Pelvic Floor Exercises
What are pelvic floor exercises?
Urinary incontinence is a condition that affects millions of men and women, often making them feel as if their bladders are in control of their lives. Control of urine leakage depends on the strength and proper function of the muscles of the pelvis as well as the external sphincter muscle. For some people simple exercises of these muscles may help them to gain the control they need.
Pelvic floor muscle exercises, commonly called Kegel exercises, help to increase strength and control of muscles that surround the tube leading out of the bladder (the urethra). Exercising these muscles can reduce urine leaks that may be associated with coughing, sneezing, bending over, laughing, or exercising (Stress Urinary Incontinence). These exercises can also reduce urine leaks that happen with a sudden urge to urinate (Urgency Urinary Incontinence).
How do I do these exercises?
The first step in pelvic floor exercises is identifying which muscles you want to exercise. Some people find it helpful to imagine trying to keep from passing gas in a crowded room. Others will identify these muscles by stopping their urine stream while urinating (but don’t do this frequently). Once you have identified these muscles, you can practice contracting them.
Women will feel this contraction as a pulling in the vagina or rectum, whereas men may note a movement in the penis or a pulling in the rectum. You should not be pushing with your stomach muscles or holding your breath. If you are unsure, place your hand on your stomach to be sure you do not feel you stomach tightening. If you are unsure whether you are doing them correctly, discuss this at your next visit and we can arrange for you to meet with a specialized provider, called a pelvic floor physical therapist, who has unique training in helping people to identify and exercise these muscles.
Exercising these muscles involves squeezing and holding them for 5-7 seconds at a time. You may find holding for this long difficult at first. Keep at it and it will become easier as your muscles strengthen. You will want to relax the muscles for about 5 seconds in between each contraction.
It is important to set reminders during the day to do your exercises. They may be done while riding in the car, watching television, while at work, or in bed before you go to sleep. We encourage patients to complete about 20 contractions in each setting and try to do this 3-5 times per day.
Remember that pelvic floor exercises take time and practice. It can take several weeks to notice a difference after you start doing the exercises. If you are unsure whether you are doing them correctly, discuss this at your next visit. Gradually increase the duration and number of exercises as your muscles strengthen. With time, you may find that you have more control over your bladder and can begin to return to the activities that make life so enjoyable.