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dr Firman Abdullah SpOG / OBGYN

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Monday, June 15, 2009

Pelvic Floor Muscle Training (Kegel Exercises)

Pelvic Floor Muscle Training (Kegel Exercises)
What is pelvic floor muscle training?
Why should I do pelvic floor muscle exercises?
How do you do pelvic floor muscle exercises?
Important Tips for pelvic floor muscle exercises
What are the most common mistakes made during pelvic muscle exercises?
When should I use the pelvic floor muscles?
How can I work this new health habit into my everyday life?


What is pelvic floor muscle training?
It is a daily training program for the muscles that support the uterus, bladder and other pelvic organs. It is also called Kegel exercise or pelvic muscle rehabilitation. This exercise will help your pelvic muscles prevent accidental urine leakage.

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Why should I do pelvic floor muscle exercises?
Regular pelvic floor muscle exercises make the muscles that support your pelvic organs stronger and helps you use the muscles more effectively. Women who have a problem with urine leakage have been able to eliminate or greatly improve this problem just by doing pelvic floor muscle exercises each day. Pregnant and postpartum women who do pelvic floor muscle exercises have significantly less urine leakage.

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How do you do pelvic floor muscle exercises?
When you are doing pelvic floor muscle exercises in a way that will build muscle strength you will feel all the muscles drawing inward and upward. A good way to learn the exercise is to pretend that you are trying to avoid passing intestinal gas. Think about the way you tighten (or contract) the muscles to keep the gas from escaping. Bring that same tightening motion forward to the muscles around your vagina. Then move the contraction up your vagina toward the small of you back. Another good way to understand pelvic floor muscle training can be found in thinking about the vagina being able to clasp the penis during intercourse. This is the same upward and inward motion that helps build strong pelvic muscles.

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Important Tips for pelvic floor muscle exercises
Each contraction should involve a concentrated effort to get maximum tightening.
Try to contract only the pelvic muscles. (If you feel your abdomen, thighs or buttocks tightening then relax and aim just for the pelvic muscles by using a less intense muscle contraction. If it seems impossible not to tighten the abdomen, thigh, or buttock muscles, then concentrate on full relaxation and try gentle �flicks� of the pelvic muscles, for example, �flick, flick, flick, relax�--working the muscles to higher layers with each flick.)
Be sure to breathe while holding the muscles contracted.
Practice fully relaxing the muscle for at least 10 seconds between each contraction.
Experiment with contracting the muscles in many different positions (standing upright, lying, sitting, on hands and knees, feet together, feet apart).
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What are the most common mistakes made during pelvic muscle exercises?
The most serious mistake women make when doing pelvic muscle exercise is to strain down instead of drawing the muscles up and in. Try doing this on purpose once so you can feel what NOT to do: take a breath, hold it, and push down with your abdomen. You can feel a pushing out around your vagina. It is very important to avoid this straining down.

To keep from straining down when you do a pelvic muscle contraction: exhale gently and keep your mouth open each time you tighten your muscles. Remember to breathe. Rest a hand lightly on your abdomen. If you feel your stomach pushing out against your hand, you are straining down. If you cannot avoid straining down, do not continue with the exercise until you check with your nurse to learn how to do it properly.

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When should I use the pelvic floor muscles?
Squeezing the pelvic floor muscles can help you right away to avoid leakage. Practice coordinating contraction of these muscles with an event in which you may be prone to leak urine (i.e., coughing, sneezing, nose-blowing, lifting a heavy object, etc.) You should also contract the muscles when you need to delay going to the toilet.

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How can I work this new health habit into my everyday life?
Think about your typical day. Pick a time (about 15 minutes) that you should have time to do pelvic floor muscle training, maybe when you first wake up or maybe during a TV program you almost always watch.
Decide on a way to remind yourself to do pelvic floor muscle training. You might put a note on a mirror you always use in the morning or a sticker on your TV or a special magnet on your refrigerator.
Reward yourself for exercising each time you do it. You might get some special small candies and treat yourself to one each day that you remember. Or you could draw a small flower on your calendar to mark each day you exercise and get yourself a real flower or bouquet when you have drawn 10 or 30 flowers. Any small reward that you know will keep you working on this habit is fine.
Everyone who is making a change like this has lapses. You may forget for several days at a time. Don�t get discouraged and think that you won�t be able to continue the exercise program. When you realize that you have forgotten, just resume the program.
Monitor your progress. You might want to keep a daily diary of whether or not you have had a leaking accident. Over the weeks you should begin to see a decrease in the frequency and amount of unwanted urine loss. Another way to check your progress is to see whether or not you can slow or stop your urine stream when you are going to the bathroom. We recommend that you try this no more than once a week. As your pelvic muscles get stronger you will find that you are able to stop the stream more quickly.
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University of Michigan, School of Nursing.
Copyright � 2000. Regents of the University of Michigan. All rights reserved.
Revised: February 07, 2001 .

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Dr Firman Abdullah SpOG/ OBGYN,                              Bukittinggi, Sumatera Barat ,Indonesia

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