Friday, November 26, 2010

KEGEL'S EXERCISE - a BRIEF HISTORY

Kegel Exercise


    The aim of Kegel exercises is to fortify muscle tone by strengthening the pelvic floor muscle. In 1948, Dr. Arnold Kegel, the OB/GYN specialist began to use this exercise for curing the patient suffering from urinary incontinence and it was named after Dr. Arnold Kegel. Dr. Kegel attempted to develop diverse exercise for the injured women’s pelvic muscle due to childbirth or natural urinary incontinence, but the exercise did not achieve the expected results because most of patients did not find the muscle exactly. For that reason, in those days, Kegel Exercise did not become the center of public attention but after that, the fact that the Kegel exercises may also increase sexual gratification becomes the public knowledge and the exercise has been to spread as the method of improving the sexual function.

Dr. Arnold Kegel, who died in 1981,   Although the exercises now bear his name—we tell patients to “Do your Kegels”—the methodology has really been known since ancient times and has numerous variants in the practices of
Eastern religions.

Kegels are what are called resistive exercises. Specifically, as you deliberately control a muscle’s movement, you incrementally increase its ability to contract. As you do your Kegels over time, this contractile strength will grow, and the muscles of your pelvic floor will become broader and thicker and will gain increased muscle tone. But not everybody should do Kegels. If you find that the Kegel clench causes pain or increased bladder or bowel frequency or urgency, stop. It may mean that the pelvic floor muscles are spasmed or shortened, and doing the Kegels may only spasm or shorten them further. See your doctor or health-care provider if that is the case. Also, it’s advisable to consult with a gynecologist or a pelvic floor physical therapist to make sure that your inconti-
nence problem is in fact a result of a weakened pelvic floor or posible prolapsed organ. In other words, be sure of the cause before  you attempt Kegels as the solution.

The Strengthen-the-Muscles routine calls for doing Kegels in conjunction with an exercise for tightening your core abdominal muscle, the transverse abdominus. Although they are only connected by fascia (connective tissue), these two sets of muscles deep in the body’s core—the pelvic floor and the transverse abdominus—
are mutually supportive. They need to work together, and for that to happen with maximum benefit, they also need to be equally fit.

Start, however, by doing the two exercises separately—maybe doing your Kegels in the morning and tight abs at night. Once you’re comfortable doing both, by all means put the two together. This will not only enhance your core strength and coordination, it will also decrease the time spent on your exercise routine by some five minutes. Their joint effect is beneficial in many ways. Obviously, these
exercises enhance muscle strength, and they increase the flow of blood to the muscles and the pelvic organs as well. The risk of infection is thereby lowered, and that too helps stave off pelvic floor disorders. What’s more, the strengthening of these muscles can enhance sexual stimulation and sexual gratification as well.







Kegels : Find the Muscles
Kegels are absolutely basic to the entire Strengthen-the-Muscles routine, and it’s very important that they be done correctly. Done wrong, Kegels simply won’t work, and patients who don’t see results can grow discouraged. Even worse, you could end up with more problems. For example, if you do the Kegels wrong and instead are overusing accessory muscles like the glutes or the inner thighs, this
could produce trigger points on those muscles—that is, hyperiritable spots that are painful to the touch and that can also lead to new pain and new problems.
The key to doing Kegels correctly is to locate your own pelvic floor muscles. There’s a simple way to do this: while urinating, stop the urine from flowing by tightening or squeezing the muscles.

Those are the muscles you’re going to clench and unclench when you do your Kegels. If you fi nd that clenching the muscles minimizes but does not completely stop the urine stream, you’ve found the right muscles, but you’ve also learned that they’re very weak indeed—a solid indication that you need to do the Strengthen-the- Muscles routine.

Do this locating and identifying exercise very briefly and only temporarily—maybe once a week initially, until you identify the muscles—because doing it repeatedly while urinating sends a confusing signal to the brain that may eventually produce a urinary dysfunction.

Another way to locate the muscles you’re looking for is during sexual activity. Squeeze around your partner’s fi nger or penis; the muscle you tighten in doing so is the precise muscle you’ll want to clench and unclench—contract and relax—when you do your Kegels.

Step 1: The Kegel Exercise


Here’s how to do your Kegels to strengthen your pelvic floor: Lie or sit down, whichever you prefer. You may use a pillow as a wedge under the small of your back if you like.

Find the muscle you identified earlier and clench it, then relax. Clench again, then relax. And so on. One clench-and-relax constitutes a repetition, and both sides of the repetition—both the clenching and the unclenching—are equally important.

You may find it difficult to do Kegels at first if your muscles are very weak. But each repetition really will increase the strength of the muscles, and in time, doing your Kegels will become easier—guaranteed. Do these Kegels three times a day if you have one of the problems listed at the beginning of this chapter, but no more than three times a week if you’re doing them just to enhance your sex life.


Here’s the formula:

1. Tighten the muscle and hold for 10 seconds, relax for 10 seconds. Do 10 repetitions to strengthen your slow-twitch pelvic floor muscles.

2. Tighten and hold for two seconds, relax for two seconds. Do 10 repetitions to strengthen the fast-twitch fiber muscles. The two different basic Kegel exercises differ only in timing, not in the process. What’s the difference?

Your first set of Kegels, held for 10 seconds, then relaxed for 10, addresses the slow-twitch fibers that make up some 70 percent of the muscles. These are the muscle fibers that provide support and resist fatigue. The second set of Kegels—two-second Kegels— strengthen those fast-contraction fibers that help open and close the bladder and bowel and that are so essential in sexual activity. The two sets of Kegels mean you’re strengthening both your marathon endurance muscles and the sprinter muscles that provide a quick jolt of power when needed.



Position of pelvic floor muscle

Sphincter is located at some parts of our body: between the stomach and the gullet the large intestine and the small intestine. This plays the role of preventing the reflux by exit block. The pelvic floor muscle is one of sphincters and is a muscle distributed around the anus, the vagina, and the urethra in the shape of number "8".

Position of pelvic floor muscle
Position of pelvic floor muscle


Function of pelvic floor muscle
1. As the abdominal muscle called Core is an important music supporting our body, so the pelvic floor muscle supports the weight of pelvic region ? particularly, uterus, bladder, the internals.
2. This controls the movement of bowels and motion of bladder, the role of sphincter. In case of passing urine, as the pelvic floor muscle around the urethra is relaxed, the tone of muscle is low so as to pass urine smoothly. At the same time, the pelvic floor muscle around the anus keeps the tone as it is so as to prevent the running out of stools
3. In case of having sex, the pelvic floor muscle keeps the tone as it is so as to prevent the running out of stools or urine and helps to reach orgasm easily.
4. This played a vital role of leading the relaxation of easy childbirth.

Problems of pelvic floor muscle related to childbearing women
1. In case that the pelvic floor muscle has gone slack and hangs down due to the weight of conceptus during the period of pregnancy, the urinary incontinence symptoms may be occurred.
2. In case that the pelvic floor muscle has gone slack due to the repeated pregnancy and childbirth, there may occurred the symptoms of urinary incontinence and lowering of sexual function. The weakening of pelvic muscle due to pregnancy and childbirth is occurred to most of women, particularly the weakening of contractile force in the vaginal muscle and the  nervimuscular injury are the representative symptoms.

Effect of Kegel Exercise
1. At the last month of pregnancy, the fetus goes down and the head puts pressure upon of the perineal region, which causes a pain. Kegel Exercise helps to mitigate the pain by strengthening the perineal region.
2. In case of training the ability of moving the pelvic floor musclefreely though Kegel exercise during the period of pregnancy, it is possible to put pressure upon the exact region at the time of childbirth. This helps to shorten the childbirth time.
3. At the time of giving birth, it is possible to prevent the tear of perineal region by applying the power to the region slowly. If not Kegel exercise, sudden application of power to the region may cause the tear of weak perineal region.
4. After childbirth, urinary incontinence may be occurred due to the relaxation of muscle under the bladder or the rupture of the nerve cell or muscle. In ordinary time, cough, sneezing or laughing may cause incontinence. Kegel Exercise is useful to settle such problems economically.
4. In case of taking a long time in natural childbirth, the fecal incontinence may be occurred. Kegel Exercise helps to return such the anus muscle to the normal state.
5. With steady exercises, it is possible to strengthen the vaginal muscle and regenerate the injured cell due to childbirth by promoting blood circulation around the vagina.
6. This exercise helps to reduce the risk of hemorrhoids caused by constipation during the period of pregnancy or after childbirth.
7. By recovering the elastic force of the vaginal muscle, which is weakened after childbirth, it helps to increase sexual gratification and feel orgasm intensively.

From what time shall we begin Kegel Exercise?
It is difficult to perceive the pelvic floor muscle since it is already too flabby after childbirth, so it is recommended to begin Kegel exercise during the period of pregnancy. The beginning before pregnancy is not matter.

How to perceive pelvic floor muscle
1. Sit the toilet bowl with setting your legs apart and attempt to stop the stream of urine in the course of passing it. At this time do not use other muscle, such as the abdomen, the hips, or legs.
If you can stop the urine, you are contracting the pelvic floor muscle and if you pass the urine again, you can relax the pelvic floor muscle. At first trial, you may not feel it well. Try repeatedly till sensing the feeling of contraction and relaxation.
* Provided that, must not take Kegel Exercise in the course of passing the urine. If you take Kegel exercise when the bladder is full or urine is passed, it may weaken the pelvic floor muscle.
2. Other method of acknowledging the pelvic floor muscle is to insert your finger into the vagina and wrap the finger in the vaginal muscle as like the method of stopping the urine. Mind not to use the muscle of thigh or abdomen.
3. As another method, when you have sex, try to contract your vaginal muscle. The contracted muscle is the pelvic floor muscle.
4. If you can not perceive the pelvic floor muscle with above methods, you may have help from an instrument.  

3-Stage Kegel Exercise
1. Beginner: For the first time it may be difficult to contract the pelvic floor muscle for 10 or more sec. If so, contract it for 3-5 sec and relax it for 4-5 times (this, 1 set). Try to repeat for 10 sets in a day.
2. Intermediate: In case of getting used to take Kegel Exercise, try to contract for 10-20sec in a time.
3. Advanced: also known as elevator. Think that you go up from the 1st to the 10th Floor. With thought, contract the pelvic floor muscle slowly. When arrive at the 10th Floor, contract it at maximum. Next think that you go down to the 1st floor again. Whenever you go down a floor, relax it step by step.

Suggestions
1. Do not bend the muscle of abdomen, inguinal region, or hips. The use of such muscles may cause the weakening of the pelvic floor muscle.
2. Take exercise with breathing slowly and deeply. If having a bad headache during taking exercise, it may be caused when using the breast muscle while ceasing the breath.
3. If feeling a fatigue or a pain on the back or the abdomen after taking exercise, it may be caused by excessive exercise or use of the muscle of the abdomen.
4. Never apply force to the abdomen, which is very dangerous to the pregnant women. The application of force to the abdomen may cause elytrorrhagia, premature pangs of childbirth, premature rupture of membrane, pain in the abdomen. In this case, do not take Kegel exercise.

About what time may I perceive the effect of exercise?
If early, it is possible to perceive the change from 4-5 days after beginning the exercise.
If taking exercise regularly and steadily, it is possible to perceive clear mitigation of urinary incontinence symptoms after 6-12 weeks.

Kegel Exercise
                    Before Kegel Exercise                                             After Kegel Exercise

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