How To Do Pelvic Floor Muscle Exercises (Kegel's)

How To Do Pelvic Floor Muscle Exercises (Kegel's)

Frederick R. Jelovsek MD


Many Women with urinary incontinence can decrease their urinary leakage during coughing, laughing, sneezing, or other activities by exercising the muscles of the pelvic floor. These exercises are often called "Kegel exercises" after the doctor, Arnold Kegel, M.D., who first described them.

To find the muscle you need to exercise, imagine that you have a tampon in your vagina that is falling out and you must tighten your muscle in order to hold it in. The muscle you tighten is the muscle you should exercise. Another way to find the right muscle, the bulbocavernosis muscle, is to sit on the toilet, place one finger in the vagina and contract that muscle around you finger. The muscle you use to tighten around your finger is the muscle you should exercise. Your doctor can help you determine which muscle to contract and make sure you are doing it properly by checking you during a pelvic examination.

Do not make a habit of doing these exercises by starting and stopping your urine flow while voiding! You can teach yourself bad bladder habits and develop voiding difficulty by doing this! Instead, you should practice your exercises at other times. Stopping your urine stream during voiding is taught by others only to help you find the correct muscle to contract .

Pelvic muscle exercises can be done in many different ways. We will give you instructions on how to do the type of exercise described by Dr. Kegel. Since continued vigorous exercise can lead to muscle soreness and fatigue, don't try to start out at maximum exercises all at once. Spread them out over the course of the day. We suggest starting with 25 muscle contractions divided into 3 daily sessions. This should take 5 minutes 3 times a day. You should eventually build up to 20 minutes (100 contractions) 3 times a day. If you do have muscle soreness starting out, try doing the exercises vigorously every other day instead. this will allow your muscle to recover from the fatigue of exercise.

These exercises can be done anywhere and at any time. You may find it helpful to associate an activity with your muscles, such as doing them while stopped at a red light, during a TV commercial, talking on the phone, or doing various household chores such as ironing, washing dishes, cooking, etc. The important think is to get in the habit of doing them!
Initially - Tighten the pelvic floor muscles for count of six and relax for six seconds. Each contraction cycle should last 12 seconds or 5 contractions a minute. Repeat 25 times. Do this 3 times each day - total 75 contractions.

Week 2 - Tighten the pelvic floor muscles for 6 seconds every 12 seconds (5 per minute) for 10 minutes, 50 contractions. Do this 3 times each day - total 150 contractions.

Week 3 - Tighten the pelvic floor muscles for 6 seconds every 12 seconds (5 per minute) for 15 minutes, 75 contractions. Do this 3 times each day - total 225 contractions.

Weeks 4-24 - Tighten the pelvic floor muscles for 6 seconds every 12 seconds (5 per minute) for 20 minutes, 100 contractions. Do this 3 times each day - total 100 contractions.

After 24 months - Continue maintainence at 10 minutes three times a day or 15 minutes twice a day, total of 150 contractions a day.
You may notice some soreness in the pelvic muscles and around the vaginal opening once you start exercising regularly. Do not worry about this - it is only soreness associated with increased muscle activity. The benefits of these exercises will continue ONLY as long as you do them! Use it or lose it! You should expect to have to do these exercises regularly for three months before you notice an improvement in your urine loss. At six months of regular exercise you will get maximum effect.

If at any time you think you are getting headaches, chest discomfort or abdominal muscle discomfort, then you are contracting other muscles in addition to, or instead of the bulbocavernosis muscle. Concentrate on just the perineum, while relaxing all other muscles.



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