Kegel exercises

Female perineal anatomy

Definition:
Kegel exercises are a series of pelvic muscle exercises designed to strengthen the muscles of the
pelvic floor.
Alternative Names:
Pelvic muscle strengthening exercises; Pelvic floor exercises (PFEs)
Information:
Kegel exercises were originally developed by Dr. Arnold Kegel in 1948 as a method of
controlling incontinence in women following childbirth. These exercises are now recommended
for women with urinary stress incontinence, some men who have urinary incontinence after
prostate surgery, and people who have fecal (stool) incontinence.
The principle behind Kegel exercises is to strengthen the muscles of the pelvic floor, thereby
improving the urethral and rectal sphincter function. The success of Kegel exercises depends on
proper technique and adherence to a regular exercise program.
Some people have difficulty identifying and isolating the muscles of the pelvic floor. Care must
be taken to learn to contract the correct muscles. Typically, most people contract the abdominal
or thigh muscles, while not even working the pelvic floor muscles. These incorrect contractions
may even worsen pelvic floor tone and incontinence.
Several techniques help the incontinent person identify the correct muscles. One approach is to
sit on the toilet and start to urinate. Try to stop the flow of urine midstream by contracting your
pelvic floor muscles. Repeat this action several times until you become familiar with the feel of
contracting the correct group of muscles. Do not contract your abdominal, thigh, or buttocks
muscles while performing the exercise.
Another approach to help you identify the correct muscle group is to insert a finger into the
vagina (in women), or rectum (in men). Try to tighten the muscles around your finger as if
holding back urine. The abdominal and thigh muscles should remain relaxed.
A woman may also strengthen these muscles by using a vaginal cone, which is a weighted
device that is inserted into the vagina. She then tries to contract the pelvic floor muscles in an
effort to hold the device the place.
For those people who are unsure if they are performing the procedure correctly, biofeedback and

electrical stimulation may be used to help identify the correct muscle group to work.
Biofeedback is a method of positive reinforcement. Electrodes are placed on the abdomen and
along the anal area. Some therapists place a sensor in the vagina in women or anus in men, to
monitor contraction of the pelvic floor muscles.
A monitor will display a graph showing which muscles are contracting and which are at rest. The
therapist can help identify the correct muscles for performing Kegel exercises.
Electrical stimulation involves using low-voltage electric current to stimulate the correct group
of muscles. The current may be delivered using an anal or vaginal probe. The electrical
stimulation therapy may be performed in the clinic or at home.
Treatment sessions usually last 20 minutes and may be performed every 1 to 4 days. Some
clinical studies have shown promising results in treating stress and urge incontinence with
electrical stimulation.
PERFORMING PELVIC FLOOR EXERCISES:
1. Begin by emptying your bladder.
2. Tighten the pelvic floor muscles and hold for a count of 10.
3. Relax the muscle completely for a count of 10.
4. Perform 10 exercises, three times a day (morning, afternoon, and night).
These exercises can be performed any time and any place. Most people prefer to perform the
exercises while lying down or sitting in a chair. After 4 to 6 weeks, most people notice some
improvement. It may take as long as 3 months to see a significant change.
A word of caution: some people feel that they can speed up the progress by increasing the
number of repetitions and the frequency of exercises. However, this over-exercising may instead
cause muscle fatigue and increase leakage of urine.
If you feel any discomfort in your abdomen or back while performing these exercises, you are
probably performing them incorrectly. Some people have a tendency to hold their breath or
tighten their chest while trying to contract the pelvic floor muscles. Relax and concentrate on
contracting just the pelvic floor muscles.
When properly performed, Kegel exercises have been shown to be 50-80% effective in
improving urinary continence.
The Help for Incontinent People Organization offers an audio cassette tape and booklet to help

coach you in performing Kegel exercise properly. To order this information write to:
HIP PME
P.O. Box 544
Union, SC 29379
Review Date: 8/8/2005
Reviewed By: Sharon Roseanne Thompson, M.D., M.P.H., Clinical Fellow, Department of
Obstetrics & Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by
VeriMed Healthcare Network.