Kegel exercises are exercises performed to strengthen the muscles in the pelvis.

They were developed by Dr. Arnold Kegel in 1948 as a way to treat women experiencing urinary incontinence following childbirth. They are now one of the methods taught to help treat incontinence in women and men and to improve pelvic muscle tone. Some women perform Kegel exercises before, during and after pregnancy to assist with delivery and help prevent problems with incontinence following childbirth.

Before Kegel exercises can be a useful treatment, the proper muscles to exercise must be identified. This can be accomplished by stopping the flow of urination midstream and repeating the process until becoming familiar with the sensation of contracting the proper muscles. Another technique that can be used is to insert a finger into the vagina (in women) or rectum (in men). The muscles can be identified by touch when contracted.

The exercises are performed by contracting the pelvic floor muscles for up to 10 seconds (a count of 10), then relaxing them for the same amount of time. In order to be effective, eight to 12 repetitions of the exercise are performed three to four times a week for at least 15 to 20 weeks.

When performed correctly, the exercises have been demonstrated to strengthen pelvic muscles and significantly improve urinary incontinence. Because Kegel exercises strengthen the vaginal muscles, they may also improve sexual satisfaction for some women.

Kegel exercises are exercises designed to strengthen the pelvic floor muscles (a series of muscles that form a sling or hammock across the opening of the pelvis). They involve the voluntary contraction, then relaxation, of the muscles.

Kegel exercises were developed by Dr. Arnold Kegel in 1948 as a way to treat urinary incontinence in women following childbirth. They are now one of the methods taught to treat some women with stress incontinence (loss or leaking of urine from the bladder involuntarily that occurs with activities such as exercising, coughing, sneezing and laughing). Kegel exercises also can be used to help some men who experience urinary incontinence following prostate surgery and some people who experience fecal incontinence (loss of stool involuntarily from the rectum).

Some women perform Kegel exercises before, during and after pregnancy. Research has shown these exercises assist women during the delivery of the baby because they help increase the strength of the muscles, improve muscle flexibility and improve muscle control. These exercises also help speed healing after childbirth. During pregnancy and delivery, pelvic floor muscles can become stretched or weakened, causing one or more of the pelvic organs to sag (e.g., uterine prolapse). This can cause certain types of urinary incontinence. Performing Kegel exercises can strengthen the muscles and improve continence.

Some older women perform Kegel exercises to help strengthen the muscles that control urination. After menopause there is a drop in estrogen, a hormone that helps keep urinary sphincter muscles strong. The Kegel exercises can aid in the maintenance of the muscle strength. Because Kegel exercises strengthen the vaginal muscles, they may also improve sexual satisfaction for some women.

The pelvic floor muscles are located at the bottom of the pelvis. They consist of several layers of muscle that stretch between the legs and attach to the front, back and sides of the pelvic bones. The muscles support the urethra, bladder, uterus and rectum.

There are two pelvic muscles that do most of the work of supporting the pelvic organs, one that stretches like a hammock (iliococcygeus muscle) and another that is shaped like a triangle (pubococcygeus muscle). These are the muscles that control the urethral sphincter, which is involved in urination.

Biofeedback (a treatment technique in which people are trained to improve their health by using signals from their own bodies) is sometimes used to ensure that the exercises are being performed correctly. Techniques involving the use of weighted cones inserted in the vagina and electrical stimulation of the muscles are sometimes used to facilitate the exercise process.

When performed correctly, Kegel exercises can improve urinary incontinence by 50 to 80 percent, according to the National Institutes of Health.

For Kegel exercises to be successful, patients must use proper technique and adhere to a regular exercise program. The following steps should be taken:

1. Identify the pelvic floor muscles (the series of muscles that form a sling or hammock across the opening of the pelvis). This can be done in several ways. One way is to sit on the toilet and begin urinating. Then, stop the flow of urine by contracting the pelvic floor muscles. It is important not to contract the buttocks, abdomen or thigh muscles. This action should be repeated until the individual becomes familiar with the sensation of contracting the correct muscles. Another way is to insert a finger into the vagina (in women) or rectum (in men) and tighten the pelvic floor muscles, as if holding back the flow of urine. The abdominal and thigh muscles should stay relaxed. While contracted, the muscles can be identified by touch.
   
   
2. Contract the pelvic floor muscles for 10 seconds (a count of 10). Patients who cannot hold the contraction for 10 seconds should hold it for as long as possible.
   
   
3. Relax the muscles for 10 seconds (a count of 10). Good relaxation is as important as a good contraction.
   
   
4. Repeat the exercise eight to 12 times, three times a day (usually morning, afternoon and evening). Exercises should be performed three to four times a week for at least 15 to 20 weeks.

Exercises can be performed anywhere, at any time. Most people prefer to do them while lying down or sitting in a chair. Most patients see improvement after four to six weeks of performing Kegel exercises, although it could take as long as three months. Patients may have to consult a physician to ensure that the exercises are being performed properly.

Patients are cautioned against performing the exercises incorrectly or increasing the frequency or the number of repetitions. Incorrect contractions or too much exercise can cause muscle fatigue and worsen urinary incontinence. If patients experience pain or discomfort in the abdomen or back while exercising, they may not be performing the exercises correctly.

Sometimes patients are trained to perform Kegel exercises using biofeedback (a treatment technique in which people are trained to improve their health by using signals from their own bodies). Special biofeedback equipment that measures muscle contraction strength helps ensure that the correct muscles are being exercised. Electrodes are placed on the abdomen and along the anal area. Sometimes a sensor is placed inside the vagina (in women) or anus (in men). The electrodes monitor pelvic floor muscle contractions.

Another exercise technique involves using weighted cones inserted into the vagina. The pelvic muscles are contracted to prevent the weighted cones from dropping from the vagina. As the ability to perform the exercises increases, heavier cones are used.

Electrical stimulation can also be used to stimulate muscles. An electrical current with low voltage may be delivered using an anal or vaginal probe. This may be performed in a physician’s office or at home.

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor or healthcare professional the following questions about Kegel exercises:

1. Can you explain how Kegel exercises work?
   
   
2. What is the best way to perform them?
   
   
3. How often should I perform Kegel exercises?
   
   
4. How can Kegel exercises improve my incontinence?
   
   
5. Can Kegel exercises help my sexual function?
   
   
6. Should I perform Kegel exercises during pregnancy?
   
   
7. Will using any equipment improve my ability to perform Kegel exercises?
   
   
8. Should I use biofeedback to improve my ability to perform Kegel exercises?
   
   
9. How long will it take before I see improvement in my incontinence?
   
   
10. Are there any restrictions to doing these exercises?
    
    
11. What are my options if the exercises do not improve my condition?