Evelyn Lyles, MD
Michelle LeBlanc, MD
James Theofrastous, MD
Nancy Howden, MD
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Evelyn Lyles, MD Michelle LeBlanc, MD James Theofrastous, MD Nancy Howden, MD
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Patient Instructions for Pelvic Floor Muscle Exercises Why do pelvic muscle exercises? Pelvic muscle exercises (also known as “Kegel” exercises) may help you improve your bladder &/or bowel control. Many studies have shown that women who perform these exercises regularly may avoid medical or surgical treatment. Pelvic muscle exercises have a lot going for them- they are free, simple, and you don’t have go to a health club to do them! What are the pelvic muscles? The muscles of the pelvis normally help to support the contents of the pelvis including the womb, the vagina, and the bladder. The pelvic muscles lie beneath the opening of the bladder (“urethra”) & rectum are important in normal bladder, bowel, & sexual function. These muscles are damaged by delivering a baby and by aging. In some women, this damage can result in incontinence, which means losing urine or bowel contents accidentally. Weakness of the pelvic muscles may also cause difficulties with intercourse and with retaining a tampon. What is a pelvic muscle contraction? Like any muscles in your body, you can make your pelvic muscles stronger by exercising them regularly. When you squeeze your pelvic muscles like you would to try to hold your urine or bowels, you are performing a pelvic muscle contraction. How do you contract your pelvic muscles? Many women have difficulty contracting their pelvic muscles. You must concentrate on squeezing the muscles which you would you use to hold your urine or bowels. It is important not to hold your breath or squeeze your stomach, buttocks, or thigh muscles. Your doctor or nurse can help you to be sure that you are contracting the right muscles during an exam. During a contraction you should get the sense of your pelvic muscles pulling upward and a drawing-in sensation in your vagina. Don’t try to contract your muscles by stopping your stream of urine because this is almost impossible for most women & may lead to difficulty emptying your bladder.
Location of the pelvic muscles
How do you perform pelvic muscle exercises? Try to keep everything relaxed except the muscles right around the vagina. At the same time, do not bear down or squeeze your thighs, back or abdominal muscles. Breathe slowly and deeply. You should do the exercises either lying or sitting down. While it is possible to do the exercises while driving down the highway or in the middle of a busy office, it is better to focus on those activities & do them when you can concentrate on them for a couple of minutes. Here’s how to do a set of pelvic muscle contractions:
Helpful Hints- Empty your bladder before exercising. - Keep your legs together until you get used to exercising. - Listen to music when you do the exercises - this can make it more fun! - Some women find the image of an elevator rising up, stopping, & then lowering down again to be useful. - Keep a calendar to keep track of how often you exercise. How often should you do the exercises? You should start with a set of contractions 3 or 4 times per day. Ten to 15 contractions per set is a good starting point. It will take you about 2 or 3 minutes to do a set. Many women find it easy to remember to do the exercises around meal times or just before going to sleep or just after waking up.. When will you see results? Don’t get frustrated if you don’t see immediate results. Like training any muscle in your body, it may take 6 to 8 weeks for you to see results from your muscle training. The more you put into these exercises, the more you will get out of them. It is a lot of work for you, but you may improve your lifestyle and, in some cases, avoid surgery. You may notice some soreness initially as you start to work your muscles. Your clinician can give you feedback about your progress and is available for questions. How will you know if the exercises are working? The goal of this therapy is to improve your bladder &/or bowel control. You may also notice an improvement in your sexual function. This usually means trying to reduce the number of leakage episodes that you have. A realistic goal is to improve your control by around 80%. Sometimes you may get even better results, but even surgery may not be 100% effective. How long should you perform these exercises? After you have had a response to exercise therapy, you may be able to decrease the amount of exercises that you are performing, but you should continue to do them. The old adage of “use it or lose it” applies here- if you stop working on the muscles they will weaken & your problems may return. These exercises are even suggested after surgery for bladder & bowel control problems. Once you get the hang of contracting your muscles you can try doing some different types of contractions. Instead of slow contractions, try squeezing your muscles fast & hard. You can also vary the time & number of the contractions. A little variety may keep you from getting bored. What else can you do to help your control? In addition to the exercises, many women find that such things as emptying regularly to avoid a full bladder, limiting caffeine & alcohol intake, avoiding excessive fluid intake, & emptying prior to strenuous exercise or sex may help their urine leakage problem. For women with leakage mainly with exercise a tampon may also help. What if you can’t contract the muscles? Women who have difficulty performing the exercises may benefit from biofeedback therapy. Biofeedback therapy may involve working with a therapist to help you identify the muscles or working with vaginal weights. On your return visit, if you are having difficulty contracting your pelvic muscles your clinician will discuss whether either of these options may help you. What if the exercises don’t work? If you have no response to exercise therapy, you may be a candidate for medical or surgical therapy, depending on your condition.
Please call the office if you have questions. Good Luck!
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