Kegel Exercises and Bladder Care
The pelvic floor muscles are special in women because they support the organs in the pelvis (uterus, bowel and bladder). Over time, weakness develops in the pelvic floor muscles due to normal wear and tear and childbirth. The bladder, uterus and rectum begin to slip down and get squeezed into the lower regions of the pelvis. Stress incontinence may develop (urine is released during lifting, sneezing or exercising).
Performing Kegel exercises (named for the individual who invented them) can help many women relieve these symptoms by:
• strengthening the muscles around the vagina and increasing your ability to control and relax these muscles completely.
• helping prevent a prolapsed uterus or poor bladder control
• may add pleasure to sexual intercourse.
Locating the muscles
1. As you begin urinating, try to stop or slow the urine without tensing the muscles of your legs, buttocks, or abdomen. It is very important not to use these other muscles, because only the pelvic floor muscles help with bladder control.
2. When you are able to slow or stop the stream of urine, you have located the correct muscles. Feel the sensation of the muscles pulling inward and upward.
Helpful hint: squeeze in the rectal area to tighten the anus as if trying not to pass gas. You will be using the correct muscles.
The exercise
In the beginning, check yourself frequently by looking in the mirror or by placing a hand on your abdomen and buttocks to ensure that you do not feel your belly, thigh, or buttock muscles move. If there is movement, continue to experiment until you have isolated just the muscles of the pelvic floor.
Set aside TWO TIMES EACH DAY for exercising: morning and evening.
Set #1 Quick Contractions (QC)
Tighten and relax the sphincter muscles as rapidly as you can.
Set #2 Slow Contractions (SC)
Contract the sphincter muscle and hold to a count of 3 (gradually increasing to 10 seconds per exercise daily) then RELAX completely before the next contraction.
Tighten the muscles a small amount at a time, “like an elevator going up to the 10th floor.” Then release very slowly – one “floor” at a time.
Your bladder control should begin to improve in 3 to 6 weeks. If you keep a record of urine leakage each day, you should begin to notice fewer marks in the bladder leakage column. ⇒
Establishing a daily routine
Whether you are doing pelvic muscle exercises to improve or maintain bladder control, you must do them regularly on a lifetime basis. An easy way to ensure making Kegel exercises part of your daily life is to use some of the following as cues or reminders to perform your Kegel exercises:
• In the shower
• Brushing teeth
• Watching TV
• Reading
• Walking
• Standing in checkout lines in stores
• Stopping at traffic lights
10 Healthy habits to improve bladder control
1. Learn to “squeeze before you sneeze” – and before you cough, laugh, get out of a chair, or pick up something heavy.
2. Use the toilet regularly. Make toilet facilities convenient. This may mean a bedside commode or a bedpan or urinal placed beside the bed.
3. Train your bladder. Use a clock to schedule times to toilet – every hour, then every 1 1/2 hours, etc. until you achieve a satisfactory schedule. Avoid frequent trips to the toilet “just in case”.
4. Remain at the toilet until you feel your bladder is empty. Don’t rush. If you feel there is still some urine in the bladder, move around or stand up if you were sitting, sit back down, and lean forward slightly over the knees.
5. Empty your bladder before you start on a trip of an hour or more. Don’t try to wait until you get home or until it’s more convenient.
6. Establish regular bowel habits. Constipation affects bladder control.
7. CLOTHING: Wear clothes that are easy to remove when it is time to use the toilet.
8. FOODS: Consider avoiding foods that are known to affect the bladder, such as tomatoes, cranberries or cranberry juice, lemon juice, and other acidic foods or drinks; spicy foods; all alcoholic, carbonated, and caffeinated beverages and colas; and sometimes chocolate. These make the bladder more irritable and may increase incontinence.
Straining due to constipation may cause damage to pelvic muscles or nerves. Eating a high fiber diet and drinking at least 8 to 10 glasses of water daily is helpful.
9. WEIGHT: Obesity makes bladder control more difficult. Ask your regular doctor about a sensible diet if you are overweight.
10. SMOKING: Smoking is irritating to the bladder, and a smoker’s cough may cause bladder leakage.
11. AEROBIC EXERCISES: Keeping aerobic exercises low impact may be helpful since it is not known for sure if the trauma of repetitive jolting leads to damage of pelvic nerves & muscles over time.
Adapted from Urology Clinic,
University of Washington Medical Center