I know how to do these but I try to do these intermittenly throughout the day when I can remember. I read that we should keep our kegels and abs tight while performing our aerobic exercise. Can you please expand on this?
I do know how to do kegels in general. You simply contract the pelvic muscles like you are stopping the flow of urine. A good way to practice using those muscles is starting and stopping urine flow. In my last lamaze class (baby is 11 months old) we practiced elevator movements: slow contractions, gradually lifting the pelvice floor as well as trying to hold a single contraction for 20 seconds or so. Sorry but I do not understand how you would do this while exercising. Perhaps while doing abs? on the upward motion? I am sure Shelia will explain better than I.
Sorry for the long time that it took me to post an answer to your questions. I hope my lengthy answer will make up for the long time that you had to wait to get it. What you were asking could not be answered in two sentences!
The pelvic floor is found at the base of the abdominal/pelvic cavity. It is also referred to as the Kegel muscle named for Dr. Arnold Kegel, an OB/GYN professor at UCLA that did most of the early research on the pelvic floor. This muscular “hammock” is suspended from the pubic bone in the front to the coccyx in the back. There are three openings in the central seam of the pelvic floor – the urethra, the vagina and the anus. The muscles form a “figure eight” around these openings.
The functions of the pelvic floor can be summarized as follows:
·To provide support for the pelvic organs and their contents (i.e. uterus, bowel and bladder) against gravity
·To withstand increases in pressure that can occur in the abdomen and pelvis. These pressures may be intermittent such as during sneezing, laughing, coughing, nose blowing, and pushing during labor. The growing uterus during pregnancy provides long-standing pressure on the pelvic floor.
·To aid in elimination by providing sphincter (valve) control of the bladder and bowel
·To aid in the getting the baby’s head out during delivery. The deep nerve endings in the pelvic floor play a role in the “pushing” stage of labor.
Ideally, the pelvic floor is firm and supportive. Pregnancy and childbirth are the major causes of pelvic floor laxity. The softening hormones of pregnancy and the weight of the growing baby, placenta, amniotic fluid, etc. place an increased workload on the pelvic floor. Normally firm and taught like a trampoline, it can sag like an overloaded shelf during pregnancy. The extreme stretching and possible episiotomy during a vaginal delivery traumatizes the pelvic floor even more, further compromising its supportive role.
Pregnant women will be at a much greater advantage if they do pelvic floor exercises during their pregnancies than if they do not. There will be better support for the uterus and other pelvic organs. An exercised pelvic floor also releases easier during birth because mom is more aware of the muscle and the muscle itself is more supple. Doing kegel exercises during pregnancy will increase the size, diameter and power of each muscle fiber of the pelvic floor as this muscle responds to the demands placed upon it.
Unfortunately, many women are totally unaware of the pelvic floor’s existence until they attend childbirth classes. It is important to teach women as early as possible in their pregnancies the benefits of strengthening the pelvic floor which include:
·Prevention of stress incontinence (i.e. leaking urine) when coughing, sneezing, laughing, jogging, doing jumping jacks, etc.
·Making the muscle more supple allowing for a smoother progression of the baby’s head down the birth canal during delivery and a faster return to its original length postpartum.
·Increased circulation to the pelvic floor possibly decreasing the incidence of hemorrhoids and/or improved healing of the perineum from an episiotomy repair. Also, improved circulation increases the chance that the pelvic floor will be elastic enough to stretch over the baby’s head with minimal damage. More muscle fibers will survive because the most of the nerve connections and blood circulation will remain intact.
·Prevention of future GYN problems (urinary incontinence, painful intercourse, etc.) or surgeries to correct a prolapsed (sagging) uterus or bladder.
·Decreased discomfort from pelvic exams.
The kegel exercise is one of the most important, if not the most important exercise for pregnant women. If no other exercise is done during pregnancy, this one should be done. This exercise should be part of every prenatal program.
The kegel exercise should be initiated as soon as possible during pregnancy. Unfortunately, many pregnancy books and childbirth education classes teach women to “kegel” by stopping and starting the flow of urine. This method should be avoided due to the hormonal effects of pregnancy on the ureters (tubes leading from the kidneys to the bladder), kidneys and bladder. Stopping the flow of urine to practice “kegeling” could set mom up for a urinary tract infection by causing urine to flow backwards into the ureters and kidneys.
The following is a direct quote from one of our handouts for our pregnant clients in "Healthy Moms."
“To locate your kegel muscles, lie on your left side making sure that you are as comfortable as possible. Imagine that you have to urinate very badly and there is no bathroom around! Tighten the muscles that you would use to “hold” your urine (urethral muscles) and gently draw them in and up. Release and repeat the gentle squeeze. While “kegeling,” your ultimate goal is to hold each pelvic floor contraction for ten seconds, and then release. Make sure that your buttocks, abdominals and inner thigh muscles are relaxed while doing this exercise.”
“You must develop an awareness of how it feels to contract and release these muscles in order to aid in your pregnancy comfort, ease of delivery and recovery afterward. The pelvic floor muscles must also be relaxed for delivery to proceed smoothly. Muscles that are tight and clenched can slow down delivery. This fact underscores the importance of learning how to relax these muscles as well as how to contract them.
There are many variations of the kegel exercise. We have discovered in our classes and personal training sessions that returning to the most basic kegel exercise has worked the best for our clients.
The goal of this exercise is to be able to hold ten kegel contractions for ten seconds each. In the beginning, you may only be able to only hold each contraction for one or two seconds. We start new clients with ten contractions holding each one for 2-3 seconds. You should release your kegels slowly and completely after each contraction to increase your body awareness of what it is like to “let your kegels go” as they will have to do when you are pushing your baby out. The position of choice is standing with the feet hip width apart. This position makes the exercise more “functional” in that standing is the position in which you spend a majority of your time during the day.
Kegels should be done daily. Since they are an invisible exercise they can be performed almost anytime and anywhere – waiting at a red light, while brushing teeth, talking on the phone, etc. Elizabeth Noble, the author of “Essential Exercises for the Childbearing Year,” says that women should kegel at least 50 times a day for life.
Now for the question of how you are supposed to keep your kegels tight while doing your aerobics…..
As mentioned above, the weight of the baby and all the abdominal organs place a great stress on the pelvic floor during pregnancy. Adding more force (i.e. weight-bearing exercise like aerobics, fast walking) places additional stress on an already compromised pelvic floor and will further weaken it. So how do we counteract the combined downward forces of the baby, abdominal organs and weight bearing exercise? We do this by always exercising with the pelvic floor slightly contracted. For example, pretend that you have to urinate. Contract the muscles that allow you to hold your urine and keep you from going in your panties. This is how you must exercise. Just as you hold your abdominals in when you exercise (yes you can still contract your abdominals when you are pregnant), you must also constantly hold a slight pelvic floor contraction as well. In our program we call this “working from the center.” It may be hard at first – kind of like scratching your head and rubbing your abdomen at the same time. It will pay off in the end though. You won’t be one of those women buying “Depends” so that she can dance with her husband when she is 50!
Hi Sheila! I agree with you on the need for Kegals, especially since they weren't taught even in medical classes when I was a nursing student...in the "olden" days! But having had 4 very closely spaced children wo benifit of the kegals I am keenly aware of the lack!! I'm not at the "Depends" stage but would be interested in knowing if there are other kegals that would be helpful to "mature" but wimpy pelvic muscles...I've also seen "aids" to kegals advertised, such as graduated weights to hold in the vagina. Any thoughts? And thanks for your very clear responses to all the questions...It's great for women who are already aware of their wonderful bodies, respectful of them and interested in being strong and healthy to have this forum to address the very special concerns in the area of pregnancy and childbirth!! If you don't feel this has been an appropriate question for this forum, please feel free to decline answering. Thanks Annie
I would suggest that you start with the basic "Contract-Hold-Release" exercise that I put in the above post. Your goal should be to hold 10 kegel contractions a total of 10 seconds each. In the beginning you may be only able to hold each contraction for 2, 3 or 4 seconds. This is actually resistance training for the pelvic floor as you add more seconds as you progress which increases the load on the pelvic floor. From personal experience.......... I would try this basic exercise before I invested in the "kegel weights." Hopefully, you will be pleasantly surprised at your progress.
Here are two more exercises for the pelvic floor.
1. THE “ELEVATOR” EXERCISE: Do this exercise after you are familiar with the basic “kegel” exercise. This exercise should be done with an empty bladder. Try to visualize your vaginal opening as the doors of an elevator and your pelvic floor the elevator itself. You will start on the “ground floor” (pelvic floor totally relaxed as if you were urinating) and lift the “elevator”from floor to floor by slowly tightening the muscles inside the vagina. Then you will reverse the process by slowly relaxing the same muscles. Start the exercise by releasing the muscles to the “ground floor” (pelvic floor totally relaxed) and lift them slowly to the “first floor.” Hold it there for a count to four. Lift to the “second floor” and hold it there for a count of four. Lift to the “third floor (the highest) and hold for a count of four. Descend slowly the same way that you went up (ie. holding for four counts at each floor). At the “ground floor” your pelvic floor should be totally relaxed.
2. THE “HAMMOCK” EXERCISE: Visualize your pelvic floor as a sling of muscles (ie. a hammock) attached to your pubic bone in front and your coccyx in back. Starting at the front of the hammock, slowly contract from front to back. When you reach the back, the entire muscular sling should be tight. Try to release the muscles from front to back. This could take some practice!
Hopefully, these exercises will get you back on track. Please let me know if you notice a difference after doing them for awhile.