The Pelvic Floor: Kegel Exercises
Pelvic Floor
Strong pelvic floor muscles contribute to control over the bladder and bowel. Weakened pelvic floor muscles can lead to poorly supported internal organs that are not fully supported, resulting in difficulty controlling the release of urine or bowel movements.
Common causes of a weakened pelvic floor include: childbirth, obesity, associated straining of chronic constipation and genetic risk factors. Pelvic floor exercises are designed to improve muscle tone and prevent the need for corrective surgery.
The Pelvic Floor Muscles
Pelvic floor muscles are the layer of muscles that support the pelvic organs and span the bottom of the pelvis. The pelvic organs are the bladder, rectum and uterus. The diagram below shows the pelvic organs and pelvic floor muscles in women.
The pelvic floor muscles stretch like a muscular trampoline from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other sitting bone (side to side). These muscles are normally firm and thick.
The pelvic floor is a combination of multiple muscles with ligamentous attachments creating a dome-shaped diaphragm across the boney pelvic outlet. This complex of muscles spans from the pubis (anterior) to the sacrum/coccyx (posterior) and bilateral to the ischial tuberosities. The bulk of the pelvic musculature is the levator ani, composed of the puborectalis, pubococcygeus, and iliococcygeus.
Imagine the pelvic floor muscles as a round mini-trampoline made of firm muscle. Just like a trampoline, the pelvic floor is able to move down and up. The bladder, uterus (for women) and bowel lie on the pelvic floor muscle layer.
There are three passages through the pelvic floor in women: the urethra, vagina and anus. The pelvic floor muscles normally wrap quite firmly around these structures to help keep the passages shut. There is also an extra circular muscle around the anus (the anal sphincter) and around the urethra (the urethral sphincter).
Although the pelvic floor is hidden from view, it can be consciously controlled and therefore trained, much like our arm, leg or abdominal muscles.
Pelvic floor muscles provide support to the organs that lie on it. The sphincters give us conscious control over the bladder and bowel so that we can control the release of urine, stool, and flatus and allow us to delay emptying until it is convenient. When the pelvic floor muscles are contracted, the internal organs are lifted and the sphincters tighten the openings of the vagina, anus and urethra. Relaxing the pelvic floor allows passage of urine and feces.
Pelvic floor muscles are also important for sexual function. In women, voluntary contractions of the pelvic floor contribute to sexual sensation and arousal.
The muscles of the pelvic floor work with the abdominal and back muscles to stabilize and support the spine.
Laxity of the pelvic floor muscles can results from:
Pregnancy and childbirth for women
Straining on the toilet
Chronic coughing
Heavy lifting
High impact exercise
Age
Obesity
Genetic risk factors
Kegel Exercises
Kegel exercises can help make the muscles under the uterus, bladder, and bowel (large intestine) stronger. Do not to start Kegel exercises if you’re experiencing pelvic pain,
Pelvic floor problems typically occur when the muscles that make up the bowl are too tight or too lax: conditions otherwise known as a high-tone or low-tone pelvic floor. If your muscles are too tight, Kegels can lead to a variety of problems, including urinary and bowel issues, poor sexual functioning, and even pelvic pain.
Kegel exercises can be done any time you are sitting or lying down.
How to Find the Right Muscles
A Kegel exercise is like pretending you have to urinate and then holding it. You relax and tighten the muscles that control urine flow. It is important to find the right muscles to tighten.
The next time you have to urinate, start to go and then stop. Feel the muscles in your vagina (for women), bladder, or anus get tight and move up. These are the pelvic floor muscles. If you feel them tighten, you have done the exercise right. Your thighs, buttock muscles, and abdomen should remain relaxed.
If you still are not sure you are tightening the right muscles:
Imagine that you are trying to keep yourself from passing gas.
You can insert a finger into your vagina. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down.
Once you know what the movement feels like, do Kegel exercises 3 times a day:
Make sure your bladder is empty, then sit or lie down.
Tighten your pelvic floor muscles. Hold tight and count 3 to 5 seconds.
Relax the muscles and count 3 to 5 seconds.
Repeat 10 times, 3 times a day (morning, afternoon, and night).
Breathe deeply and relax your body when you are doing these exercises. Make sure you are not tightening your stomach, thigh, buttock, or chest muscles.
After 4 to 6 weeks, you should feel better and have fewer symptoms. Keep doing the exercises, but do not increase how many you do. Overdoing it can lead to straining when you urinate or move your bowels.
Notes
Once you learn how to do them, do not practice Kegel exercises at the same time you are urinating more than twice a month. Doing the exercises while you are urinating can weaken your pelvic floor muscles over time or cause damage to bladder and kidneys.
In women, doing Kegel exercises incorrectly or with too much force may cause vaginal muscles to tighten too much. This can cause pain during sexual intercourse.
If you have incontinence, it will return if you stop doing these exercises. Once you start doing them, you may need to do them for the rest of your life. It may take several months for your incontinence to lessen once you start doing these exercises.
At Home Devices to Help with Kegels
kGoal Smartphone Connected Exerciser
The kGoal is a squeezable, silicone ‘pillow,’ that is inserted into the vagina. Like the Elvie, the kGoal delivers real-time biofeedback to your smartphone, ensuring that your Kegels are being done correctly. It also tracks your performance and progress over time and allows you to calculate your regimen. The biggest difference between this and the Elvie is that the kGoal’s pillow design enables it to fit better inside the user’s individual vagina. Simply insert it when it’s deflated and then inflate it to fit your unique shape and size, which enables it to stay inside better, which of course may yield more accurate metrics.
Unlike more traditional Kegel exercisers, some devices use electrostimulation to make your muscles to contract on their own. This training program helps people see results quickly and easily. It comes with six different workouts, and you can set the intensity and duration of the contraction to suit your comfort level.
Intimate Rose Kegel Weight Exercisers
For people who know they need to increase their pelvic floor’s muscle tone , Kegel weights can be a great way to increase the coordination and function of the muscles. Weighted Kegel exercisers are designed to complement traditional, manual Kegel exercises. By adding extra resistance, the balls make for a more effective workout in less time. Weights are recommended only for short periods of time as it is easy to overwork the muscles and end up with other issues. It is recommended to start out by using the weights for one-minute intervals, two or three times a day at the maximum.
Je Joue Ami Progressive Pelvic Weights
These are silicone weights and are offered in a collection of different sizes and weights that allow for greater flexibility for the perfect fit for every body.
While they’re not the best for beginners, more experienced users of Kegel weights might consider Laselle’s exerciser made from medical grade silicone. You can buy the weighted balls individually (they’re available in weights from 28 to 48 grams), or as a set of three.
A pelvic wand is an excellent way to find those over-toned muscles and release them. The curved-shape device makes it easy to reach and massage muscles on the pelvic floor. The wand comes with detailed instructions and video guides to help you identify tender, over-toned muscles. Its thinner side is designed to reach shallow pelvic muscles, while the wider end is better for reaching muscles deeper inside the pelvis. Kegels exercises can be done with the wand already inserted so that an individual can see the wand move to obtain feedback.
Better Kegels