Kegel Exercises  
(Pelvic Muscle Strengthening Exercises)
 
Kegel exercises were originally developed as a method of controlling incontinence in women following childbirth. These exercises are now recommended for women with urinary stress incontinence, some men who have urinary incontinence after prostate surgery, and people who have fecal (stool) incontinence.

The principle behind Kegel exercises is to strengthen the muscles of the pelvic floor, thereby improving the urethral and/or rectal sphincter function. The success of Kegel exercises depends on proper technique and adherence to a regular exercise program.

Some people have difficulty identifying and isolating the muscles of the pelvic floor. Care must be taken to learn to contract the correct muscles. Typically, most people contract the abdominal or thigh muscles, while not even working the pelvic floor muscles. Several techniques exist to help the incontinent person identify the correct muscles.

One approach is to sit on the toilet and start to urinate. Try to stop the flow of the urine midstream by contracting your pelvic floor muscles. Repeat this action several times until you become familiar with the feel of contracting the correct group of muscles. Do not contract your abdominal, thigh, or buttocks muscles while performing the exercise.

Another approach to help you identify the correct muscle group is to insert a finger into the vagina (in women), or rectum (in men). You should then try to tighten the muscles around your finger as if holding back the urine. The abdominal and thigh muscles should remain relaxed. Women may also strengthen these muscles by using a vaginal cone, which is a weighted device that is inserted into the vagina. The women should then try to contract the pelvic floor muscles in an effort to hold the device in place.

For those people who are unsure if they are performing the procedure correctly, biofeedback and electrical stimulation may be used to help you identify the correct muscle group to work. Biofeedback is a method of positive reinforcement. Electrodes are placed on your abdomen and along the anal area. Some therapists place a sensor in the vagina in women or anus in men, to monitor contraction of the pelvic floor muscles. A monitor will display a graph showing which muscles are contracting and which are at rest. The therapist can help you identify the correct muscles for performing Kegel exercises.

Electrical stimulation involves using low-voltage electric current to stimulate the correct group of muscles. The current may be delivered using an anal or vaginal probe. The electrical stimulation therapy may be performed in the clinic or at home. Treatment sessions usually last 20 minutes and may be performed every 1 to 4 days. Some clinical studies have shown promising results in treating urge incontinence with electrical stimulation.

PERFORMING PELVIC FLOOR EXERCISES:
  1. Begin by emptying your bladder.
  2. Tighten the pelvic floor muscles and hold for a count of 10.
  3. Relax the muscle completely for a count of 10.
  4. Perform 10 exercises, three times a day (morning, afternoon, and night).
 

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