There is a possibility that your muscles are too weak for manual Kegel exercises to be effective. Or you may have some nerve damage as a result of a pelvic surgery or childbirth, which can prevent you from voluntarily contracting and relaxing these muscles.
Not relaxing the muscles completely can contribute to additional problems, such as pelvic pain, spasms and poor emptying of the bladder. Also, if your incontinence is caused by an overly tight pelvic floor, you will need to learn how to relax rather than contract these muscles.
When Kegels are done properly, consistently, and in adequate volume, improvement in pelvic floor strength and symptoms of incontinence (weak bladder control) or pelvic organ prolapse should be noted around 6-8 weeks.
There are many reasons why women may have difficulty feeling their Kegel exercises including: Weak pelvic floor muscles. Overactive (too tight) pelvic floor muscles. Previous injury and damage to the pelvic floor nerves and muscles (pregnancy /childbirth/ pelvic floor surgery)
Common causes of a weakened pelvic floor include pregnancy, childbirth, prostate cancer treatment in males, obesity and the associated straining of chronic constipation. Pelvic floor exercises are designed to improve your muscle tone. In addition they improve your brain connection to these muscles.
Pelvic floor dysfunction is the inability to correctly relax and coordinate your pelvic floor muscles to have a bowel movement. Symptoms include constipation, straining to defecate, having urine or stool leakage, and experiencing a frequent need to pee.
The Exercises Still Don't Work
There is a possibility that your muscles are too weak for manual Kegel exercises to be effective. Or you may have some nerve damage as a result of a pelvic surgery or childbirth, which can prevent you from voluntarily contracting and relaxing these muscles.
If you're doing your kegel exercises correctly, you should feel your muscles tighten as you do this. As with all muscle training exercises, practice makes perfect. “Often you can squeeze the muscles for a quick second but then the muscles fatigue really fast,” explains Dr. Levin.
Pelvic pain, discomfort, or a sensation of heaviness in the lower abdomen or pelvis for six months or longer is one of the main symptoms of pelvic floor tension myalgia.
To do Kegels, imagine you are sitting on a marble and tighten your pelvic muscles as if you're lifting the marble. Try it for three seconds at a time, then relax for a count of three. Maintain your focus. For best results, focus on tightening only your pelvic floor muscles.
Doing Kegel exercises with a full bladder or while emptying your bladder can actually weaken the muscles. It can also lead to incomplete emptying of the bladder, which increases your risk of a urinary tract infection. If you're having trouble finding the right muscles, don't be embarrassed to ask your doctor for help.
At first, it may be difficult to hold the contraction for more than 1 or 2 seconds. Ultimately, the goal is to hold the contraction for 10 seconds then rest for 10 seconds between each long contraction to avoid taxing the muscles.
When you first begin to do Kegels you may find that you can't hold a contraction for more than a second or two, or you can't keep it tight because the muscles just don't have enough tone. Don't be discouraged and don't worry. This is typical. As you practice daily, your muscles will gradually develop more strength.
Although Kegel exercises themselves are simple, finding the right muscles to exercises isn't. One-third or more of women and men who do Kegels are actually working their abdominal, buttock, or inner thigh muscles.
Contract your pelvic floor muscle by imagining that you are stopping the flow of urine. You should be able to feel a squeezing and lifting sensation around your finger. If, after performing these self-exams, you were able to see and feel your muscles contracting, congratulations!
Even a very tight pelvic floor can be weak. Weak and strong refer to a muscle's ability to exert force. A shortened or tight muscle may be just as incapable as exerting force as a long or loose muscle. Being tight does not mean your pelvic floor is strong.
You should feel your finger resting on a ledge (the pelvic floor being like a bowl). In the 3:00 and later in the 9:00 position, check your ability to kegel. Can you feel your finger get lifted up and in with the contraction? That's a good sign!
Start by tightening your pelvic floor muscles for three seconds, then relaxing for three seconds. This is one Kegel. Try to repeat this 10 times. If 10 feels too hard, reduce this to five times until you get stronger.
Fast kegel exercises will strengthen the fast twitch muscle fibres, enabling your body to avoid “accidents” when dealing with sudden shocks to the system, whilst slow kegel exercises will improve the endurance of your pelvic floor.
Signs of a tight pelvic floor:
Difficulty with starting your stream with urination. Spraying urine while peeing or having a wildly unpredictable stream. Dribbling after you pee or feeling like you have to pee again right after you go. Constipation and/or very skinny poops.
After 4 to 6 weeks, most people notice some improvement. It may take as long as 3 months to see a major change. After a couple of weeks, you can also try doing a single pelvic floor contraction at times when you are likely to leak (for example, while getting out of a chair).
Tighten your pelvic floor muscles, hold the contraction for three seconds, and then relax for three seconds. Try it a few times in a row. When your muscles get stronger, try doing Kegel exercises while sitting, standing or walking. Maintain your focus.
Regular gentle exercise, such as walking can also help to strengthen your pelvic floor muscles.