Effective Kegel Exercises For Incontinence

Pelvic Floor: Kim Vopni

Have you been told to do kegel exercises to help with your incontinence?

Kegel exercises are a bit of an elusive exercise that people know they should do. But are never sure if they are doing it correctly.

The kegel exercise was designed by doctor, Dr. Kegel, who used a biofeedback device called a perineometer, to help women learn how to contract and relax their pelvic floor after childbirth. Read that again…contract AND relax.

“Incontinence is when urine leaks out of the body when you don’t want it to.”

Studies have shown that over 50% of women are doing Kegels incorrectly. And many are simply trying to squeeze as hard as they can and end up using their inner thighs or their glutes instead of their pelvic floor muscles. Most also fail to consider the relaxation portion but it is not their fault. They have never been taught. They may have been told to do kegels or given a brochure about how to do them. But they have never actually been taught and evaluated to see if they are doing them correctly.

Types Of Urinary Incontinence:

Incontinence is when urine leaks out of the body when you don’t want it to. You can experience urinary incontinence and anal incontinence. Stress urinary incontinence occurs when you leak urine upon exertion like coughing or jumping or running. Urge incontinence is a sudden overwhelming need to pee that can result in a bit of leakage or a complete release of the bladder. Mixed incontinence is a combination of both stress and urge incontinence. Anal incontinence occurs when gas or stool leaks out when you don’t want it to.

Is Incontinence Treatable?

Many believe or are told that incontinence is ‘just part of being a woman’ or a normal part of aging. Especially after giving birth and as we approach menopause. It is not something we need to accept as normal and it is very treatable often without drugs or surgery. Pelvic floor therapy and Kegels are always the best first line of defense.

Why Kegel Exercises Matter:

Kegel exercises are a form of pelvic floor exercise and are effective when done correctly AND consistently. They are evidence-based and more and more research is highlighting that they can work in isolation, with devices such as biofeedback, and when coordinated with whole-body exercise and resistance training.

When you do a Kegel exercise, it should be in synergy with your breath. When you inhale your pelvic floor lengthens and relaxes. You can imagine your vulva blossoming as you take a breath in. As you exhale, the pelvic floor shortens and contracts and lifts. You can imagine that your vulva/vagina is picking something up. Visualize a little blueberry at the opening of your vagina and anus. Now as you exhale, imagine grabbing the blueberries and lifting them up into your body. 

“The best way to ensure you are doing a kegel correctly is to see a pelvic floor physiotherapist.”

Strengthening Your Pelvic Floor Muscles:

Most people think of Kegels as a squeeze only and they squeeze as hard as they can often using their inner thighs or glutes. Kegels involve a squeeze and a lift and a let-go. Doing repetitions is helpful and for some, it may be beneficial to use vaginal weights or biofeedback devices.

The best way to ensure you are doing a Kegel correctly is to see a pelvic floor physiotherapist. A pelvic floor physio will use gloved fingers to assess the external and internal genitalia and will evaluate your ability to contract and relax your pelvic floor muscles.  

Control Your Pelvic Floor Muscles:

Some people need to work more on the squeeze and lift, while other people need to work more on letting go – the release. Focusing your Kegel training on the aspect that your pelvic floor needs will help ensure you have balance and control and the appropriate timing to help support your internal organs and close of the openings that are responsible for the leaks. 

Some people find that being upright when they’re doing their pelvic floor exercises (Kegels) is harder than lying down. The influence of gravity can be necessary feedback for some and a challenge for others. Try Kegels lying down first, then in a wide-leg child’s pose, then in a seated position, and then in standing. Once you have built up some endurance you will add Kegels to movement to make them more functional. 

How Often Should I Exercise?

Evidence suggests that three sets of 10, 10-second holds done three times a day is what is best. Because compliance is a key part of success, Kegels are also beneficial when added to movements like lunges and squats and bridges.

You can even add Kegels to exercises and activities of daily living such as lifting groceries or children or standing up from a chair. This makes them much more functional and also more likely to get done. A set or two done seated or lying down is fine but then add them throughout your day…when you pick something up, when you are standing in line, when you are lifting weights. Add the contract and lift part of the Kegel as you exhale, just prior to lifting or exerting the force.  As you inhale you will relax the pelvic floor.

“Kegels are also beneficial when added to movements like lunges and squats and bridges.”

While there are surgical interventions and pharmaceuticals that may sometimes be needed or chosen, it is always best to explore non-invasive methods with your healthcare team first. Even if you need or choose to have surgery, if you can strengthen your body prior to surgery you can improve your outcome and reduce the likelihood of recurrence.

Alternatives To Kegels:

Many people have avoided surgery altogether once they understood what their pelvic floor needed and began a consistent pelvic floor fitness program. The Hypopressive Method offers a unique approach to training the core and pelvic floor that has helped many overcome incontinence and organ prolapse. Avoiding common bladder irritants like artificial sweeteners, acidic foods, and caffeine can be helpful.

Staying well hydrated during the day and aiming for two to three liters of water over the course of the day is helpful in avoiding strong urges. Finally, avoiding constipation will help prevent urinary urges and also straining that can damage the pelvic floor.

Urinary incontinence is not just something women need to put up with. Pelvic floor exercises can put you back in the driver’s seat for your health and wellness. When done correctly, you can start seeing quite quickly – often within one to two weeks. 

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