Pelvic Muscle Exercises
Pelvic muscle exercises, also called Kegel or pelvic floor exercises, have been shown to improve mild to moderate urge and stress incontinence. When performed correctly, these exercises help to strengthen the muscles at your bladder outlet. Through regular exercise you can build strength and endurance to help improve, regain, or maintain bladder and bowel control. Pelvic muscle exercises also help improve sexual vitality.
How to find and recognize the muscles:
Imagine that you need to hold back gas. Squeeze and lift the rectal area, and for women also the vaginal area, without tightening the buttocks or belly (abdomen). When you first begin your exercise program, check yourself frequently by looking in a mirror or by placing your hands on your abdomen and buttocks to insure that you do not feel your belly, thighs, or buttocks move. If there is movement, continue to experiment until you have isolated the correct muscles of the pelvic floor.
Another technique used only to help you identifying the correct pelvic muscles is to attempt to stop or slow the flow of urine. While urinating, partially empty your bladder then try to stop or slow the flow of urine. Remember to relax and completely empty your bladder when you have finished this test. Do not be discouraged if you are unable to stop or change the flow. Slowing the flow is a good start. Twice a month, you may try to stop the stream as a test to see if your muscle strength is improving. Do not do this start-and-stop test on a regular basis. It is not a helpful way to exercise the pelvic floor muscles.
Suggested exercises:
There are two types of exercises you need to do. Doing both types of exercises is the best way to help improve your bladder control.
The first exercise, type 1, works on the holding ability of the muscles (building a strong dam to hold back urine). It is done by slowly tightening, lifting, and drawing in the pelvic floor muscles and holding them to a count of five. At first, you will probably notice that the muscles do not want to stay contracted or tightened very long. If you feel the contraction letting go, just retighten the muscles. In a week or two, you will probably notice an improvement in the control and holding power of the contractions. In fact, in the beginning, you may only be able to hold the contraction for 1-2 seconds. Concentrate on lifting the muscles and holding the contraction while progressing slowly over a period of weeks to a goal of 10-seconds. Rest for 10 seconds between each contraction.
The second exercise, type 2, is a quick contraction. The muscles are quickly tightened, lifted up, and let go. This works the muscles that quickly shut off the flow of urine (like a faucet) to help prevent accidents.
If you have any questions or difficulties with these exercises, talk to a health care provider. Other behavioral treatments include pelvic weights (vaginal cones), biofeedback training to help isolate and use the correct muscles, and electrical stimulation of the muscles that may help with your exercise efforts. Sometimes a combination of all or some of these techniques is most helpful in managing and improving your incontinence. NAFC publishes an audio cassette tape and manual to assist with pelvic muscle exercises. It is most helpful for women with mild to moderate stress and urge incontinence and men experiencing urine leakage after prostate surgery. The audio recording teaches how, coaches through, and encourages continuously. The accompanying manual helps you to follow the verbal instructions with written descriptions and detailed drawings. Refer to our Online Store for ordering information.
