By Cynthia Lewis, MD, Urogynecologist, Women’s Surgical Specialists
It’s no fun to pee unexpectedly when you sneeze. Doing Kegel exercises on your own can be very helpful in strengthening the muscles below the bladder to help control urination and reduce leaking. What’s a Kegel? Kegel exercises involve squeezing the muscles of the pelvic floor to strengthen them. Both men and women can benefit from performing Kegel exercises.
Recommended routine for Kegel exercises
• Start by pulling in and holding a pelvic muscle squeeze for 3 seconds then relax for an equal amount of time (3 seconds).
• Do this for 10 repetitions three times a day. It can take up to 3 – 4 months to see results.
• Increase your contraction hold by 1 second each week until you are contracting for a 10 second squeeze.
• Remember to rest and breathe between contractions.
• For women, when you start, do the exercises while lying down. As you get stronger, do an exercise set both sitting and standing.
Many women come to the Women’s Surgical Specialists Clinic and say they are doing their Kegel exercises diligently. However when checked during the exam, it turns out they are doing them incorrectly— and are not experiencing the benefits of their effort. Because pelvic muscles are hidden from view, it is difficult to know if you are doing Kegel exercises correctly.
Tips to help you find the right Kegel exercise muscles
• Try to stop your urinary stream. If you succeed, then you have identified the right muscles to exercise. This is a learning tool. Do not stop your urine frequently as there is concern that this may create problems with bladder emptying.
• Imagine you are going to pass gas, then squeeze the muscles that would prevent that gas from escaping from your rectum. Exercising the muscles around the rectum will also strengthen those around the pelvic organs.
• For women, download the Kegel Exercises Instruction sheet to help you ensure you are doing the exercises correctly and benefitting from your efforts.
• For men, find Kegel exercise instructions here.
• Do not hold your breath while exercising.
• Remember not to tighten your stomach and back muscles or squeeze your legs together—these muscles should be relaxed as you isolate and contract just your pelvic muscles.
• You don’t have to do this alone! If you are not sure if you are doing the exercises correctly, ask your doctor or nurse at a pelvic or urology exam to check if your squeeze is working the right muscles.
• GET A PERSONAL TRAINER FOR YOUR PELVIC FLOOR! Ask your doctor for a referral to a physical therapist with expertise in pelvic floor muscle rehabilitation. There are many excellent, specially trained female therapists who treat women with urinary incontinence, prolapse and pelvic pain. They will also evaluate your back and abdominal strength, your walk and your posture as these also affect how your pelvic muscles work.
For women who want to learn more about pelvic floor problems, including what they are and what surgical and nonsurgical treatment options there are, check out the American Urologynecologic Society (AUGS) patient website. This article was adapted from information on the AUGS website.
Questions about men’s or women’s urologic treatments or want to connect with a physician? Visit valleymed. org/urology. Interested in an appointment? Call Women’s Surgical Specialists at 425.656.4110 or the Urology Clinic at 425.656.5365.