What are KEGEL exercises?

| The pubo-coccygeus muscle is located on the floor of the pelvic cavity, and extends from the pubis to the coccyx.

It is made up of three rings whose function is to keep the bladder, uterus and rectum in position, counteracting the force of gravity.

What is genital prolapse?

With age, the muscles weaken and lose strength, which can produce a fall of these organs called prolapse. In the event that only the uterus descends it is called, if the bladder descends it is called a cystocele and if the rectum descends it is called a rectocele. Pregnancies weaken the pelvic floor muscles due to the force that the pressure of the belly exerts on the pelvic floor.

Others risk factor's to have a genital prolapse (of any of the three organs) are:

• The pregnancies and especially vaginal deliveries with large fetuses.
• The realization of impact sports, with jumps and with lifting of important weights,
• The constipation, with the force that is performed against the pelvic floor,
• The hormonal changes of the, with the weakness of the tissues and the atrophy due to the lack of estrogens.
• The reason for the greater weight that these muscles must hold.
• The chronic cough, by the force exerted by abdominal pressure on the pelvic floor muscles

Urinary incontinence

In addition to genital prolapse, weakening of these muscles can produce a stress urinary incontinence. It is characterized by the involuntary loss of urine when making some effort such as coughing, sneezing, laughing, jumping, running ... The prolapse of the bladder of urine produces a change in outlet angle of urethra, the tube that carries urine from the bladder to the outside. This anatomical change hinders the correct closure of the urethra with pressure and, therefore, the involuntary exit of urine. If it is possible to improve the tone of the pelvic floor musculature, that of light effort can be corrected.

This type of incontinence must be distinguished from urination urgency that is produced by the involuntary muscle contraction from the bladder of urine without the command to do so. For this reason, the patient has a compelling sensation to urinate and sometimes cannot prevent the bladder from emptying before reaching the bathroom. This type of incontinence is not caused by a structural change in the pelvic floor and therefore the treatment is different from that of stress incontinence.

How to exercise this zone with KEGEL exercises

In the 1940s, the gynecologist Arnold Kegel described a series of exercises to prevent and solve the urinary incontinence effort after delivery. Later it was found that these exercises they improve the support of the pelvic organs and also the sexual function.

The success of these exercises depends on proper practice of technique and adherence to exercise planning. Physiotherapists are the specialists in planning a good Kegel exercise chart suitable for each patient. First of all, the woman must learn to locate and control the pelvic floor muscles well. An easy way to become aware of where these muscles are located is to try to hold back the flow of urine while urinating while sitting in the bathroom. Many patients locate it incorrectly or instead of contracting it, they push it towards the ground, worsening the pressure on the musculature.

• In order to be aware of the muscles to work and how to work them, you can use the biofeedback and electrical stimulation. Electrodes are placed on the abdomen, in the perineal area and in the vagina, in order to monitor the contraction of the muscles to work. Contractile activity is recorded on a monitor so that the patient can tell if she is really doing the exercises well. The electrical current stimulates the muscles in a way that forces them to contract repeatedly.
• Another way to work the pelvic floor muscles is with the vaginal cones. They are devices that are placed in the vagina as a tampon with a thread that is let out through the vulva to be able to extract it easily. These cones have different weights to be able to start with the one with the lowest weight and progressively increase the weight of the cone to be retained. For the insertion of the cone, some type of lubricant can be used if necessary and inserted as a tampon with the narrowest part in the upper area of ​​the vagina. The cone should be kept inside the vagina for about 15 minutes a few times a day while walking, standing, living a normal active life at home ... so the muscles must work to keep the cone there. Little by little the weight of the cone increases as the muscles increase their strength.

• With the age and pregnancies weaken the pubo-coccygeal muscles and it can cause a drooping of the bladder, uterus, or rectum, called genital prolapse, as well as urinary incontinence.
• The exercises described in 1940 by gynecologist Arnold Kegel help to prevent and solve the urinary incontinence and to improve the support of the pelvic organs.
• The physiotherapists are the specialists in planning a good table of Kegel exercises suitable for each patient.

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