How to Do a Kegel: Different Positions Can Improve Your Performance

by KegelsPelvic Floor MusclesPelvic Floor Weakness

This blog is an addendum to our 11-part article series of 11 New Year’s resolutions that actually work and WILL improve your pelvic health. We thought it relevant to add this blog post since the first 2 New Year’s Resolutions are all about Kegels and pelvic floor muscle exercises! Get the full list of all 11 New Year’s resolutions HERE.

How to do a Kegel for Newbies
There are tons of articles out there that talk about how you can do Kegels while waiting in line at the grocery store, while driving car, or while sitting at your office desk. Yup, even we have been guilty of writing those types of articles. We talk about doing Kegels in these various places because we want to emphasize the fact that adding Kegels and other exercises for your pelvic floor muscles does NOT have to be difficult, complicated, or impossible. We try to emphasize that Kegels can be done whenever you have a spare minute or two, with the goal of encouraging more women to do Kegels for their pelvic health.

But here’s the thing … for the woman who has never done Kegels or the woman who is not doing a Kegel correctly, trying to do these exercises while sitting in a car or standing in the grocery line is going to be next to impossible. For these women, it is best to start doing Kegels from positions of less resistance, such as lying down or lying on her side. If you think about it, doing Kegels in these positions make sense. After all, in both sitting and standing positions gravity exerts a strong downward pull on everything, including the pelvic floor muscles. Since the goal of Kegels is to pull the pelvic floor muscles upward and inward, any woman in a sitting or standing position has to work against the force of gravity … which is no small force! If a woman has never done Kegels or has difficulty doing Kegels, fighting gravity while doing these exercises just doesn’t make sense!

Best Positions for Pelvic Floor Muscle Exercises
Now that we’ve established that doing pelvic floor muscle exercises, such as Kegels, while sitting or standing is not ideal for beginners or women struggling with these exercises, let’s talk about strong positions for these women. The best positions for these women to start practicing Kegels are supine and side-lying. In regular human words, supine and side-lying mean this:

  • Supine: This just means that you lie on your back with your legs stretched out in a relaxed position (you can do this on your bed or on the floor, whichever is most comfortable for you)
  • Side-Lying: As the name implies, you lie on your side with your legs bent at a relaxed and comfortable angle (again, on the bed or floor)

With either of these positions, feel free to use a pillow to support your neck if necessary (our goal is your pelvic health, not to give you a pain in the neck!). The side-lying position offers the least resistance, but can also be a bit awkward for some women. Try both positions and see which one seems more comfortable for you. In fact, you might try both positions and try to do a Kegel contraction in both. Also remember that if you want to troubleshoot  your Kegels, you’ll need to be able to place one hand between your legs.

We suggest that you try doing Kegels in the supine position first. If you continue to have trouble doing a correct Kegel , then move to the side-lying position and try the contractions again there. If you are new to doing Kegels or are not sure you are doing them correctly, please check this post  to test yourself. If you continue having trouble doing a correct Kegel contraction in either the supine or side-lying positions, then seek the help of a specialist in women’s pelvic health.

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

 

How to Do a Kegel: Do You Know How?

by KegelsPelvic Floor MusclesPelvic Floor Weakness

This blog is an addendum to our 11-part article series of 11 New Year’s resolutions that actually work and WILL improve your pelvic health. We thought it relevant to add this blog post since the first 2 New Year’s Resolutions are all about Kegels and pelvic floor muscle exercises! Get the full list of all 11 New Year’s resolutions HERE.

Do You Know How to Do a Kegel, Really?
For many women, this sounds like a silly question. Of course women know how to do a Kegel. After all, women are often handed direction sheets on how to do a Kegel–whether post-partum or as an alternative therapy for symptoms such as urinary leakage. Just in case you’re not sure about the vocabulary we are using here, a Kegel is a pelvic floor muscle contraction developed by Dr. Arnold Kegel to help women improve their pelvic floor.

So who doesn’t know how to do a Kegel, right?

Wrong.

It turns out that about 50% of women cannot do a Kegel (or contraction of the pelvic floor muscles) correctly. What do these women do wrong?

  • contract the wrong muscles (such as the thigh or buttock muscles)
  • contract no muscles (including the pelvic floor muscles)
  • forget to release the muscles between contractions
  • push the pelvic floor muscles downward and outward rather than pulling them up and in

And these are just a few of the possible problems that women could encounter when learning how to do a Kegel based on written instructions alone. The negative result is that women who do Kegels incorrectly then assume that Kegels do not work for alleviating symptoms of urinary incontinence, pelvic organ prolapse, or decreased sexual sensation. They could not be more wrong! If you don’t believe us, check out the statistics on how well Kegels work to alleviate these types of symptoms.

How to Do a Kegel Correctly
So if at least 50% of women are doing Kegels incorrectly based on written instructions alone, what should those women do? Simple: troubleshoot the Kegel. This exercise for your pelvic floor muscles is simple to troubleshoot if you can create about 45 minutes of quiet time in your house … alone! Do whatever you have to do to get the kids, hubby, and pets out of the way. Turn off your phone ringers and pager sounds. This may seem like a lot of work just to troubleshoot the Kegel, but you’ll find this small investment of time well worth it!

Once you’ve created an oasis of quiet in your home, follow these steps to troubleshoot your Kegel. Be aware that you will need to be willing to touch yourself in your pelvic region. If you are unwilling to do this, then please refer to our blog post on getting help from a physical therapist specializing in women’s pelvic health.

How to Do a Kegel

  1. To prepare yourself, wash your hands thoroughly, and then remove your pants and underwear (if you feel comfortable doing so). Lie on your bed (or the floor, if you prefer) face up with your legs straight out in a relaxed position. You may want to cover yourself with a light blanket for comfort.
  2. Place two fingertips of one hand between your legs on the perineum, which is the space between your vagina and your anus. You will be using these two fingers to feel whether your pelvic floor muscles pull up and in when you do a Kegel. Place your other hand under your buttock, slightly toward the outside edge. With this hand, you will be testing whether you tighten your buttock muscles when you do a Kegel contraction. Note that you want to avoid tightening your buttock muscles when you do a Kegel.
  3. Now do a Kegel (or pelvic floor muscle contraction). Not sure how to do this? No worries. Just picture that you are in a crowded elevator and you have intestinal gas. To prevent yourself from passing gas, you tighten certain muscles in your pelvic region, right? These are the same muscles you tighten to do a correct Kegel. As you do so, feel whether there is an inward and upward contraction where you have your two fingers (on the perineum). If you are doing a correct Kegel, you should feel this slight “in and up” sensation. At the same time, you should feel NO tightening of your buttock muscles. Now release the contraction. Releasing your muscles between contractions is VERY important because a lack of release can lead to over-tightening of the pelvic floor muscles, as well as pelvic pain and other unwanted side effects.
  4. Now repeat the process, this time moving the hand that was on your buttock to your inner thigh. Keep your other hand on your perineum, between your legs. Do another Kegel contraction, checking again that the perineum has a slight inward and upward pull, while your thigh muscle remains relaxed. Release the contraction.
  5. Finally, move your hand from your inner thigh to your abdomen. Repeat the process and ensure that your abdominal muscles do not push outwards as you do your Kegel. Again release the contraction.

If you were able to follow these instructions on how to do a Kegel without tightening your thigh or buttock muscles, and without pushing out your abdominal muscles, during each contraction, then you DO know how to do a Kegel. If, on the other hand you felt your thigh or buttock muscles tightening (or your abdominals pushing outward), you need to slow down and retrain yourself how to do a Kegel.

Taking Your Time Doing Pelvic Floor Muscle Exercises
If you found yourself doing your Kegels incorrectly based on the above instructions, then you have two options: you can retrain yourself to do a correct Kegel or you can get help from a specialist in women’s pelvic health. If you want to try to retrain your pelvic floor muscles yourself, simply follow the instructions given above. As you do each Kegel, consciously focus on contracting your pelvic floor muscles while keeping your thigh and buttock muscles relaxed. If you tend to push your abdominal muscles outward, focus on using them to help you pull your pelvic floor muscles inward and upward.

Take your time practicing these contractions. You may need to move your hand from thigh to buttock to abdominal muscles. Touching these muscles can help you consciously relax them even as you tighten your pelvic muscles. At first it may take you up to 10 slow practice contractions to do a correct Kegel. Don’t worry. Be patient with yourself. Remember that you don’t spend a lot of time thinking about your pelvic floor muscles, so it may take a while for your brain and body to make the proper connections necessary to do a correct Kegel.

If you try to retrain your pelvic muscles yourself but are unsuccessful, we suggest you seek the help of a women’s pelvic health specialist  right away. Not only will this save you a lot of frustration, but getting help means that you will have far less to “unlearn” than if you keep trying to troubleshoot the Kegel by yourself.

Don’t worry! Learning how to do a kegel isn’t rocket science … sometimes you just need to take a little time to learn how to do it right or get some help. Either option is perfectly wonderful, and we applaud you for your focus on your pelvic health!

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

 

Pelvic Floor Exercises: How a Physical Therapist Can Help Improve Your Results

by KegelsPelvic Floor MusclesPelvic Floor Weakness

This blog is part of an 11 article series of 11 New Year’s resolutions that actually work and WILL improve your pelvic health. Get the full list of all 11 New Year’s resolutions HERE.

Get this: 50% of women cannot identify or contract the appropriate muscles to do pelvic floor exercises correctly by following only written results.

That’s right … we said 50%! No wonder there are so many women out there who think that pelvic floor exercises (also called Kegels) don’t work. Chances are that at least 50% of these women are not contracting their pelvic floor muscles properly, or not even contracting their pelvic floor muscles at all. In fact, women commonly contract other muscles–such as thigh or buttock muscles–instead of pelvic floor muscles. The result is that their thighs and buttocks are nicely toned, but their pelvic floor muscles remain neglected and out-of-shape! The other result is that if you have a New Year’s resolution to improve your pelvic health, you won’t achieve your goal if you are exercising your pelvic floor muscles incorrectly.

Do You Know How to Do a Kegel?
This might be a difficult question for you to answer. After all, if you are following written instructions on how to do a Kegel, you might THINK you are doing the exercise correctly, but how do you really know? One of the best ways to find out whether you are exercising your pelvic floor muscles correctly is to have a specialist test you.

Examples of specialists include physical therapists specializing in women’s pelvic health, urologists, and ob/gyns. All of these medical professionals will test the strength and correctness of your Kegel by asking you to tighten your pelvic floor muscles around a finger inserted into your vagina. While this does not sound like the most fun experience in the world, this test WILL help you determine whether you have been properly exercising your pelvic floor muscles … or just wasting your time!

If you have been wasting your time, the good news is that your specialist can either help you correct the way you do your Kegels, or recommend someone who can work with you. For instance, many women who cannot do a correct Kegel are referred to physical therapists who specialize in women’s pelvic health.

Do You Need a Physical Therapist to Help You Correctly Exercise Your Pelvic Floor Muscles?
Physical therapists specializing in women’s pelvic health work with women over a number of sessions to locate and properly contract the correct pelvic floor muscles. What can a physical therapist do for you that you can’t do for yourself? A physical therapist can help you in many ways.

First, the therapist will most likely take a “hands on” approach, which means that they will put their hands in various areas of your pelvic region to help you “feel” when you contract the correct pelvic floor muscles, as well as helping you “feel” when you are contracting the wrong muscles, such as your buttock or thigh muscles. Just having the sensation of a therapist’s hands in your pelvic region can help your brain make the connection to the correct pelvic floor muscles for a Kegel.

Second, your specialist has tools that you don’t that can help further help you identify and contract the right pelvic floor muscles. Two commonly used tools include biofeedback machines and electrical stimulation devices. Biofeedback machines are simple devices that give you either visual or auditory feedback when you contract the right muscles. This additional feedback helps you learn to contract the right muscles more quickly. The electrical stimulation device involves placing electrodes in your vagina or rectum for short periods of time. The device delivers very mild electrical stimulation, which actually lightly contracts and tones the correct pelvic floor muscles. This form of stimulation is especially useful for women who have little or no sensation in their pelvic floor muscles, and are thus unable to contract those muscles. Your specialist may also have you use vaginal weights, which are weighted plastic cones inserted into the vagina for short periods of time. As you hold the weights inside your vagina to prevent them from dropping out, you tighten and tone your pelvic floor muscles. As your muscles become stronger, your specialist will increase the weight until you can hold heavier weights.

The third way your specialist can help you is by designing a pelvic floor muscle exercise program customized to your current level of pelvic fitness. This prevents you from exercising your pelvic muscles too little or too much. Too much exercise can lead to excessive tightening of your pelvic floor muscles, which can result in pelvic pain and other unwanted side effects. Doing too few contractions means that your pelvic floor muscles won’t get toned, and you won’t get the results that you want.

By working with a custom program, you exercise your pelvic muscles at just the right level. As your muscles get stronger and have more stamina, your specialist will change your program to match by increasing the number of contractions or the length that you hold each contraction. With this kind of customized support, you are much more likely to achieve the results you want, whether that means alleviating symptoms of urine leakage, reducing signs of pelvic organ prolapse, or improving your sexual sensation.

Women’s Pelvic Health and Your New Year’s Resolution
Is women’s pelvic health still a New Year’s Resolution? If so, good for you! And, if you have are having difficulty achieving the results you want by doing pelvic floor muscle exercises at your home, it may be time to get help from a specialist. A women’s pelvic health specialist can teach you how to do a Kegel correctly, can design a custom program just for you, and has a wide range of tools that can help you achieve lasting results. You may need to get a referral for this kind of specialist from your family doctor, urologist, or ob/gyn, so we encourage you to call for an appointment to get the ball rolling right away!

If you enjoyed this post, we invite you to check out our book, leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.

 

woman lifting monitor

Pelvic Organ Prolapse: What’s With All the Heavy Lifting?

by Pelvic Floor WeaknessPelvic Organ ProlapsePOPUrinary Incontinence

woman lifting monitorIf you have been diagnosed with pelvic organ prolapse (POP) and you lead an active lifestyle or have a physically-demanding job, chances are good that your lifestyle and/or your job may have contributed to your condition.

Pelvic organ prolapse describes the condition in which one or more of your pelvic organs sags downward, or “falls” out of place. Pelvic organs that can prolapse include the bladder, small intestine, large intestine, or uterus. How many women have POP? Between 43% and 76% of women have POP, but don’t experience any symptoms. Less than 10% of women with POP notice symptoms, such as feeling pressure on the vaginal wall, feeling as if one is sitting on a ball, seeing a bulge falling out of the vagina, urinary incontinence, difficulty urinating, being constipated, low back pain, or feeling pain during sex.

POP and Heavy Lifting
While there are many risk factors for POP, a surprising number of those risk factors are associated with heavy lifting of one sort or another. Pregnancy and childbirth (either vaginal or Cesarean) top the list of factors. If you think about it, pregnancy is one of the most vigorous kinds of heavy lifting a woman can do. Plus, this form of heavy lifting is long-term–about nine continuous months!

Another kind of heavy lifting that can contribute to POP is work-related. If your job requires you to lift, move, or otherwise handle heavy objects on a regular basis, your work may be a big contributing factor to POP. All of this lifting puts pressure and strain on the pelvic organs and their supporting tendons, ligaments, and muscles. When the strain becomes too much, one or more pelvic organs will literally slip out of place, causing the symptoms described above.

Constipation causes straining similar to that of frequently lifting heavy objects. If you suffer from chronic constipation, then you are putting pressure on your pelvic organs several times per day. That’s a lot of heavy lifting for your pelvic organ support system.

Finally, your weight is a consideration. When it comes to your pelvic floor muscles, every pound of weight you carry about your pelvic region exerts a strong downward push. That means your pelvic floor support system has to do “heavy lifting” whenever you are sitting or standing. This is doubly true if you have an active or athletic lifestyle. Bouncing around in an aerobics class adds heavy impact into the equation, more than doubling the strain on your pelvic floor.

Lifestyle Changes to Reduce the Risk of POP
If you are at risk for POP because of any of the reasons listed above, it’s not too late to make some lifestyle changes. Simple changes that will help can include:

  • lose weight
  • change jobs to avoid lifting heavy objects
  • increase fiber intake to reduce constipation
  • switch from high-impact exercise to low-impact exercise (such as swimming or walking)
  • start doing pelvic floor exercises (like Kegels), especially if you have had children
  • consider using a pessary to temporarily increase support for your pelvic organs

These are all simple conservative measures that can prevent further sagging of your pelvic organs, and can often relieve symptoms of POP. These measures have almost no side effects, and studies have shown them to be quite effective. POP doesn’t have to consign you to being an armchair athlete. Instead, try these conservative approaches and see just how active you can be. You will be surprised!

Photo Credit: http://www.flickr.com/photos/76029035@N02/6829303627/

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Women: Are Your Bedroom Encounters “Not” Instead of “Hot”?

by Decreased Sexual SensationPelvic Floor Muscles

A woman’s ability to experience pleasurable sex can be a much more complicated issue than it is for a man. Not to say that men don’t have their own sexual issues, but studies show that the route a woman must travel to reach sexual satisfaction–if not actual orgasm–involves many more factors, from hormones to brain waves to emotions. Even temperature can play a factor. For instance, did you know that research found that women were more likely to achieve orgasm if their feet were warm? It’s true!

Decreased Sexual Sensation: A Primary Cause
One of the main reasons that women are not as sexually satisfied as they could be is that they have poor pelvic floor muscle tone, which leads to less sensation during sex. For women, strong pelvic muscle tone can play an important role in increasing sexual satisfaction. Toned pelvic muscles mean more circulation, more nerve endings, more “stretch” during penetration, and overall better sex!

5 Questions to Ask Yourself
If you think you may be missing out on better sex because of decreased sexual sensation, ask yourself these 5 questions:

1. Do you have difficulty reaching orgasm during sex?
2. Have you experienced less sexual satisfaction or sensation in your sexual organs after menopause?
3. Do you feel little or no sensation in your sexual organs during sex (including masturbation)?
4. Do you have little or no interest in sex because you do not feel pleasurable sensations during sex?
5. Do you have less sensation than you used to in your sexual organs?

If you answered “Yes” to 2 or more of these questions, chances are that you experience decreased sexual sensation. That may not make you a happy camper, but the good news is that your condition is not permanent. More importantly, you can take steps to improve your condition and your sexual experience. Learn more about decreased sexual sensation here.

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