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Kegel Exercise / Pelvic Floor Muscle Training

- By Dr Vikas Singh,
M.B.B.S., M.S., M.Ch.
Urologist, Genito Uro Oncologist and Kidney Transplant Surgeon,
Kokilaben Dhirubhai Ambani Hospital, Indore.

Kegel exercises, also known as pelvic floor muscle training, are a type of workout that focuses on strengthening the muscles that support the bladder, uterus, and rectum. These exercises can be done by both men and women, and they can be very beneficial in preventing or treating issues such as urinary incontinence, prolapse, and even sexual dysfunction. In this article, we will take a closer look at Kegel exercises and explore how they work, how to do them correctly, and the benefits they offer.


What are Kegel Exercises?

Kegel exercises were first developed by Dr. Arnold Kegel in the 1940s as a way to help women who were experiencing urinary incontinence after childbirth. These exercises involve contracting and relaxing the muscles of the pelvic floor, which are the muscles that support the bladder, uterus, and rectum. The pelvic floor is made up of several muscles that stretch like a hammock from the pubic bone to the tailbone, and they play a crucial role in maintaining urinary and bowel control, as well as sexual function.


How do Kegel Exercises Work?

Kegel exercises work by strengthening the muscles of the pelvic floor, making them more toned and better able to support the pelvic organs. When these muscles are weak or damaged, it can lead to urinary or bowel incontinence, pelvic organ prolapse, or even sexual dysfunction. By doing Kegel exercises regularly, individuals can improve their pelvic floor strength and reduce their risk of these conditions.


How to do Kegel Exercises?

To perform Kegel exercises, first, identify the muscles you need to target. The best way to do this is to try to stop the flow of urine midstream. If you are able to do this, you have located the correct muscles. If you still have difficulty finding the correct muscle you need to contact urologist will help you find that muscle. Once you have identified the correct muscles, follow these steps:

Please complete the following exercises every day:


Lying Down
  Short quick exercise: Do 5 exercises holding for 1 to 2 seconds.
  Long sustained exercise: Do 5 exercises holding for 5 to 10

   Short quick exercise: Do 5 exercises holding for 1 to 2 seconds.
   Long sustained exercise: Do 5 exercises holding for 5 to 10

   Short quick exercise: Do 5 exercises holding for 1 to 2 seconds.
   Long sustained exercise: Do 5 exercises holding for 5 to 10

   Do two exercise sessions each day—one in the morning and one in the evening, for a total of 60 exercises. (30 in the morning, 30 in the evening).


(Reference: Campbell's Urology and Modified from Newman DK, Wein AJ. Office-based behavioral therapy for management of incontinence and other pelvic disorders. Urol Clin North Am 2013;40:613–35; and Newman DK, Wein AJ. Managing and treating urinary incontinence, 2nd ed. Baltimore: Health Professions Press; 2009. p. 245–306.)

Special Tips

  • After each muscle contraction, be sure to rest your muscle for the same amount of time.

  • Always empty your bladder before beginning your exercise session.

  • Count out loud with sustained or long exercises; speak or  one...two...three... remember to keep breathing!

  • Keep your stomach, leg, and buttock muscles relaxed. Rest your hand on your stomach; it should not move or tense.

  • If it helps, take a deep breath between each exercise to help you keep other muscles relaxed.

  • It is important to note that you should not do Kegel exercises while urinating, as this can actually weaken the muscles over time.


What are the Benefits of Kegel Exercises

Kegel exercises offer a wide range of benefits, including:

  1. Improved bladder control: Kegel exercises can help prevent and treat urinary incontinence, which is a common issue among both men and women.

  2. Reduced risk of pelvic organ prolapse: Kegel exercises can help prevent or treat pelvic organ prolapse, which occurs when the pelvic organs (bladder, uterus, or rectum) drop down into the vagina.

  3. Improved sexual function: Kegel exercises can help improve sexual function by increasing blood flow to the pelvic area and improving muscle tone.

  4. Improved quality of life: By improving bladder control and reducing the risk of pelvic organ prolapse, individuals can experience an overall improvement in their quality of life.


What is “Squeeze before you sneeze" technique that you teach for Stress Incontinence.

Urine leakage occurs when the pressure pushing urine out is higher than the pressure holding it in your bladder. Any activity that increases pressure in your stomach may cause you to lose urine. Leakage can occur during coughing, sneezing, standing up, when exercising, bending, or lifting. It is possible to squeeze your pelvic floor muscles during specific activities and prevent leakage. A bladder diary will help you identify activities that cause leakage.

1. Quickly squeeze your pelvic floor muscles (like trying to hold back gas) just before and during activities that normally cause you to leak (coughing, sneezing, bending, lifting, getting up from a chair).
2. If you forget to squeeze your muscles and urine leaks out, go ahead and squeeze your muscles right then. It will not prevent that leakage, but will help link squeezing the muscles with that activity.
3. The Stress Strategy requires careful timing and practice. It may take some time for you to get the “knack” of doing it. Do not get discouraged. Eventually, it will become automatic.
4. Remember: “Squeeze before you sneeze.”

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