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The Honolulu Advertiser
Posted on: Thursday, August 3, 2006

Kegels can help treat urinary incontinence

By Laurie Steelsmith

Q. Ever since my child was born, I've suffered from urinary incontinence. Is there anything I can do?

A. Yes, and it can be summed up in one word: Kegels! Pronounced to rhyme with "bagels," Kegels are exercises that strengthen the muscles that support your lower pelvis, or "pelvic floor." By firming and toning these muscles, you can help treat or prevent urinary incontinence (the involuntary release of urine).

Urinary incontinence affects more than 16 million women in the United States. The most common type of urinary incontinence that women experience, stress incontinence, often develops after childbirth. To allow for a baby's passage, the muscles of the pelvic floor are stretched dramatically, and sometimes remain overly stretched and can become weak, resulting in stress incontinence. If you have this condition, involuntary urine leakage can occur whenever there's increased pressure in your abdomen — for example, when you cough or sneeze. Doing Kegels regularly can eliminate stress incontinence by toning and strengthening the muscles that support your urethra and bladder.

To do Kegels, you have to become aware of the muscles that support your pelvic floor. The muscles you strengthen with Kegels are the ones you use if you stop the flow of urine while you are urinating. (You don't want to make a practice of this, but doing so once or twice can help you become accustomed to the sensation of contracting these muscles.) Once you learn to control these muscles, you will be able to do Kegels.

There are two types of Kegels: slow and fast. It's best to combine them, with an emphasis on the slow. Slow Kegels build the slow-twitch fibers in your pelvic floor muscles; this promotes strength and endurance, and helps develop muscle tone when your pelvic floor muscles are at rest. Fast Kegels, which strengthen the fast-twitch fibers, are important for preventing leakage of urine when you cough or sneeze.

In a typical Kegel routine, you hold a fast Kegel for two seconds, relax for two seconds, and repeat this 10 times; then you hold a slow Kegel for 10 seconds, relax for 10 seconds, and again repeat 10 times. This routine can be done three times a day, or whenever it's convenient. You can do Kegels at any time, and practically anywhere — while you're sitting at stop lights, standing in line at the bank or grocery store, cooking dinner, on hold on the phone, waiting for a computer file to open or sitting on a plane.

Laurie Steelsmith is a naturopathic physician and licensed acupuncturist in Honolulu, as well as author of "Natural Choices for Women's Health" (Random House). Reach her at www.drsteelsmith.com. This column is for information only. Consult your health provider for medical advice.