What are Kegel exercises?
Kegel exercise is a type of pelvic floor exercise that involves squeezing and relaxing muscles in the pelvic and genital areas.
These pelvic floor muscles are responsible for supporting the pelvic organs such as bladder, uterus, small intestine, and rectum. Improving pelvic floor muscle strength, helps prevent and treat several common pelvic floor disorders that are common in women, particularly those who had given birth. These include urinary incontinence, fecal incontinence, and pelvic organ prolapse--which may occur due to pregnancy and childbirth.
Regular Kegel exercise during pregnancy and after giving birth can help improve and maintain bladder and bowel control by increasing the strength, endurance, and correct function of these muscles. Although Kegels can be beneficial throughout life, you can start doing them during pregnancy or after giving birth- when pelvic floor muscles often need to be strengthened.
What are the benefits of Kegel exercises?
Several studies have shown that regularly doing Kegels before, during, and after pregnancy can help decrease the odds of pelvic floor problems. The benefits of doing Kegel exercises — especially during pregnancy and after giving birth — include:
Improved bladder control
Many women experience leaking urine during pregnancy or after having given birth. The risk increases with a vaginal delivery, as well as with having had a lot of children. Kegels can help prevent or treat conditions like urinary incontinence - this is the strong urge to urinate and pass urine before you can get to the bathroom, - or stress incontinence, which involves leaking a few drops of urine when you cough, laugh, or sneeze.
Strengthening pelvic organ support
Vaginal childbirth is one potential cause of pelvic organ prolapse (when the uterus, urethra, and/or bowel sag down into the vagina). This is because pregnancy and vaginal childbirth can weaken the pelvic floor muscles. As part of a treatment plan, your doctor may recommend Kegels.
Reduced risk of fecal incontinence
This is a condition that causes you to leak stool before you make it to the bathroom. Kegels can help strengthen the rectal muscles to help prevent this.
Helps prepare for vaginal birth
Strengthening the pelvic floor muscles during pregnancy also helps you develop the ability to relax and control these muscles in preparation for labour and birth. In the postpartum period, Kegels can help heal perineal tissues, which are stretched during vaginal birth.
How to do Kegel exercises
Kegel exercises are usually custom-made. The number of contractions, duration of holding time, and sets vary across different participants. Currently, there is no fixed protocol for Kegel exercises, but the fundamental rules include:
1. Identify the appropriate muscles:
Before you begin, make sure you are engaging the right muscles. If you are not sure where to find your pelvic floor muscles, try stopping urination mid-stream. The muscles you are tightening to do this are the same ones you want to contract when you do a Kegel. If you are still not sure you have found the right muscles, put a clean finger in your vagina. If you are doing a Kegel correctly, the vagina should contract around your finger.
2. Contract the correct muscles:
Once you have located your pelvic floor muscles, follow this recommended Kegel routine:
· 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.
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.
3. Repeat the cycle for several times:
Repeat 10 times, 3 times a day (morning, afternoon, and night).
Tips for doing Kegel exercises
To get the most out of doing your Kegels, keep these tips in mind:
Don't do Kegels while peeing, as this may prevent your bladder from fully emptying and this can lead to urinary tract infections.
Don't strain or hold your breath, and keep your abdominal, buttock, and thigh muscles relaxed.
Don't overdo it. After starting to do these exercises, it can be normal to feel some soreness around the pelvic area, but if you feel pain, stop and talk to your doctor.
Doing these exercises regularly is important. If you find yourself forgetting, there are apps you can download that remind you to do your Kegels and guide you through different training sessions.
Some women find contracting the pelvic floor impossible to start with, or they find it tricky to locate the right muscles. Your healthcare provider may recommend biofeedback training, which helps check which muscles are being contracted, or electrical stimulation, which uses painless electric currents to contract the correct muscles.
Take home message
Kegel exercises are a simple way a woman can strengthen her pelvic floor muscles. These exercises are very easy to perform and have a lot of benefits to the pregnant women (antenatally and postnatally).
This article is written by Dr. Itumeleng Buti (MBChB)
References
1. Wu JM, Vaughan CP, Goode PS, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol. 2014;123(1):141-148. doi:10.1097/aog.0000000000000057
2. Huang YC, Chang KV. Kegel exercises. StatPearls [Internet]. 2021 May 9.
3. Memon HU, Handa VL. Vaginal childbirth and pelvic floor disorders. Womens Health (Lond). 2013;9(3):265-77. doi:10.2217/whe.13.17
4. Newman DK, Burgio KL. Conservative management of urinary incontinence: behavioral and pelvic floor therapy and urethral and pelvic devices. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 121.
5. MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); Kegel Exercises; [updated 2020 Jun 10; reviewed 2016 Aug 25; cited 2022 May 1]; Available from: https://medlineplus.gov/ency/patientinstructions/000141.htm
6. Pampers. Why Kegel Exercises Are Great During and After Pregnancy. [Internet] [updated 2019 August 21; Cited 2022 May 1] Available from: https://www.pampers.com/en-us/pregnancy/prenatal-health-and-wellness/article/kegel-exercises
7. Maria Masters. How, When and Why to Do Kegel Exercises During and After Pregnancy. [internet] Whattoexpect:[ updated 2021 July 1; Cited 2022 May 1] Available from: https://www.whattoexpect.com/womens-health/kegels.
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