you do it regularly. 
• Helps to reduce pain associated with prostatitis and benign prostatic hyperplasia in men. 
• It helps improve orgasm in both men and women.
• Improves the tone of pelvic & vaginal muscles thereby preventing prolapse of uterus/cervix & vagina.
• When performed during pregnancy, Kegel exercises help to relax the pelvic muscles & increase their flexibility, thus helping in a smooth vaginal delivery. 

Word of caution 

• If you notice that your back and muscles hurt while performing the Kegel’s, it is a sign that you are not performing the exercise accurately and you might be using the wrong muscles.  
• Practicing Kegel while urinating very frequently which is more than twice a month can lead to UTI & damage the bladder and the kidneys. 
• Once started, Kegel exercises should be continued as incontinence returns if you stop performing the exercise. 
• Too much of anything can have negative effects. Similar is with this exercise, overdoing it can tire the muscles and they won’t be able to function well.

Finally, reap the maximum benefit of the Kegel exercise by doing it the right way. In case you are unable to figure out the technique feel free to seek professional help.

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