Have you been told to do kegel exercises to help with your incontinence? Urinary incontinence in women is very common and kegel exercises are often the initial prescription but Kegel exercises are a bit of an elusive exercise that people know they should do but are never sure if they are doing them correctly.
Kegel exercises were designed by doctor, Dr. Kegel, who used a biofeedback device called a perineometer, to help women learn how to contract and relax their pelvic floor after childbirth. Read that again...contract AND relax.
Studies have shown that over 50% of women are doing kegels incorrectly and many are simply trying to squeeze as hard as they can and end up using their inner thighs or their glutes instead of their pelvic floor and they fail to consider the relaxation portion. But it is not their fault.
What's happened to the kegel over time is that its regularly prescribed, but rarely taught and seldom do people have a proper pelvic floor evaluation to determine what type of kegel training their pelvic floor needs. This has meant that women have not been well-served as far as pelvic wellness goes and have endured far more discomfort than necessary. They accept that urinary incontinence is something they need to live with.
The most common type of incontinence is Stress Urinary Incontinence (SUI). Some call it peezing or sneeze-pee. It is characterized by tiny amounts of urine leaking out during times of exertion such as laughing, coughing, sneezing, running etc. This type of incontinence responds very well to kegel exercises.
Urge Incontinence (UI) is characterized by strong and sudden urges to urinate that can sometimes not be overcome. It can result in a complete release of the bladder. UI can respond to kegel exercises and lifestyle modifications with the help of a bladder diary.
Mixed Incontinence is a combination of both types.
Kegel exercises (also called pelvic floor exercise) done correctly AND consistently are two of the keys to getting rid of the leaks that are holding you back from living the life you want. Because kegels are not taught, women try them but don’t think they work so end up giving up.
When you do a kegel exercise, it should be in synergy with your breath. When you inhale, think of your vulva blossoming, then as you exhale, you want to imagine that your vulva is picking something up. Visualize a little blueberry at the entrance to your vagina and anus. Now as you exhale, imagine grabbing the blueberries and lifting them up into your body.
Most people think of kegels as simply squeezing as hard as they can, and they miss the lift and as mentioned earlier, they miss the letting go. You need to have a balance between the ability to contract and the ability to relax. I call it Yin Yang Yoni!
The best way to ensure you are doing a kegel correctly is to see a pelvic floor physiotherapist. A pelvic floor physio will use gloved fingers to assess the external and internal genitalia, and your ability to contract and relax your pelvic floor muscles.
Some people need to work more on the squeeze and lift, while other people need to work more on the letting go - the release. Focusing your kegel training on the aspect that your pelvic floor needs will help ensure you have balance and control and the appropriate timing to help support your internal organs and close of the openings that are responsible for the leaks.
Some people find that being upright when they're doing their pelvic floor exercise is harder than lying down. The influence of gravity can be necessary feedback for some and a challenge for others. Try kegels lying down first, then i wide leg child’s pose, then in seated and then in standing. Once you have built up some endurance you will add kegel exercises to movement to make them more functional.
Many believe 3 sets of 10, 10 second holds done 3x a day is what is best. I don’t believe this is realistic for most so I like to show people how to add kegels to other exercises and activities of daily living which makes them much more functional and also easier to complete. A set or two done seated or lying down is fine but then add them throughout your day...when you pick something up, when you are standing in line, when you are lifting weights. Add the contraction part of the kegel as you exhale, just prior to lifting or exerting the force. Exhale just before exertion. Once you become more trained you will exhale with exertion and then eventually your pelvic floor will respond as needed on its own.
While there are surgical interventions and pharmaceuticals that may sometimes be needed or chosen, it is always best to explore non-invasive methods with your health care team first. Even if you need or choose to have surgery, if you can strengthen your body to improve prior to surgery you can improve your outcome and reduce the likelihood of recurrence. Many people have avoided surgery altogether once they understood what their pelvic floor needed and began a consistent pelvic floor fitness program.
Hypopressive Low Pressure Fitness is a technique that can be very helpful in healing incontinence and other pelvic floor challenges. It is a series of postures that are considered low pressure, meaning they don't increase intra-abdominal pressure. A rhythmic breathing pattern and breath hold is added that initiates an involuntary response in the pelvic floor that draws the viscera up and helps improve the response of the pelvic floor muscles and core.
Urinary incontinence is not just something women need to put up with. Pelvic floor exercises can put you back in the driver’s seat for your health and wellness. When done correctly, you can start seeing quite quickly - often within 1-2 weeks. My Buff Muff Challenge is the perfect place to start to learn how to do kegels correctly...get you doing them consistently AND helping you coordinate them into key exercises that will help you eliminate your incontinence!