In various women's magazines, much attention is paid to diets, hair condition, skin care for the face and body, problems of figure correction, invasive and minimally invasive plastic surgery techniques to change the shape of the ears, eyes, mammary glands, lifting and a healthy lifestyle. And at the same time, there are very few publications devoted to the problem of incompetence of the pelvic floor muscles, prolapse of the vaginal walls, prolapse of the genital organs and urinary incontinence during physical activity.
And this problem is global, because at least 40% of all women suffer from this disease.
About Kegel exercises
The main purpose of Kegel exercises is to help you strengthen your pelvic floor muscles. She will help you:
- Control or prevent urinary incontinence. Incontinence is the leakage of urine or stool (feces) that you cannot control.
- Support the pelvic organs (uterus, bladder and intestines). This will help reduce incontinence and pain.
- Relax your vaginal muscles. This will provide better elasticity to the vagina, which is important if you experience pain or discomfort during intercourse or during a pelvic examination.
- Relieve pain in the pelvic area.
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What to do if exercises don't help
With serious muscle damage, training may not bring a therapeutic effect. If Kegel exercises do not help, you should immediately consult a doctor. He will prescribe a different course of treatment. In severe cases, patients are referred for surgery.
A doctor’s consultation will be needed if the patient was unable to find his pelvic muscles or if pain and other unpleasant symptoms occurred during training. Kegel exercises usually do not cause pain, but this may occur if the patient has a history of severe injury, difficult childbirth, or chronic muscle disease.
About the pelvic floor muscles
The pelvic floor muscles form the pelvic cavity and support the pelvic organs. These are the muscles you use to stop urinating and stop yourself from passing gas or having a bowel movement (when you go to the toilet in a big way). Additionally, these muscles may contract (tighten) during orgasm. Figure 1 shows the pelvic floor muscles and pelvic organs.
Figure 1. Pelvic floor muscles and pelvic organs
How to identify the pelvic floor muscles
If you're not sure which muscles are part of your pelvic floor, there are several ways to identify them.
- Imagine that you are urinating. Tighten the muscles that you use to break the stream of urine when you urinate. Don't exercise your pelvic muscles by stopping the flow of urine while urinating in real life, especially with a full bladder. This can weaken your pelvic muscles and cause your bladder to not empty completely when you urinate, increasing your risk of urinary tract infection (UTI).
- Tighten the muscles you use to hold back bowel movements or intestinal gases, but don't contract the muscles in your buttocks, abdominals (belly), or inner thigh muscles. If you do it correctly, your body should not rise at all. If you feel your body lifting slightly, you are most likely using your butt muscles.
- Insert your finger into your vagina and then squeeze your pelvic floor muscles around your finger. You should feel your vaginal muscles tighten and your pelvic floor move upward.
When contracting the pelvic floor muscles, you do not need to use the muscles of the abdomen, legs or buttocks. Contracting these muscles does not strengthen the pelvic floor muscles. To find out if your abdominal, leg or buttock muscles are also contracting, you can place one hand on your stomach and the other under your buttocks or thighs. Tighten your pelvic floor muscles. If you feel movement in your abs, thighs, or buttocks, you're using the wrong muscles.
Be sure to completely relax your pelvic floor muscles after contracting them. If you have difficulty identifying your pelvic floor muscles, contact your doctor.
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How to increase duration
In the early stages, a weakened pelvic floor can tire quickly. Not everyone can withstand 5 seconds of tension, especially to the end of the lesson. But gradually the muscle fibers will become stronger, and Kegel exercises will be easier. As a rule, by this time the woman is already making progress: she more easily reaches a state of arousal and orgasm.
The relaxation time between episodes of tension should be no shorter than the periods of contraction.
After this, you should move on to the next stage: increase the execution time of the complex. In this case, the count is no longer carried out to 5, but to 6, 7 and so on. The ultimate goal is a tension of 10 seconds.
Kegel exercises. How to do it correctly and what techniques exist. Gynecologist Olga Sergeevna Gorodetskaya tells. Candidate of Medical Sciences, Chief Physician of the Family Health and Reproduction Clinic NIKA SPRING, Obstetrician-Gynecologist, Gynecologist-Endocrinologist, Ultrasound Doctor.
Doing Kegel exercises
Once you learn how to properly contract your pelvic floor muscles, perform 2-3 sessions of Kegel exercises daily for best results. These sessions are best done at specific intervals throughout the day.
Instructions
Before you begin, find a comfortable position so that your body is relaxed. Mostly people prefer to do Kegel exercises while lying in bed or sitting on a chair. Once you become familiar with the exercises, you can perform them in any position and anywhere, for example, standing somewhere and waiting in line.
Once in a comfortable position, follow the instructions below:
- Inhale deeply through your nose to contract your abdominal muscles and fill your lungs with air. While inhaling, the pelvic floor muscles should be relaxed.
- Take a slow, deep breath through your mouth while gently contracting your pelvic floor muscles.
- Keep your pelvic floor muscles contracted for 3 to 6 seconds (until they begin to tire) while you exhale. This is called shortening.
- Inhale again and stop contracting the muscles. This will allow the muscles to relax.
- Completely relax your pelvic floor muscles for 6-10 seconds. It is very important to completely relax the muscles between each contraction and not hold your breath. Always keep the muscles relaxed for the same amount of time as they were contracted, or a little longer.
Perform this exercise for 10 repetitions each session.
If you feel pain while doing Kegel exercises, stop doing them immediately. Kegel exercises are not harmful, but they are not suitable for everyone. When done correctly, many people find them relaxing. They should not cause pain. If you experience pain during or after Kegel exercises, you may be doing them incorrectly, or Kegel exercises may not be right for you. Call your healthcare provider to discuss this.
When should you increase the duration of contractions?
If your pelvic floor muscles do not begin to tire after contracting for 3 to 6 seconds or after doing 10 repetitions of Kegel exercises in a row, you can increase the duration of the contraction to 6 to 10 seconds, then relax the muscles completely for 10 seconds. Be sure to continue breathing while contracting the muscles.
Try to achieve the goal of holding a strong contraction for 10 seconds 10 times in a row.
If you are having difficulty doing Kegel exercises, a physical therapist who specializes in pelvic floor muscles may be able to help. Ask your healthcare provider to refer you to such a specialist.
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When to do exercises
You can train at any time. It is most convenient to train while sitting on a chair or toilet, or while lying in bed. Most exercises do not require additional equipment, so you can perform them unnoticed by others. But Dr. Kegel also created special exercise machines - balls (for women) and rods (for men).
It is very important to do the exercises before:
- cough or sneeze;
- laugh;
- lift a heavy object;
- go to the toilet;
- get up from your seat.
Every day you need to train 2-3 times a day. This will take no more than 5–10 minutes.
Kegel exercises should not be performed on patients who have a Foley catheter (a long elastic tube). There should be no foreign objects in the urethra, otherwise you can seriously damage the muscles and cause infection. Other contraindications are acute inflammatory processes and bleeding, vascular pathologies, and oncological diseases.
What to do if you have pain or persistent incontinence
If you continue to have problems with pelvic pain or incontinence, contact your healthcare provider for a referral to one of MSK's physical therapists, a pelvic health specialist. This specialist will be able to understand the causes of pain or problems in the pelvic floor. You can also ask for a referral to a physical therapist if you have difficulty doing Kegel exercises.
MSK physical therapists provide services at the following locations:
Sillerman Center for Rehabilitation 515 Madison Avenue, 4th Floor (entrance on 53rd Street between Park Avenue and Madison Avenue) New York, NY 10022
The Sillerman Recovery Center can be reached at 646-888-1900.
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Is it possible to do training at home?
Kegel gymnastics is good because you can do it in any place convenient for you. When performing exercises, only the internal muscles actively work, so those around you will not even guess about your training.
In reviews, women mention the most unexpected places for exercise - from public transport and a queue at a store to a meeting with their bosses. But it is best to do gymnastics at home, where you can focus on the technique, take a comfortable position and use a vaginal simulator.
Support and information regarding sexual health and intimacy
If you need more support or information about sexual health and intimacy, talk to your healthcare provider about the Female Sexual Medicine & Women's Health Program at Memorial Sloan Kettering (MSK). For more information or to make an appointment, call 646-888-5076.
Services through the Female Sexual Medicine & Women's Health Program are available at the following locations:
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Contraindications
Kegel exercises are good for their versatility: they are suitable for almost everyone. Contraindications are very rare, but nevertheless, they should not be forgotten either.
The list of contraindications is as follows:
- miscarriage that occurred less than six months ago;
- premature birth that occurred several months ago;
- surgery performed on the pelvic organs recently;
- malignant formations.
After all such conditions, you can start Kegel exercises only after consulting a doctor.
What are the dangers of Kegel exercises? How not to harm yourself? If this condition is not met, kegels can be dangerous and harmful.
When should you strengthen your perineal muscles?
Age, lifestyle and certain events in a woman’s life can negatively affect the condition of the woman’s perineal muscles. The best way to avoid consequences is prevention. The sooner a woman begins to understand the importance of the problem and work to solve it, the greater her chances of minimizing potential negative consequences. It is recommended to start strengthening the perineum:
- during pregnancy to prevent muscle weakening;
- after childbirth to restore prenatal tone;
- with a gaping genital slit to reduce the risk of pathological flora entering;
- for any tension in the abdominal region to eliminate and prevent urinary incontinence;
- in order to enhance sexual sensations with controlled tension of the vaginal muscles.
Workouts during menstruation
Before answering the question of whether it is possible to do Kegel exercises during menstruation, you need to know that women who use this technique have easier periods and with less discomfort. Even the number of days of menstruation is most often reduced.
Such gymnastics is not contraindicated on critical days, but it should not be performed to the limit of one’s capabilities, but in a gentle manner. It also helps to reduce the amount of painkillers you take if you previously had to take them.
A complex approach
In our clinic, to achieve maximum effect in working with muscles, we offer patients complex treatment: exercises and osteopathy. The presence of chronic diseases in the pelvic organs, accompanied by venous and lymphatic congestion in this area, is directly related to impaired blood circulation and innervation. This condition could be caused by bruises, fractures of the pelvic bones, injuries to the pelvic tissue during childbirth, or hormonal disorders. All this actively forms dysfunction in muscle function. Osteopaths have unique manual techniques in their arsenal that allow them to prepare tissues in a given region for further work with a movement specialist (kinesitherapist).
Until the muscle is fully innervated and supplied with blood, exercises can make the muscle work fully, but this process is delayed.
The osteopath restores the mobility of the pelvic bones, removes intraosseous tension, and relieves tension from the dura mater. Allows the pelvic floor muscles to be a good link between the chest and lower extremities, which is a good prevention of vascular and orthopedic diseases. Osteopathic treatment and physical therapy strengthen the pelvic area with its muscles, organs, bones, improve human health, and improve the quality of life. Therefore, we actively recommend an integrated approach to rehabilitation. This helps keep your pelvic floor muscles in check.
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