We all know that Kegels or pelvic floor exercises are the exercise for urinary health, but it turns out that having a strong back and core is key too. Learn all the workout moves you need to help control urine leaks.
Your pelvic floor muscles support a lot of very important organs, like your colon and bladder, so keeping them strong is imperative to preventing—and stopping—leaks. And doing Kegel exercises, which involve contracting and releasing the pelvic floor muscles, is the best leak-ending workout around. Kegels are often compared to the squeeze you would do when trying to stop the flow of urine.
"Kegels are the dental floss of the female pelvis," says Dr. Romanzi, author of Plumbing and Renovations: A Vagina and Pelvic Floor Primer (Beauty Call Books, 2008). "They're a good starting point for anyone with a bladder problem. And there are decades of data to bear this out."
Luckily, you can really strengthen these muscles and start seeing positive results with minimal work—just 10 or so controlled contractions, three times a day.
Doing Kegels Correctly
Only about 50 percent of women can correctly identify which muscles to activate to build pelvic strength and tone.
To ensure you're contracting the right muscles, insert a finger into your vagina and squeeze as if you were trying to stop a urine flow. You should feel your finger lifted and compressed.
If you're not confident that you're working the right muscles, consider seeing your OB/GYN or a physical therapist with special training in incontinence. She can use techniques like biofeedback or electrical stimulation to help you locate the proper muscles.
Another Option: There's a Food and Drug Administration-approved over-the-counter pelvic muscle strengthener called the Myself Trainer. It identifies the muscles you need to strengthen and guides you through a five-minute exercise session, providing resistance and telling you when to contract and relax. It also displays the strength of your contractions on a small monitor. ($150; the myselftrainer.com; 800.383.2588)
Try this Kegel exercise routine recommended by the American Urogynecologic Society (AUS):
- Lie down with your knees bent. (As you get used to the movement, you can do this while sitting and standing.)
- In a slow, sustained way, gradually pull in and hold a pelvic muscle-squeeze for three seconds, then relax for three seconds. Repeat 10 times, three times a day to work your "slow-twitch" muscle fibers, which maintain general muscle support. After each set, add 10 quick squeezes. This works the "fast-twitch" muscle fibers that come into play when you experience sudden increases in pelvic pressure.
- Increase your contraction hold by one second each week until you are contracting for a 10-second squeeze.
- Rest and breathe between contractions.
Start Using Weights
Strength-training is not just for sculpted arms: If you're having difficulty isolating the correct muscles for Kegels, inserting a cone-shaped vaginal weight can help. The weight requires you to contract the proper pelvic floor muscles in order to keep the weight in place. (Vaginal weights are available without a prescription at drugstores or online at stores like vagacare.com, $56, or aquaflexvaginalweights.com, $90.)
Work your Abs and Back
Your back and abdominal strength, posture and gait all play a role in how well your pelvic muscles work. "We're finding more and more research that shows our pelvic and core muscles work together as a group," Sebastian says. "Your abs and adductors—hip muscles—attach directly to the pubic bone. And muscle fibers in the hip feed into the pelvic floor. They all help each other activate.” Failure to strengthen these muscles as a group may help explain why some women seem to do plenty of Kegels but don't always get results.
Take Vivian Tisevich, 58, of Canton, OH: She had tried pelvic floor exercises, as well as biofeedback, medication and even surgery to combat her overactive bladder, with little success. But when a back injury sent her to physical therapy, "the exercises I was given to tighten my core and my transverse abdominal muscles really helped me with my Kegels. This is what's keeping me dry," she says.
What's important is engaging the crucial core muscles, which strengthens your abs, back and hips at the same time. "Once you learn to activate these muscles together, you can incorporate this into your regular gym program or exercise activities—walking, running or biking," Sebastian explains.
She advises the following simple regimen: Start with two sets of Kegels. If you like, use a pillow to elevate your hips to avoid working against gravity as your pull your pelvic floor muscles up and in. Then, do these three exercises:
Pelvic Floor Exercise 1: Inner-thigh squeeze
While lying on your back with your knees bent, very lightly squeeze a ball or pillow between your knees to work your adductors. Inhale, and as you exhale, draw your pelvic floor up and in while keeping your tailbone on the floor. You may feel the pelvic floor contract more strongly in this position. Hold this muscle contraction for 10 counts while breathing normally. Relax completely. Repeat 10 times.
Pelvic Floor Exercise 2: Ab pull
To work your deep ab muscles (transverse abdominals), inhale, and on your exhale pull your pelvic floor up and in while squeezing a ball or pillow between your knees. Then flatten your lower abs, keeping your tailbone on the floor. Hold this contraction for a count of 10. Relax completely. Repeat 10 times.
Pelvic Floor Exercise 3: Hip flexors
Inhale, and as you exhale, pull your pelvic floor up and in, while flattening your lower abs. Hold this contraction and breathe normally. Lift your hips up to create a "bridge," then slowly open and close your knees 10 times. Lower your hips and relax completely. Repeat two to three times for a total of 20 to 30 hip rotations.