I have been spending a lot of time in the past few months tending to a very dear one at a senior citizen’s home. Old age is painful physically and psychologically. A common thread in the travails of old age I noticed is urinary incontinence and that probably tops the list in most cases. We cannot undo the damage resulting from weak bladders, we cannot do much after the onset of urinary incontinence, we cannot alleviate the pain of the seniors that have reached that stage, but we can certainly prepare ourselves even while we have age on our side. Hence this blog post on Kegel exercises.

What is Kegel exercise?

Pelvic floor muscles support the uterus, bladder, small intestine and rectum. Kegel exercises strengthen the pelvic floor muscles and hold your pelvic organs in place. They can be done just about anytime. Men and women should strengthen their pelvic floor muscles, it is a myth that only women suffer from urinary incontinence.

Kegel exercises are known to improve your sex life too.

Why Kegel exercises?

Factors like pregnancy, childbirth, surgery, ageing, chronic constipation and coughing and obesity can weaken the muscles of the pelvic floor region resulting in several kinds of leaks.

Exercising muscles of the pelvic region can arrest or alleviate these conditions of stress incontinence and urge incontinence :

• If you leak a few drops of urine while sneezing, laughing or coughing (stress incontinence)
• If you have a sudden urge to urinate so strong that you cannot wait till you reach the toilet (urge incontinence)
• Pelvic floor weakness due to childbirth which results in sagging of pelvic organs leading to urine control problems.

Who should do Kegel exercises?

Rakhi Kapoor of Dwi Maternity Studio, Chennai,  well known for her specialisation in pre-natal and neo-natal physiotherapy recommends the following :

• It is best to start Kegel exercises during pregnancy or after childbirth but nothing stops us from beginning even earlier in preparation.
• Men and women that are obese.
• Men and women who do heavy weight-lifting as part of body-building.
• Men and women that are on weight-loss programs.
• Athletes or anyone who is into strenuous exercising.
• Genetic weakness of the pelvic muscles.

There is a common belief that women who undergo C-section surgery during childbirth are spared of muscle-weakening in the pelvic region and therefore, need not concern themselves with related health issues. Far from truth. In comparison with normal deliveries, the level of muscle-weakening may be lower, nevertheless not to be taken for granted. Further, another pregnancy may be coming up. Either way, Kegel exercises are a must to combat ageing issues.

However, some women suffer from severe urine leakage issues when they cough, sneeze or laugh. Some others unexpectedly leak small amounts of urine due to a full bladder (overflow incontinence). Kegel exercises may not help much in the above scenarios. It is best to see a doctor.

How to do Kegel exercises? (Women)

• Find the right muscles.To start with, identify your pelvic floor muscles by stopping urination midstream. If you succeed, you’ve got the right muscles. Now that you have identified your pelvic floor muscles, start the exercises in any position. You may find it easier to do them lying down for starters.
• Perfect your technique.You need practice to perfect the technique. Tighten your pelvic floor muscles, hold the contraction for five seconds, and then relax for five seconds. Do it four or five times in a row. As you progress, increase the muscle-contraction for 10 seconds and then relax for 10 seconds between contractions.
• Maintain your focus. Avoid holding your breath during the exercises, instead breathe normally. Focus on tightening only the pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks.
• Repeat three times a day. Aim for at least three sets of 10 repetitions a day after you have the technique right.

A word of caution : Do not ever use Kegel exercises to start and stop your urine stream when not required. Doing so will lead to incomplete emptying of the bladder and can end up in urinary tract infections.

Kegel Exercises for Men

If you thought only women are afflicted with urinary incontinence, ask those that have elderly males at home. Male urinary incontinence is manageable and preventable with Kegel exercises – a practice of the exercises for five minutes, two to three times daily. In some cases, men have regained complete control of the bladder. An added advantage is that Kegel exercises can help with more intense orgasms and improve erections.

What are Kegel Exercises for Men?

In men, the muscles below the bladder benefit from Kegel exercises.

Most often, the weakening of these muscles is caused by a weak urinary sphincter resulting from surgeries for prostrate, an overactive bladder or a weak bladder that fails to contract.

How to do Kegel exercises? (Men)

The process is the same for men and women.

• Try to stop or slow down urination midstream.
• Focus and do not tense your abdomen, leg muscles or the buttocks.
• Do not hold your breath, breathe freely.
• If you succeed in slowing or stopping the flow, then you have identified the right muscles.
• Practice till you are able to use the right muscles each time.
• You might find it easier to do the exercises lying down at first so that you don’t have to resist gravity.
• Contract the muscles for a slow count of five, release likewise. Repeat 10 times.
• Do a set of 10, thrice a day building it gradually. Do not become tense if you cannot progress fast. The key is to get it right and then look for more repetitions.
• After you achieve a certain comfort level, do the exercises standing, it exerts more weight on the muscles, thereby improving your control.

Be patient, it may take a few days to a few weeks for you to see results as with any exercise. Keep a record of urine leakages each day to help track your progress. See a urologist if you do not see any significant improvement, they can help you locate the muscles and offer tips to do the exercises efficiently.

Tips to get the best out of your Kegel exercises ( Men & Women)

• Be consistent : Do your Kegel exercises at the same time each day.
• Consider doing them first thing in the morning while brushing your teeth, or while standing at the kitchen counter fixing your morning cup of tea or coffee.
• While you are at work on your chair, talking on the phone or at a traffic signal. The best part of these exercises is that you can do them almost anywhere anytime. Trust me, no one will ever know you are doing them!!
• There should be no movement of your tummy, back, shoulders or legs; you should not be able to see any movement of anyone doing the exercise correctly and no one should see any change in your body while you perform the exercises.
• Continue doing the exercises for ever, even after you have seen best results, i.e complete control of your bladder. Like every other muscle, pelvic region muscles need maintenance too.
• You can incorporate Kegel exercises in you workouts like squats, calf raises, planking, butt squeezes or even ironman. A few pictures below to illustrate the point
• Add Kegel exercises in your daily routine if possible.

It is never too late to start Kegel exercises if you haven’t already. Present day gynaecologists work with physiotherapists to offer pregnant women Kegel exercise sessions to help keep their bladders in good stead during and post pregnancy. Not everyone from the older generation has had access to the know-how of these exercises. But YOU can start now. Rakhi Kapoor makes it a point to impress upon all those that accompany the to-be-moms to her clinic, the importance of Kegel exercises.

Educate people around you and spread awareness whenever you can, they will remember and thank you in their advanced ages. You can help your elders make a beginning, now! Like I said, it is never too late to start Kegel exercises. Your 50+ life can be stress-free. Help spare the 70+ and 80+ seniors the discomfort of diapers.

Wishing Wellness !

PS : The nature of this blog is informative and not prescriptive.