Kegel exercises: role and meaning

Kegel exercises owe their name to the name of the American gynecologist Arnold Kegel, who developed them in the 40-years of the last century. As we deepened our knowledge of the medical conditions in which Kegel exercises are applicable, their role and importance have grown. If you are wondering how to train your pelvic floor muscles, in this article we will introduce you to pelvic floor muscle training and give you some examples.

Why is Kegel Exercise Important?

Kegel exercises are a group of exercises that generally increase the strength and endurance of the pelvic floor muscles. These muscles play a very important role in the female body. Together with the intricate fascial system, they form a flexible suspension, extending from the coccyx to the pubic bone, compared by many to an hanging hammock. The role of the abovementioned suspension is to support the internal organs of the small pelvis, i.e. the bladder, uterus, vagina and anus. 

The role of Kegel exercises

Kegel exercises have a very wide range of applications. They are used in:

• stress urinary incontinence (XNUMXst and XNUMXnd degree);
• lowering of the pelvic organs (XNUMXst and XNUMXnd degree);
• pain syndromes in the small pelvis;
• in some neurological diseases;
• or a case intervertebral disc herniation.

In addition, Kegel exercises are an extremely important part the process of restoring the fitness of patients after gynecological surgeries. The period in which special attention is paid to Kegel exercises is also pregnancy and puerperium. This mainly applies to: deliveries after 42 weeks of pregnancy, deliveries longer than 24 hours and women who gave birth more than twice.

Research shows that correctly performed Kegel exercises during pregnancy reduce the percentage of loss of urine during pregnancy and immediately after childbirth. They are also able to cure up to 50% of cases of stress urinary incontinence, especially of a mild degree, at a time distant from childbirth.

When to start using Kegel exercises?

We start Kegel exercises as soon as possible after the first symptoms of urinary incontinence appear. The first symptoms usually develop with sneezing and coughing.

Stress urinary incontinence

Often, especially in young women, the first symptoms may appear during exercise, e.g. while playing with children on a trampoline, during fitness exercises or other physical activity. We are talking then about stress urinary incontinence. Stress urinary incontinence is the most common form of urinary incontinence. It is associated with an increase in pressure inside the abdominal cavity, which most often occurs during coughing, sneezing or exercise.

Prevention is the most important thing

Kegel exercises should be regularly used not only by women who already have a problem with incontinence and who require a specialized therapeutic program, but also all women. First of all, it concerns women classified as the so-called risk group, i.e. in the period perimenopausal, menopausal and late menopausal i.e. after 70 years of age and women who have given birth many times. It is associated with the aging of the connective tissue and the reduction of collagen content in the muscles, which reduces the flexibility and endurance of the pelvic floor muscles.

Prevention is also important in young women aged 20-29. There is a misconception that pelvic floor disorders generally do not affect young women and women who have undergone cesarean section, or those who have had only one birth. This is not entirely true. The risk of urinary incontinence in these women is actually lower, but according to statistics, problems with urinary incontinence occur in about 4% of women at a young age and in 11% of women after cesarean section.

Overweight a pelvic floor muscle exercises 

An example of women who should also be serious about prophylactic exercises to strengthen the pelvic floor muscles are women struggling with overweight.

Overweight, and above all obesity, as well as smoking cigarettes, which stimulate chronic cough, promote the development and progression of stress urinary incontinence.

Bearing in mind the above, regardless of age, in order to prevent the onset of the troublesome and affecting the quality of our life problem of urinary incontinence, do not delay, but start prophylactic Kegel exercises as soon as possible.

Pelvic floor muscle preventive exercise: examples

Such exercises consist of performing isolated pelvic floor muscle tension. They can be performed at any time convenient for a woman, e.g. while standing in a queue, riding public transport or watching TV. A few / a dozen regular pelvic floor muscle tensions are enough.

Kegel exercises: how to exercise your pelvic floor muscles?

If you're still wondering how to exercise your pelvic floor muscles, you need to know that very simplified Kegel exercises involve conscious, repeatedly repeated tightening and relaxing of the pelvic floor muscles. In theory it sounds simple, but in practice, many mistakes are made and they result in the establishment of an incorrect pattern of contraction.

We talk about the correct contraction of the pelvic floor muscles when the muscles around the vagina are lifted and tightened. The correct activation of the pelvic floor muscles is greatly facilitated by visualization, i.e. imagining the contraction. The most frequently used are:

• Clenching a tampon, apricot or pearl in the vagina along with pulling it towards the head.
• It is a good idea to imagine the parasol unfolded with the canopy facing down and to close it.

On the other hand, it is not advisable to exercise the pelvic floor muscles while urinating by stopping the urine flow, which is quite often recommended. This is a common mistake that should be avoided.

Kegel exercises and breathing

A very important issue when using Kegel exercises is synchronization of contraction with breathing. Any tension in the pelvic floor muscles should be accompanied exhaust. This is very important because as you exhale, the pressure in the abdominal cavity decreases and the pressure in the small pelvis automatically decreases. You should also not hold your breath when you are tightening your muscles.

Properly performed contraction of the pelvic floor muscles should not be associated with simultaneous tension of the abdominal muscles, gluteal muscles and thigh adductors muscles. These muscles should be completely relaxed. One of the most common mistakes made by beginners is starting the abdominal pumping station during contractions - that is why it is so important to synchronize the contraction with the exhalation.

How to exercise your pelvic floor muscles: items

Learning Kegel exercises begins with low positions (prone position) and gradually moves to higher positions (propped kneeling, sit down, standing position). The frequency of pelvic floor exercises, the number of series, repetitions or contraction time depends on the severity of the underlying disease and the woman's abilities. Therefore, training parameters should be set individually.

The ideal solution seems to be adjusting the exercise program to the patient by a qualified therapist. Research shows that exercises performed under the supervision of a physiotherapist bring better results than those performed by the patient himself.

Kegel exercises: regularity

Regular use of Kegel exercises can increase your strength, resting tone, and pelvic floor muscle responsiveness, which can eliminate urine leakage. However, the use of Kegel exercises requires a lot of discipline and regularity.

To achieve the full effect, Kegel exercises should be used for 3 to 6 months. The earliest effects related to the increase in the number of active muscle fibers or strength gain, some women may achieve after 4-8 weeks of regular training.

Many women expect quick results, not achieving them within a few days or weeks, giving up the established therapeutic program. It has been shown that 54 to 95% of women achieve a complete recovery or a significant relief of their ailments, provided that they impose themselves the daily discipline of using Kegel exercises according to the established therapeutic program. Especially that the pelvic floor muscle exercises are not particularly complicated, which is confirmed by the examples indicated in the article. Remember that a positive attitude to exercise, discipline and perseverance are features that are very desirable in the treatment of pelvic floor muscles.

Authors:
Dr. n. Kul. phys. Teresa Orlik - physiotherapy specialist, Head of the Therapeutic Improvement Department, Institute of Mother and Child;
Magdalena, MSc Kalinowska - physiotherapist, Department of Healing Improvement, Institute of Mother and Child.