The Kegel exercise is now recognised as the first line of treatment for women with urinary leakage.
MOST people may have heard of the pelvic floor exercise by now, also known as the Kegel exercise, named after Dr Arnold Kegel, assistant professor of gynecology at the University of Southern California School of Medicine, in the 1940s.
It's claimed to be effective, discreet and can help women regain important control of a body part critical to their feminity. Apart from that, it also increases self-confidence and is cost-effective, and good for the general health of a woman in the long run.
Anytime, anywhere: Kegel exercises can be done in a variety of positions, whether standing, sitting or lying down. Although it was widely reported that Prof Kegel invented these internal exercises, it is believed that practitioners of ancient civilisations have long been practising them to improve health, longevity, spiritual development and sexual gratification.
The Taoists in ancient China referred to it as Deer Exercises, while Indian yogis of yore called them the Aswini Mudra (the horse gesture).
According to Neng Shahidah Sabullah, a physiotherapist (special interest in women's health) from Prince Court Medical Centre, regular practice of Kegel exercise helps strengthen, tone and condition the pelvic floor muscles, the hammock-like muscles stretching across the floor of the pelvis.
"Studies prove that having stronger pelvic floor muscles help to prevent and improve urinary incontinence, ease childbirth and prevent pelvic organ prolapse in the future," she explains.
Considering the many short and long term benefits that can be derived from Kegel exercises, it is the time for every woman to start practising it!
The lying down position is recommended for beginners. The Kegel exercise is the regular contracting and relaxing of the pelvic floor muscles. Like any muscle in other parts of the body, exercising or regular use of the pelvic floor muscles (correctly) will strengthen it, whereas lack of use will lead to atrophy or loss of tone, and eventually, function.
In Prof Kegel's research over 18 years on young female cadavers, he found that women with vaginal repairs after childbirth did not have improved function of their pelvic function as the tissues surrounding the genitals will once again become weak and thin after surgery.
He discovered later that the pubococcygeus, or pelvic floor muscle, plays a large role in supporting and controlling the entire pelvic region, with numerous fibres extending out and inter-woven with the urethra, vagina and rectum.
"With modern science, advanced knowledge and studies done on female anatomy, we now know that the pelvic floor muscles play an important role in supporting the pelvic organs which consist of the uterus, bladder and bowel," says Neng. "The muscles ensure the bladder and the bowel stay ‘closed' or contracted, preventing urine release when you cough, sneeze or exert yourself carrying heavy materials."
She adds that the pelvic floor muscles tend to get weaker during pregnancy, after childbirth, menopausal age and obesity.
The most common and distressing effect of weak pelvic muscles is urinary incontinence or urine leakage.
"Urine leakage is not just a physical problem," adds Neng. "It affects the self-esteem, family life, normal daily routine, sexual and social life, career advancement and travelling options. Many women feel handicapped if they have problems with urine leakage, yet are too shy to see a doctor or seek help for it."
In the recent years, the Kegel exercise has been recommended as the first line of treatment for urinary incontinence. According to Neng, women who practise the correct techniques of Kegel exercise regularly will be able to experience a significant improvement in their symptoms within a few weeks.
She explains: "There are three main steps in the Kegel exercise. Firstly, it is being able to identify the right muscles, and next is learning the correct techniques and then practising frequently."
Step 1: Awareness of and identifying the muscles
The most common mistake people make when doing Kegel exercises is to work the wrong muscles. Instead of working the inside muscles at the pelvic floor, many people end up exercising the muscles at the buttocks.
Try squeezing the muscles around the anus, vagina and urethral areas alternately to feel the different contractions. Refer to a diagram of the pelvic floor muscles while you are doing this so you can better understand the effects of these contractions on the pelvic organs the various muscles support.
Step 2: Learn the correct technique
There are various ways to do the Kegel exercises and it can be done in a variety of positions, whether standing, sitting or lying down. The lying down position will be a better option for beginners. Think about the pelvic floor muscles and synchronise your breathing with the contractions.
Slow contractions help increase the endurance of pelvic floor strength and improve an over active bladder. To do it, lift up your pelvic floor muscles and count slowly to 10. Relax and repeat up to 10 times.
Fast contractions, on the other hand, helps you cope with pressure and protect you from urine leakage immediately whenever you sneeze, laugh or cough. To do this, lift up your pelvic floor muscles and hold for one second. Relax and repeat as many times as possible.
Step 3: Practise regularly
The exercises should be repeated at least three times a day for maximum benefit and you will find your Kegel exercises getting easier with continuous practice. However, as with most exercises, it's easy to forget doing them after the initial novelty has worn off. The best way to keep at it is to incorporate it into your daily routine, such as doing your exercises every morning and night when you are brushing your teeth, driving in between traffic or checking your e-mail.
"Some no-nos when doing the Kegel's exercise include holding your breath, tightening the tummy, thigh or buttock muscles, and squeezing your legs together. These movements indicate that you are not targeting the right muscle group," says Neng. "Also, avoid practising the exercises while urinating as it may backfire and cause your pelvic floor muscles to weaken instead. In the long-term, this might increase your risk of a urinary tract infection."
It also helps to wear the right protection during the exercise sessions. An extensive range of discreet urinary liners and pads are available for varying degrees of urinary leaks ranging from light, regular and heavy.
"We need not wait till we have problems to start learning and practising the Kegel exercise," advises Neng.
"Start now and practise regularly so you can reap the long-term benefits of stronger pelvic floor muscles."
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