What are Kegel exercises? Kegel exercises help to strengthen the pelvic muscles. Kegel exercises may help to bring back or improve bladder control in people with urinary incontinence (in-KON-ti-nens) (urine leakage). These exercises are done by contracting (tightening) and relaxing the pelvic muscles. Kegel exercises are also called pelvic floor muscle training or pelvic floor exercises. They must be done correctly and regularly in order to help strengthen the pelvic muscles.

What are pelvic muscles? Pelvic muscles are attached to the area between your pelvic (hip) bones. These muscles act like a strong floor that helps hold your pelvic organs in place. Examples of pelvic organs are the bladder (holds urine), vagina, uterus (womb), and rectum (holds bowel movements). Certain conditions may cause the pelvic muscles to weaken. Some of these conditions include being overweight, aging, or pregnancy and childbirth. When your pelvic muscles become weak, you may have urinary incontinence or other problems.

Which are the correct muscles to use for Kegel exercises? Some people use the wrong muscles when doing Kegel exercises. Instead of using the pelvic muscles, they use their back, abdominal, or upper leg muscles. If you use the wrong muscles, the Kegel exercises will not help you. To make sure you are using the right muscles, try the following:

• Sit on the toilet. While passing urine, tighten your muscles to stop the flow of urine. Do this several times until you know what it feels like to tighten the correct muscles. Once you have found the right muscles to use, only do Kegel exercises when you are not urinating.
  
  
• Lie down and put one finger in your vagina. Tighten your vaginal muscles as if trying to stop urine and a bowel movement from coming out. You should feel the correct muscle tightening around your finger. Once you've isolated the muscle several times, there is no need to place your finger in the vagina to do the exercises.

How are Kegel exercises done? Kegel exercises can be done any time and anywhere. You can do them in the morning, noon or night. The exercises can be done while sitting, standing, lying on your back or taking a bath. Always urinate (empty your bladder) before starting. Do these exercises each day or as directed by your caregiver.

• Slow contractions:
  
  
  • Contract the muscles around your vagina (birth canal) and anus (rear-end). This should feel like you are trying to hold back urine or gas.
    
    
  • Hold these muscles for a count of 10. Remember it is as important to relax as it is to squeeze this muscle.
    
    
  • Slowly release these muscles and relax for a count of 10. Repeat the cycle again.
    
    
  • Do a set of 10 contractions at least three times every day, or as often as your caregiver suggests.
  
  
• Quick contractions: Do 5 to 10 quick, strong contractions after you are finished doing the slow contractions. These exercises may help you prevent an accident by quickly stopping urine leaks.
  
  
• Remember: Keep your abdominal (stomach), back and leg muscles relaxed during Kegel exercises. You should feel only the muscles between your legs (pelvic muscles) contracting. Try not to hold your breath while doing these exercises.

What can I do if my muscles are too weak to hold contractions? At the beginning, many people cannot contract their muscles for a count of 10. Start Kegel exercises by squeezing and relaxing pelvic muscles for 4 to 5 seconds each. You can increase your count as your muscle tone improves.

How can I remember to do my Kegel exercises regularly? Do your exercises at the same times every day. For example, do Kegel exercises when you wake up in the morning, right before lunch, and at bedtime. Keep a Kegel exercise chart or diary. Write down or check off how many times each day you do Kegel exercises. Write down how many exercises you do each time.

What else should I know about Kegel exercises?

• It may take 3 to 6 months after starting Kegel exercises to see a difference in bladder control. You may begin to notice improved bladder control after 6 to 8 weeks.
  
  
• Do not stop doing Kegel exercises until you have talked to your caregiver. Kegel exercises may be useful for the rest of your life.
  
  
• Tighten your pelvic muscles before sneezing, coughing, or lifting to prevent urine leakage.

What are other methods that can be used to strengthen the pelvic muscles? There are other methods that may be used along with Kegel exercises or separately to strengthen your pelvic muscles. Following are some methods that may be suggested by your caregiver:

• Biofeedback: Your caregiver may do biofeedback to help you use the correct muscles. The caregiver may put electrodes on your abdomen and rectal area, or a sensor inside your vagina. Electrodes and sensors are patches or inserts with wires that are attached to a machine. The electrodes or sensors detect your muscle activity and strength and send this information to the machine. This information may help you locate and contract the correct muscles during Kegel exercises.
  
  
• Vaginal cones: Vaginal cones are small teardrop-shaped weights that are placed inside the vagina. The cones are held in place while doing your normal activities for 15 to 20 minutes, about 3 to 5 times a week. The weight of the cones are increased as the pelvic muscle strength increases.
  
  
• Electrical stimulation: Electrical stimulation exercises and strengthens your pelvic muscles through contractions. An electrode sends an electrical current or pulse that contracts your pelvic muscles for you.

Call your caregiver if:

• You cannot feel your muscles tightening and relaxing. Call if you think you are using the wrong muscles to do Kegel exercises.
  
  
• Your incontinence is getting worse.