My Doctor Online The Permanente Medical Group
Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Rebecca Margulies, MD
Urogynecology
Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.
Quick Links
- Dr. Margulies' Recommended Pelvic Health Web Resources
- Curriculum Vitae
- Take the Floor
- National Association for Continence
General References
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Pelvic Floor Muscle Exercises
The pelvis is the bone that surrounds the pelvic organs, such as the bladder, uterus, and rectum. The pelvic floor muscles stretch over the bottom of the pelvis between your legs (the pelvic floor). The pelvic floor muscles support your uterus, vagina, and bladder. This muscle group also wraps around the urethra (the tube where urine comes out of the bladder), the vagina, and the anus. Squeezing the pelvic floor muscles prevents your body from leaking urine or stool and also supports the walls of the vagina.
Pelvic floor muscles can become weak or injured through pregnancy or childbirth, from being overweight, or just due to genetics. Exercising the pelvic floor muscles can strengthen them and reduce symptoms of associated conditions, such as incontinence, prolapse, or an overactive bladder.
Identify the pelvic floor muscles
Use one of the following methods to first find your pelvic floor muscles:
- Pretend you are trying not to pass gas. The muscles you squeeze to keep from passing gas are the pelvic floor muscles.
- Gently pull a tampon out of your vagina and try to stop it. The muscles that hold the tampon in place are the pelvic floor muscles.
- Try to stop urinating when you’re on the toilet. The muscles you squeeze to prevent urination are the pelvic floor muscles. After you have performed this exercise once and determined how to squeeze the muscles, be sure not to do this again on the toilet or it may become more difficult to empty your bladder.
- You can also place a finger inside your vagina and squeeze. The muscles that respond to your squeeze are the pelvic floor muscles.
Isolate and contract the pelvic floor muscles
The next step is to squeeze (contract) only the pelvic floor muscles. Keep the stomach muscles relaxed. Try not to move your leg or buttocks while you’re contracting the pelvic floor muscles. Be sure to keep breathing normally and do not hold your breath.
Performing the exercises
Follow these steps to properly perform one set of the pelvic floor muscle exercises:
- Squeeze the pelvic floor muscles and hold for 3 seconds.
- Relax the muscles for 3 seconds.
- Repeat 10 times.
You should perform one set (squeezing 10 times) of these exercises 3 times each day. To begin with, we recommend that you perform 3 sets of pelvic floor muscle exercises 3 to 4 times per week. Eventually, you can work up to doing the full set of these exercises daily.
It helps to perform these exercises in different positions. For instance, complete one set while you are standing, one set while sitting, and one set while lying down.
Once you get comfortable with how to properly perform these exercises and build up some muscle strength, try holding the squeeze for 6 to 8 seconds, with a 6 to 8 second rest in between contractions.
Because no one can tell when you are doing these exercises, you can perform them at almost any time during your day.
Doing 3 sets of Kegel exercises each day is like going to the gym – this gives you better control over your muscles and makes them stronger. You still need to use them properly. To prevent urine leakage, be sure to squeeze your muscles when you cough, sneeze, or laugh in order to squeeze the urethra closed. Also, squeeze these muscles when you feel a sudden strong urge to urinate in order to hold back the urine.
Improvement
You may notice improvement in pelvic floor muscle strength within 2 to 3 weeks. You will probably notice such improvement after performing these exercises 3 times a day for 6 to 8 weeks.
Once you are able to easily contract these muscles, you should have fewer instances of accidental bladder or rectal leakage. If you stop doing these exercises, your pelvic floor muscles may weaken and lead to renewed urine and stool control problems.
If you do not see improvement within 6 to 8 weeks, or if you have difficulty performing these exercises, be sure to call us.
Additional References:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.