Tuesday, December 7, 2010

Do You Really Know Kegels?

by Alyce Adams, RN, BSN, "the Kegel Queen"

Midwives are experts at applying low-tech, low-cost health care strategies that promote self-care and help women avoid the dangers of unnecessary interventions. Every midwife is familiar with the cesarean epidemic and with the safe, simple approaches that can keep birthing women out of the operating room.

But many health care providers and consumers don't know enough about another surgical epidemic affecting women. Each year, 200,000 US women have surgery to treat urinary incontinence or pelvic organ prolapse (POP). Eleven percent of women in this country will have this type of surgery by the time they're 80 years old — that's a lifetime risk of one in nine. Of those who have surgery to treat prolapse, one third will end up back in the operating room at least once.

Millions more will suffer without any treatment at all: 50% of women will experience urinary incontinence at some point in life, and 50% of mothers will have some form of POP.

Kegel exercises — when performed correctly — are a highly effective treatment for urinary incontinence and POP. The exercises are simple, promote self-care, and they're completely safe. The only side effect is better sex! But most people don't realize how effective kegels can be to solve these health problems without surgery, because they don't have the facts about correct kegel technique.

Check out these popular kegel myths. Do you have the facts?

Myth: Kegels are intentional contractions of the pubococcygeus (PC) muscle.
Fact: Correct kegel technique involves the entire pelvic floor, not just the PC.

Myth: Women should do kegels whenever they think of them — at a boring meeting, at a red light, or waiting in line.
Fact: There are three reasons this approach to kegels doesn't work. First, effective kegels are sustained, high-intensity muscle contractions. Real kegels require your full attention. If you're trying to drive and do kegels, you'll either do weak, useless kegels or crash the car. Second, you must relax the pelvic floor fully after each kegel contraction. This complete relaxation requires your full attention as well. Finally, research shows that women who do kegels "whenever" simply don't end up doing them. Doing kegels on a regular schedule and connecting kegels with preexisting daily routines is the way to succeed.

Myth: Women should do 200 kegels a day, or more.
Fact: Too many kegels can lead to hypertonic pelvic floor muscles and pain with intercourse. A few dozen kegels a day is all you need — then far less for maintenance over time. Correct kegel technique takes just a few minutes a day.

Myth: Truly effective kegels require a kegel device.
Fact: Devices make kegels complicated, messy, and inconvenient. Study after study shows excellent kegel results with no devices at all.

When done correctly, kegels can eliminate prolapse symptoms, stop incontinence, and transform women's sexual health. Get the facts!


Anonymous said...

What about recotocile (did I spell it right?). I have had 7 babies, one D&E for fetal demise after my 4th born, and had pain with bowels for a while after that. I also was instructed to push for an hour and 1/2 by a terrible nurse...with an OP baby for #6 and then had a bad decel with #7 and pushed until I had blood vessels pop in my face, she was also OP and I had a good midwife who told me we don't normally push this way but this time we need to (I could hear that heartbeat drop and not come back up). So, consequently, my bowels come into my vaginal area. I did kegels for a while, no help. I have started tightening "in back" now instead. What's the best exercise to fix my problem, don't like to have to "go in" to get bowels out. It's horrible, it's not the same as it used to be...I blame poor instructions during pushing and me not standing up for myself...and possibly the D&E (and I had an epis with my first born too).

Anonymous said...

I was feeling like I was the only one like what you describe. I have had 6 kids and have the same symptoms.
I had a repair in 2007 and did not take, I am hoping kegels and herbal and vitamin supplements may help, I am also going thru menopause and notice it more.

Kegel Queen said...

Hi Anonymous,

I'm so sorry to hear what a rough time you've had with your births, and for the loss of your fourth baby.

Any and all of what you've been through with childbearing, including simply having been pregnant, can certainly cause pelvic floor damage. The other factor with pelvic organ prolapse (rectocele, cystocele, and uterine prolapse), of course is the stretching of the ligaments that support those organs. There's not much you can do to tighten up the ligaments, so for non-surgical treatment, the two big options are kegels and/or a pessary. Many women also see positive results with the Arvigo Techniques:

I don't know what your previous experience was with kegels. Your technique might have been perfect, and kegels just aren't the right treatment for you. But as I indicated in this post, virtually every woman is doing kegels incorrectly. No amount of bad kegels will give you a good result.

Some of my students have received poor-quality kegel instructions even from physical therapists working in women's health, and have seen better results when they started using my research-based techniques.

Certainly, as with any treatment, kegels can't bring about complete cure 100% of the time. But many of my students have great success stabilizing, reversing, or eliminating rectocele with correct kegel technique.


Alyce, the KQ

patty love said...

Thank you for your inspiring, concise, and fact-based post. I feel sad knowing that many people often miss out on getting information that will help them live a better life. I hope your post will reach a number of people who need this information.