Posts Tagged ‘Kegels-on-demand’

Kegels-on-Demand: Use Them As Needed

March 24, 2018

Andrew Siegel MD   3/24/2018

The concept of pelvic floor muscle training is not just to develop a strong and flexible pelvic floor, but also to put that capacity into practical use.  By knowing how to use your pelvic floor in real-life situations, you can improve your quality of life and many pelvic floor-related issues that may have surfaced over the years. This is the  essence of “functional fitness.”   Although this entry is primarily geared towards females, Kegels-on-demand on equally useful for men who have overactive bladder, stress incontinence, tension myalgia and premature ejaculation.

shutterstock_femalebluepelvic

 

Putting Your Pelvic Floor Muscle Training Into Action: Kegels-on-demand

Functional pelvic fitness is the practical and actionable means of applying pelvic floor muscle (PFM) proficiency to common everyday activities to improve pelvic function. This encompasses the knowledge of how to contract and relax PFM muscles through their full range of motion in the real world (as opposed to isolated, out-of-context contractions), when to do so, how often do so and why to do so.  For many women, this is the essence of PFMT–having stronger and more durable PFM to improve their quality of life.  These purposeful and consciously applied PFM contractions are not intended as exercise or training—although they will secondarily serve that purpose—but as management of the various pelvic floor dysfunctions at the times and moments that the problems become apparent.  When practiced diligently, these targeted PFM contractions can ultimately become automatic and reflex behaviors.

“Gotta” Go: Urgency Management

When you feel the sudden and urgent desire to urinate or move your bowels, snap your PFM several times, briefly but intensively. When your PFM are so engaged, the bladder muscle reflexively relaxes and the feeling of intense urgency should disappear. Understand that this is most effective when the bladder or bowels are not full, but are contracting involuntarily.

Staying Dry

For urgency incontinence, prior to exposure to the specific provoking trigger—hand washing, key in the door, running water, entering the shower, cold or rainy weather, etc.—snap your PFM rapidly several times to preempt the involuntary bladder contraction before it occurs (or diminish or abort the bladder contraction after it begins).

With respect to stress urinary incontinence (SUI), by actively contracting the PFM immediately before exposure to the activity that prompts the SUI, the incontinence can be improved or prevented. For example, if changing position from sitting to standing results in SUI, do a brisk short duration PFM contraction prior to and when transitioning from sitting to standing to brace the PFM and pinch the urethra shut.

Keeping Your Insides In

If you have pelvic organ prolapse (POP) and have defined activities that cause the prolapsed pelvic organ to drop or protrude—often standing, bending or straining—engage the PFM prior to or during these triggers. If you need to manually reduce the POP (by pushing the prolapse in with your fingers), after doing so, consciously engage the PFM to maintain the prolapsed pelvic organ in its proper anatomical position.

Better Sex for You and Your Partner

Integrate your newfound PFM powers in the bedroom and intensify your sensation as well as his by tightening your vaginal “grip” around his penis during sexual intercourse.  Alternatively, you can pulse your PFM rhythmically while pelvic thrusting or pulse your PFM without pelvic thrusting, the snapping providing penile stimulation in the absence of active thrusting.

As you develop increasing PFM proficiency, you may be able to selectively contract individual PFM in isolation, simultaneously, or in such a sequence that can result in a titillating experience for both you and your partner. You may be able to develop as much fine motor control of your vagina as you have of your fingers and hands! At the time of sexual climax, focus on the involuntary rhythmic contractions of your PFM and try to heighten the experience by explosively contracting them.

Try This: “Pompoir” is a technique in which a woman contracts her PFM rhythmically to stimulate the penis without the need for pelvic motion or thrusting. Women who diligently practice Kegel training can develop powerful PFM and become particularly adept at this, resulting in extreme vaginal “dexterity” and the ability to refine pulling, pushing, locking, gripping, pulsing, squeezing and twisting motions, which can provide enough stimulation to bring a male to climax. 

Relaxing the High-strung Pelvic Floor

If you suffer with tension myalgia of the PFM, focus on consciously unclenching the PFM over the course of your day. Be particularly aware of the natural PFM relaxation that occurs when urinating or moving your bowels and strive to replicate that feeling of PFM release.

 Limber hip rotators,

A powerful cardio-core,

But forget not

The oft-neglected pelvic floor.

 

Wishing you the best of health!

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

 MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

Cover

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

 

 

 

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5 Kegel Exercise Mistakes You Are Probably Making

October 21, 2017

Andrew Siegel MD 10/21/17

Do it right or don't do it

I have always been fond of this sentiment, the words of which were immortalized for me on a coffee mug courtesy of then 10-year-old Jeff Siegel (my son).  This statement holds true for everything in life, including pelvic floor exercises. 

Dr. Arnold Kegel (1894-1981), a gynecologist who taught at USC School of Medicine,  popularized pelvic floor muscle exercises to improve the sexual and urinary health of women following childbirth. His legacy is the pelvic exercise that bears his name—Kegels.

“Do your Kegels” is common advice from many a gynecologist (and from well-intentioned friends and family), particularly after a difficult childbirth has caused problems “down there.”  These pelvic issues include urinary leakage, drooping bladder, and stretching of the vagina such that things look and feel different and sex is just not the same.

“Do your Kegels” is sensible advice since this strengthens the pelvic floor muscles that support the pelvic organs, contribute to urinary and bowel control, and are intimately involved with sexual function. Developing strong and durable pelvic floor muscles is capable of improving, if not curing, these pelvic issues. Unfortunately, mastery of the pelvic floor is not as easy as it sounds because these muscles are internal and hidden and most often used subconsciously (unlike the external glamour muscles that are external and visible and used consciously).  

  The Kegel problem is threefold:

  1. Many women do not know how to do a proper Kegel contraction.
  2. Of those that can do a proper Kegel contraction, most do not pursue a Kegel exercise training program.
  3. Even those women who do know how to do a proper Kegel contraction and pursue a Kegel exercise training program are rarely, if ever, taught the most important aspect of pelvic muscle proficiency: how to put the Kegels to practical use in real-life situations  (“Kegels-on-demand”).

If a Kegel pelvic floor contraction is done incorrectly, not only will the pelvic issue not be helped, but actually could made worse. Only doing pelvic muscle contractions without pursuing a well-designed pelvic floor muscle training program is often an invitation to failure. Finally, if “Kegels-on-demand” to improve pelvic issues are not taught, it is virtually pointless to learn a proper contraction and complete a program, since the ultimate goal is the integration of Kegels into one’s daily life to improve quality. 

How does one do a proper Kegel pelvic contraction?  Simply stated, a Kegel is an isolated contraction of the pelvic floor muscles that draw in and lift the perineum (the region between vagina and anus). The feeling should be of this anatomical sector moving “up” and “in.”

5 Common Kegel Exercise Mistakes

Mistake # 1: Holding Your Breath

Breathe normally.  The Kegel muscles are the floor of the core group of muscles, a barrel of central muscles that consist of the diaphragm on top, the pelvic floor on the bottom, the abds in front and on the sides, and the spinal muscles in the back. Holding your breath pushes the diaphragm muscle down and increases intra-abdominal pressure, which pushes the pelvic floor muscles down, just the opposite direction you want them moving.

Mistake # 2: Contracting the Wrong Muscles

When I ask patients to squeeze their pelvic floor muscles during a pelvic exam, they often contract the wrong muscles, usually the abdominals, buttocks or thigh muscles. Tightening up the glutes is not a Kegel!  Others squeeze their legs together, contracting their thigh muscles.  Still others lift their butts in the air, a yoga and Pilates position called “bridge.” The worst mistake is straining and pushing down as if moving one’s bowels, just the opposite of a Kegel which should cause an inward and upward lift.

Fact: I have found that even health care personnel—those “in the know,” including physical therapists, personal trainers and nurses—have difficulty becoming adept at doing Kegels. 

Sadly, there is a device on the market (see below) called the “Kegel Pelvic Muscle Thigh Exerciser,” a Y-shaped plastic device that fits between your inner thighs such that when you squeeze your thighs together, the gadget squeezes closed. This exerciser has NOTHING to do with pelvic floor muscles (as it strengthens the adductor muscles of the thigh), serving only to reinforce doing the wrong exercise and it is shameful that the manufacturer mentions the terms “Kegel” and “pelvic muscle” in the description of this product.

kegeler

Learning to master one’s pelvic floor muscles requires an education on the details and specifics of the pelvic floor muscles, learning the proper techniques of conditioning them and finally, the practical application of the exercises to one’s specific issues.

Mistake # 3: Not Using a Kegel Program

Kegel exercises can potentially address many different pelvic problems—pelvic organ prolapse, sexual issues, stress urinary incontinence, overactive bladder/bowel, and pelvic pain due to excessive pelvic muscle tension.  Each of these issues has unique pelvic floor muscle shortcomings.  Doing casual pelvic exercises does not compare to a program, which is a home-based, progressive, strength, power and endurance training regimen that is designed, tailored and customized for the specific pelvic floor problem at hand. Only by engaging in such a program will one be enabled to master pelvic fitness and optimize pelvic support and sexual, urinary and bowel function.

Mistake # 4: Impatience

Transformation does not occur overnight!  Like other exercise programs, Kegels are a “slow fix.”  In our instant gratification world, many are not motivated or enthused about slow fixes and the investment of time and effort required of an exercise program, which lacks the sizzle and quick fix of pharmaceuticals or surgery. Realistically, it can take 6 weeks or more before you notice improvement, and after you do notice improvement, a “maintenance” Kegel training regimen needs to be continued (use it or lose it!)

Mistake # 5: Not Training for Function (“Kegels-on-Demand”)

Sadly, most women who pursue pelvic training do not understand how to put their newfound knowledge and skills to real life use. The ultimate goal of Kegels is achieving functional pelvic fitness, applying one’s pelvic proficiency to daily tasks and common everyday activities so as to improve one’s quality of life.  It is vital, of course, to begin with static and isolated, “out of context” exercises, but eventually one needs to learn to integrate the exercises on an on-demand basis (putting them in to “context”) so as to improve leakage, bladder and pelvic organ descent, sexual function, etc.

Bottom Line: Kegel pelvic floor muscle exercises are a vastly under-exploited and misunderstood resource, despite great potential benefits of conditioning these small muscles.  In addition to improving a variety of pelvic issues (urinary and bowel leakage, sexual issues, dropped bladder, etc.), a strong and fit pelvic floor helps one prepare for pregnancy, childbirth, aging and high impact sports.  The Kegel Fix book is a wonderful resource that teaches the reader how to do proper Kegels, provides specific programs for each unique pelvic issue, and reveals the specifics of “Kegels-on-demand,” how to put one’s fit pelvic floor and contraction proficiency to practical use in the real world.

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

 MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

Cover

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.