Kegel Instructions

Pelvic muscle exercises, also called Kegel (kay-gull) exercises after Dr. Arnold Kegel who developed them, strengthen the pelvic floor muscles. These muscles contract and relax under your command to control the opening and closing of your urethral sphincters -- the muscles that give you urinary control. When they are weak, urine leakage results. Through regular exercise, however, you may be able to build up their strength and endurance and, in many cases, regain bladder control.

Begin by locating the muscles to be exercised

  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.

Now you are ready to exercise regularly
When you have located the correct muscles, set aside two times each day -- morning and evening -- for exercising.

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 three (gradually increasing to count of 10 per exercise daily); then RELAX completely before the next contraction.

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.

Your bladder control should begin to improve in three to six weeks. If you keep a record of urine leakage each day, you should begin to notice fewer marks in the bladder leakage column.

The notation

5 QC, 10 3 sec SC, 5 QC
means five quick contractions, then 10 three second slow contractions, then five quick contractions. The three second slow contraction means holding the contraction for three seconds.)

The notation

20 QC, 25 10 sec SC, 20 QC
means 20 quick contractions, then 25 10-second slow contractions, then 20 quick contractions.

Make pelvic muscle exercises a part of your daily routine
Whether you are doing pelvic muscle exercises to improve bladder control or to maintain it, you must do them regularly throughout your lifetime. Use daily routines, such as watching TV, reading, stopping at traffic lights, and waiting in the grocery check-out line, as cues to perform a few exercises.

These 10 healthy habits will help improve your bladder control

  1. Use the toilet regularly and make toilet facilities convenient, which may mean a bedside commode, bedpan or urinal placed near the bed.
  2. Wear clothes that are easy to remove when it is time to use the toilet.
  3. Train your bladder. Use a clock to schedule times to toilet (e.g., every hour, then every 1-1/2 hours) 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; then 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. Learn to squeeze before you sneeze -- and before you cough, laugh, get out of a chair or pick up something heavy.
  7. Establish regular bowel habits. Constipation affects bladder control.
  8. Consider avoiding foods that are known to affect the bladder, such as tomatoes, chocolate, spicy foods, and certain beverages (alcoholic and those containing caffeine). These make the bladder more irritable and therefore, increase incontinence.
  9. Watch your weight. Obesity makes bladder control more difficult. Ask your regular doctor about a sensible diet if you are overweight.
  10. Stop smoking. Smoking is irritating to the bladder, and a smoker's cough may cause bladder leakage.

When you have the urge to urinate try these

  1. Stop what you are doing and sit down or stand still and remain quiet. Relax you body by taking a few deep breaths.
  2. Do some quick Kegel squeezes (pelvic floor exercises) three or four times without relaxing.
  3. Concentrate hard on suppressing the urge to urinate and wait until the urge passes or subsides.
  4. When the urge has subsided, walk at a regular pace to the bathroom. Don't run. Continue to do the Kegel squeezes as you walk.