Pelvic Muscle Exercises

Q: A few weeks ago, I had surgery to create a pelvic pouch. I have been instructed to perform pelvic muscle exercises to prevent incontinence. Can you explain the best way to do this?

A: The pelvic floor is made up of muscles called Kegel muscles. These muscles support the body's lower organs, including the bowel and bladder. There is often a lot of pressure on these organs as we walk, exercise, cough or bend over. These muscles may be weakened by the pelvic pouch surgery. Exercising the Kegel muscles is a good way to strengthen them.

First, it is important to locate and identify the correct muscles to exercise. Tighten your anal muscles as if you are trying to refrain from having a bowel movement; release the anal muscles. You are sure that you are tightening the correct muscles if you can stop your urine in midstream. Avoid tightening your abdominal or thigh muscles as they do not strengthen the pelvic floor muscles.

As soon as you have identified the correct muscles, you are ready to start your exercise program. You may sit, stand or lie on your back with your head elevated on a pillow. With practice, you will find the best position for you. Here's how to proceed:

1. Tighten the anal muscles as hard as you can. There may be tenderness at first.
2. Hold the muscles tight for 10 seconds.
3. Relax the muscles for 10 seconds.
4. Repeat as instructed by your doctor or ET nurse.

Generally, it is best to begin with 5 to 6 repetitions. Remember that one repetition consists of 10 seconds of tightening and 10 seconds of relaxation.

You may wish to try a variation of this exercise. While sitting, standing or lying with your head elevated, tighten and release the anal muscles in rapid succession. Repeat 10 to 15 times. Another variation is to tighten the anal muscles while you exhale. Hold the muscles for a count of 30 seconds. Repeat 5 to 10 times.

For additional help with your Kegel exercises, consult your ET.