About all

Exercises for bladder: Kegel Exercises for Urinary Incontinence

Содержание

Kegel Exercises for Urinary Incontinence

You won’t really look like you’re working out. You’ll be watching television, driving in your car, working at your desk, or brushing your teeth. But you’ll also be squeezing and strengthening the pelvic floor muscles through Kegel exercises, a series of muscle contractions that can help control or prevent urinary incontinence.

Dr. Arnold Kegel created these pelvic floor exercises in 1948 as a way to help women who developed stress urinary incontinence following childbirth.

Childbirth or menopause can weaken the pelvic floor muscles that hold the bladder and urethra in place. With those muscles weak, any additional pressure on the bladder caused by a laugh, sneeze, cough, or exercise can cause urine to leak.

Kegel exercises, if done correctly and over an extended period of time, strengthen those muscles to better support your bladder. A review of studies from New Zealand found that women who regularly practiced Kegels were up to 17 times more likely to be cured of incontinence symptoms than women who did not.

Men can benefit, too. Though women make up 75 to 80 percent of the 25 million Americans living with incontinence, men may face similar bladder issues after they’ve had their prostate removed. Kegels are often prescribed for women, but recent research published in the Journal of the American Medical Association suggests more men should be doing them as well. The study found that men who did Kegels over an eight-week period had fewer than half as many weekly incontinence episodes as they had prior to learning the exercises.

Performing Kegel Exercises

Before you start your Kegel regimen, you’ll need to figure out which muscles are the correct ones to focus on. The best way to do that is to sit on the toilet with your legs slightly apart and start to urinate. After a few seconds, try to stop the stream of urine by squeezing without moving your legs. If you stop the urine flow, you’ve likely used the pelvic floor muscles: These are the muscles you will need to strengthen to help control urinary incontinence. It may take more than one try to be sure you have found the right muscle group.

The individual contractions of a Kegel workout require you to squeeze the pelvic floor muscles just as you would if you were trying to stop urine flow. Ideally, Kegel exercises should be done as follows:

  • Empty your bladder before beginning.
  • Contract the pelvic floor muscles and hold for a count of 10.
  • Relax the muscles completely for a count of 10.
  • Stand and perform 10 of these contractions. Repeat 10 times each while sitting, and 10 times while reclining, for a total of 30 contractions in a single exercise routine.
  • Perform your Kegel exercises three times a day, for a total of 90 contractions a day.

Your Kegel Program

Ninety contractions a day may sound daunting, but keep in mind that you can do them anywhere-while waiting on a supermarket line or pumping gas, for example. After all, no one can see you doing them.

You can help make these exercises second nature by performing them during set triggers — for example, whenever you are stopped at a red light or during commercial breaks. After a while, you might find yourself performing Kegel exercises automatically.

Remember that these are like any other exercises in that results are not automatic. Most notice some improvement in their urinary incontinence after four to six weeks, but it could take as long as three months before you experience noticeable results.

And as with other forms of exercise, remember that overdoing it is a bad thing. Some people try to speed up their progress by performing more repetitions or doing their exercises more often. By doing so, they’re running the risk of overtiring or injuring the pelvic floor muscles, which can make urinary incontinence worse.

how to help a weak bladder

For many people with urinary incontinence, the following self-help tips and lifestyle changes are enough to relieve symptoms.

Do daily pelvic floor exercises

Pelvic floor exercises can be effective at reducing leaks, but it’s important to do them properly. Find out how to do pelvic floor exercises.

You may have to do pelvic floor exercises for 3 months before you see any benefits.

Stop smoking

If you smoke, you put yourself at risk of incontinence, because coughing puts strain on your pelvic floor muscles.

Find out about NHS Smokefree support services, or call the Smokefree National Helpline to speak to a trained adviser on 0300 123 1044 from Monday to Friday 9am to 8pm and Saturday and Sunday 11am to 4pm.

Find out more about how to stop smoking.

Do the right exercises

High-impact exercise and sit-ups put pressure on your pelvic floor muscles and can increase leaks.

To strengthen your pelvic floor to relieve symptoms, replace high-impact exercise, such as jogging and aerobics, with strengthening exercise, such as pilates.

Pilates strengthens your core muscles, which is beneficial for stress incontinence.

Avoid lifting

Lifting puts strain on your pelvic floor muscles, so avoid it whenever you can.

When you do need to lift something, such as picking up children or shopping bags, tighten your pelvic floor muscles before and during the lift.

Lose excess weight

Being overweight can weaken your pelvic floor muscles and cause incontinence because of the pressure of fatty tissue on your bladder.

Your symptoms may improve, and could go away completely, if you lose any excess weight.

Use the healthy weight calculator to check you’re a healthy weight for your height.

Find out more about how to lose weight.

Treat constipation promptly

Straining to poo weakens your pelvic floor muscles and makes urinary incontinence worse.

Never ignore the urge to poo. If you have constipation, it may help to change your diet and lifestyle.

Eating more fibre and exercising more can help. It may also help if you change the way you sit and use your muscles to empty your bowels. A specialist physiotherapist can advise you on this.

Find out more about how to have a healthy diet.

Cut down on caffeine

Caffeine irritates the bladder and can make incontinence worse.

Coffee has the biggest effect, so stop drinking it or switch to decaffeinated coffee.

Fizzy drinks, tea, green tea, energy drinks and hot chocolate also contain caffeine, so cut down on these too and replace them with water and herbal or fruit teas.

Cut down on alcohol

Alcohol is a diuretic, which makes you urinate more often. Cutting down may help incontinence symptoms.

Find out more about how to cut down on alcohol.

Drink plenty of water

Drink 6 to 8 glasses of fluid a day (but no more) unless your doctor advises you otherwise.

Many people with urinary incontinence avoid drinking fluids, as they feel it causes more problems. However, limiting your fluid intake makes incontinence worse, because it reduces your bladder’s capacity.

Not drinking enough fluid can also cause constipation or make it worse.

Find out which are the healthiest drinks.

Eat the right foods

Avoid spicy and acidic foods, such as curries and citrus fruits, as they can irritate the bladder and make leaks and other incontinence symptoms worse.

Page last reviewed: 07 November 2019
Next review due: 07 November 2022

Step-by-step guide to performing Kegel exercises

Doing Kegels right means find your pelvic floor muscles and working them.

Kegel exercises won’t help you look better, but they do something just as important — strengthen the muscles that support the bladder. Strong pelvic floor muscles can go a long way toward warding off incontinence.

These exercises were developed in the late 1940s by Dr. Arnold H. Kegel, an American gynecologist, as a nonsurgical way to prevent women from leaking urine. They also work for men plagued by incontinence.

Although Kegel exercises themselves are simple, finding the right muscles to exercises isn’t. One-third or more of women and men who do Kegels are actually working their abdominal, buttock, or inner thigh muscles. They don’t reap the benefits of the exercises.

Locate your pelvic muscles

Several techniques can be used to find the right set of muscles to exercise.

Women:

  • Pretend you are trying to avoid passing gas.
  • Pretend to tighten your vagina around a tampon.

Men:

  • Pretend you are trying to avoid passing gas.
  • While urinating, try to stop your urine stream.

If you’ve identified the right muscles, you’ll feel the contraction more in the back of the pelvic area than the front.

Practice contractions

Choose your position. Start by lying on your back until you get the feel of contracting the pelvic floor muscles. When you have the hang of it, practice while sitting and standing.

Contract and relax

  • Contract your pelvic floor muscles for 3 to 5 seconds.
  • Relax for 3 to 5 seconds.
  • Repeat the contract/relax cycle 10 times.

Keep other muscles relaxed. Don’t contract your abdominal, leg, or buttock muscles, or lift your pelvis. Place a hand gently on your belly to detect unwanted abdominal action.

Extend the time. Gradually increase the length of contractions and relaxations. Work your way up to 10-second contractions and relaxations

Aim high. Try to do at least 30 to 40 Kegel exercises every day. Spreading them throughout the day is better than doing them all at once. Since these are stealth exercises that no one notices but you, try to sneak in a few when waiting at a stoplight, riding an elevator, or standing in a grocery line.

Diversify. Practice short, 2 to 3 second contractions and releases (sometimes called “quick flicks”) as well as longer ones.

Kegel exercises in an emergency

If you leak urine when you cough, sneeze, laugh, bend over, or lift something heavy (stress incontinence), doing one or more Kegels before a “trigger” may be enough to prevent any leakage. If you have the urge to urinate and doubt you are going to make it to the toilet, doing Kegels may get you safely to a restroom.

As a service to our readers, Harvard Health Publishing provides access to our library of archived content.
Please note the date of last review or update on all articles. No content on this site, regardless of date,
should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Pelvic Floor Exercises | Stress Incontinence

If you develop stress incontinence, there is a good chance that it can be cured with pelvic floor exercises. Pelvic floor exercises are also useful to prevent incontinence, particularly for women who have had children.

What are the pelvic floor muscles?

The pelvic floor muscles are a group of muscles that wrap around the underneath of the bladder and rectum. Your doctor may advise that you strengthen your pelvic floor muscles:

  • If you develop stress incontinence. In stress incontinence, urine leaks when there is a sudden extra pressure (‘stress’) on the bladder. Urine tends to leak most when you cough, laugh, or exercise (like jump or run). Strengthening the pelvic floor muscles can often cure stress incontinence.
  • After childbirth. The common reason for the pelvic floor muscles to become weakened is childbirth. If you do pelvic floor muscle exercises after childbirth, it may prevent stress incontinence developing later in life.

In addition, some people feel that having strong pelvic floor muscles heightens the pleasure when having sex.

Female urinary system

Pelvic floor exercises to treat stress incontinence

It is important that you exercise the correct muscles. Your doctor may refer you to a continence advisor or physiotherapist for advice on the exercises. They may ask you to do a pelvic floor exercise while they examine you internally, to make sure you are doing them correctly.

The sort of exercises are as follows:

Learning to exercise the correct muscles

  • Sit in a chair with your knees slightly apart. Imagine you are trying to stop wind escaping from your back passage (anus). You will have to squeeze the muscle just above the entrance to the anus. You should feel some movement in the muscle. Don’t move your buttocks or legs.
  • Now imagine you are passing urine and are trying to stop the stream. You will find yourself using slightly different parts of the pelvic floor muscles to the first exercise (ones nearer the front). These are the ones to strengthen.
  • If you are not sure that you are exercising the right muscles, put a couple of fingers into your vagina. You should feel a gentle squeeze when doing the exercise. Another way to check that you are doing the exercises correctly is to use a mirror. The area between your vagina and your anus will move away from the mirror when you squeeze.\
  • The first few times you try these exercises, you may find it easier to do them lying down.

Doing the exercises

  • You need to do the exercises every day.
  • Sit, stand or lie with your knees slightly apart. Slowly tighten your pelvic floor muscles under the bladder as hard as you can. Hold to the count of five, then relax. These are called slow pull-ups or long squeezes.
  • Then do the same exercise quickly and immediately let go again. These are called fast pull-ups or short squeezes.
  • The aim is to do a long squeeze followed by ten short squeezes, and repeat this cycle at least eight times. It should only take about five minutes.
  • Aim to do the above exercises at least three times a day.
  • Ideally, do each set of exercises in different positions. That is, sometimes when sitting, sometimes when standing and sometimes when lying down.
  • As the muscles become stronger, increase the length of time you hold each slow pull-up or long squeeze. You are doing well if you can hold it each time for a count of 10 (about 10 seconds).
  • Do not squeeze other muscles at the same time as you squeeze your pelvic floor muscles. For example, do not use any muscles in your back, thighs, or buttocks.
  • Some people find it difficult to remember to do their exercises; a chart or a reminder on your phone may help.
  • Try to get into the habit of doing your exercises at other times too, whilst going about everyday life. For example, when brushing your teeth, waiting for the kettle to boil, when washing up, etc.
  • You may find it helpful to do a ‘squeeze’ just before you do something that would otherwise cause you to leak, like coughing or lifting.
  • After several weeks the muscles will start to feel stronger. You may find you can squeeze the pelvic floor muscles for much longer without the muscles feeling tired.

It takes time, effort and practice to become good at these exercises. It is best do these exercises for at least three months to start with. You should start to see benefits after a few weeks. However, it often takes two to five months for most improvement to occur. After this time you may be cured of stress incontinence. If you are not sure that you are doing the correct exercises, ask a doctor, physiotherapist or continence advisor for advice.

If possible, continue exercising as a part of everyday life for the rest of your life. Once incontinence has gone, you may only need to do one or two bouts of exercise each day to keep the pelvic floor muscles strong and toned up and to prevent incontinence from coming back.

Other ways of exercising pelvic floor muscles

Sometimes a continence advisor or physiotherapist will advise extra methods if you are having problems or need some extra help performing the pelvic floor exercises. These are in addition to the above exercises. For example:

  • Electrical stimulation. Sometimes a special electrical device is used to stimulate the pelvic floor muscles with the aim of making them contract and become stronger.
  • Biofeedback. This is a technique to help you make sure that you exercise the correct muscles. For this, a physiotherapist or continence advisor inserts a small device into your vagina when you are doing the exercises. When you squeeze the right muscles, the device makes a noise (or some other signal such as a display on a computer screen) to let you know that you are squeezing the correct muscles.
  • Vaginal cones. These are small plastic cones that you put inside your vagina for about 15 minutes, twice a day. The cones come in a set of different weights. At first, the lightest cone is used. You will naturally use your pelvic floor muscles to hold the cone in place. This is how they help you to exercise your pelvic floor muscles. Once you can hold on to the lightest one comfortably, you move up to the next weight and so on.
  • Other devices. There are various other devices that are sold to help with pelvic floor exercises. Basically, they all rely on placing the device inside the vagina with the aim of helping the pelvic muscles to exercise and squeeze. There is little research evidence to show how well these devices work. It is best to get the advice from a continence advisor or physiotherapist before using any. One general point is that if you use one, it should be in addition to, not instead of, the standard pelvic floor exercises described above.

Pelvic floor exercises if you do not have incontinence

The type of exercises are exactly the same as above. If you are not used to doing pelvic floor exercises then perhaps do the exercises as often as described above for the first three months or so. This will strengthen up the pelvic floor muscles. Thereafter, a five-minute spell of exercises once or twice a day should keep the muscles strong and toned up which may help to prevent incontinence from developing in later life.

How to strengthen your pelvic floor

What are pelvic muscles?

Pelvic muscles are located at the base of your core. They stretch like a trampoline or hammock from the pubic bone back to the tailbone. Pelvic muscles support the bladder, bowel and uterus. When these muscles contract, the organs are lifted and tightened, preventing accidental urination, bowel movements, and gas. When these muscles relax, you are able to urinate and have a bowel movement. These muscles also play a role in sexual pleasure and the birthing process.

For many, weak pelvic muscles can cause bladder control problems and leakage when you cough, sneeze, laugh, or strain. Weakening of pelvic muscles result from pregnancy, childbirth, aging, hormones associated with menopause, and straining these muscles due to constipation, chronic cough, or being overweight.