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

Exercise Tips What applies to you?




Moving at all time, not just when you feel like it
Exercise improves your metabolism. When you get moving several times a day it keeps that internal calorie burner amped up. Try a two 15 minute cardio sessions daily, the improvement will be more noticeable than if you did one 30 minute session one a day.

Push your muscles to the limit
Next time you strength (resistance) train, try not to rest more than 15 seconds after the last repetition instead, pick up a lighter weight and do 3 to 5 more reps. You have fast and slow twitch muscle fibers. The fast ones will tire quickly, and the slow ones can endure longer. Switching over to lighter weights and continuing to fatigue all the muscle fibers will help build strength and tone faster.

Step aside without pain
We usually move in one direction (frontward and backwards), so strengthening your hips will not streamline your shape below the waist, but it can keep those knees from aching.

Keep your body guessing
Switch the number of repetitions and sets you do to fool your body so that it doesn’t get used to the same routine. In fact pulse or do half time repetitions instead of the standard, 1, 2, 3 set.

Try to get off the ground
Jumping uses all the large lower body muscles…guts, hips, and thighs. Using these muscles raises your metabolism.

Pump that heart...extend the burn
The more often you get your heart pumping during exercise, the longer your metabolism stays revved up afterwards. For instance in a circuit series do one set of every exercise without rest. These movements will fatigue your muscles so your body has to work harder and use more energy (calorie burn) to recover.

Imagery is important too
Try imaging for example contracting your gluts for 15 minutes a day for a few months; now combine that imagery with “live” techniques: and you’ll be able to shape your body and firm those stubborn muscles.
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Get rich on vitamin B
If you are combining diet and exercise (a wise move if you are serious about changing your body), be sure you consume fish with omega-3, poultry, low fat dairy products and fortified whole-grain cereals. It easier for your body to build muscles.

Move a little faster in this case
People who lift weights at a brisk pace (two second - one second lower and one second lift) saw greater strength endurance than those who took three seconds to do the same movements. Be sure to maintain good form and you’ll have more time left over to other moves or add some extra cardio to your workout and burn more calories.

Get on a Stability ball or Bosu
Do a push-up on a stability ball or Bosu, your arms (especially those hard to change triceps) will be more challenged than if you were doing them on the floor.

Do a combo
Combine resistance training with a squat or use a weighted ball when doing crunches (provided this is a level you are comfortable with, it can be more advanced). Combo work engages more muscles, increases your heart rate, burns more calories and saves time.

Go heavy
Once a week try lifting a weight that you don’t normally lift, and try three to five repetitions. Studies show that this is a good way to build muscle and give your metabolism a boost. As in any exercise use common sense.

And the band plays on
Using resistance bands with weights (dumbbells for instance) will make your muscles work nearly 25% harder.

Take a break
Give your muscles 24 to 48 hours off between strength-training (resistance work) to recover. If you are doing any kind of power exercises such as jumps ( plyometric) than rest at least 72 hours so your muscles have a chance to rebuild the fibers that were used, that’s when you see improvements.








Exercises

Lie aside: Lie on your left side, head in your left hand, with legs about 45 degrees in front of you, knees bent. Keeping your feet together with hips stacked, raise top leg about 10 inches; lower it without touching the bottom knee. Do 15 to 20 repetitions then repeat on the opposite side.

Keep your body guessing: Increase your upper and lower body strength twice as much over 12 weeks. If you lift three days a week, do 2 sets of 10 to 12 repetitions with lighter weights on the first day, 3 sets of 8 to 10 reps (with more resistance weight) on the second, and 4 sets of 4 to 6 repetition with your heaviest weight on the third.

Try to get off the ground: Twice a week do 3 sets of 10 jump squats (knees over the ankle NOT the toes when landing). Stand with your feet shoulder width apart, arms bent at the elbow and hands clasped in front of your chest. Lower to a squat until your thighs are parallel to the floor. Jump up, pushing off the balls of your feet. Land with you knees soft (slightly bent), lower into a squat again, and repeat.

Get on a ball or Bosu: Get into a push-up position with your hands about 12 inches apart on top of a stability ball or Bosu, extend your legs behind you. If you are having trouble balancing, place the ball only against a wall. Lower your chest toward the equipment, and then press up. Do 2 sets of as many repetitions as possible, 3 times a week.

And the band plays on: Hold the end of a tube and weight in each hand and stand in the middle of the tube as you move the tube with your hands up and down for bicep curls, shoulder presses and rows. Depending upon your strength and experience, different bands are easier to use than others. (Green is easier than red).


Keep in mind not all exercise tips will apply to your particular situation. These tips are for the more active adults and not for those who are non-ambulatory. Be sure to be warmed up prior to starting and give yourself time to cool down and stretch. Many exercises require supervision to avoid injury especially if you are de-conditioned or new to exercise. In some cases you would need to consult with your physician first.