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Kegel exercises - what they are and why they work

Arnold Kegel (1894 – 1981) identified the link between the diagnosis of urinary incontinence and prolapse, specifically following childbirth, and weakness, damage or atrophy in a muscle that we now refer to as The Pelvic Floor Muscle or Pubococcygeus (PC). Most crucially, he established that, with the correct exercise, this muscle could be restored to a healthy, well-toned state and the symptoms of incontinence and prolapse could be relieved.

The basis of Kegel Exercises

Arnold Kegel first introduced a simple, effective clinically proven treatment for weak pelvic floor muscles in 1948 but his work was largely ignored. The first recorded use of the phrase ‘Kegel Exercises’ is in 1975 (Merriam-Webster online dictionary), nearly 30 years after his principles were first documented in the medical literature.

The basic principles identified by Arnold Kegel were fundamental to the success he achieved but the exercises that now bear his name, as promoted by health professionals and the media, bear no relationship to the rigorous techniques he originally identified. As a result, millions of women suffer the long term consequences.

Kegel's Principles

•    Muscle training and learning with the development of the neural pathway from brain to pelvic floor

•    Feedback to confirm to the user that the correct muscles are being engaged

•    An intense programme of daily resistive exercise

•    Progressive resistance so that the user can measure and monitor improvement over time and increase the resistive force in line with their improving strength

The Clinical Evidence

Kegel’s 1948 paper reported results on thousands of women and the objective and measurable improvements were impressive. He noted that in patients who exercised correctly and diligently, the following progressive changes would occur:
•    greater awareness of the pubococcygeus muscle and its function

•    significantly improved muscle strength

•    muscular contractions could be felt in areas of the vaginal walls where none could be demonstrated before

•    development of the pubococcygeus so that weak and irregular contractions became strong and sustained.

•    improvement in tone and texture of all muscle tissues of the pelvic floor

•    an increased in muscle bulk of the pubococcygeus

•    the vaginal canal became tighter and longer.

•    previously flaccid vaginal walls improved in tone and firmness.

•    bulging of the anterior vaginal wall (often diagnosed as ‘moderate cystocele’) becomes less pronounced.

•    prolapse of the uterus, when present, was usually improved and in some instances the cervix ascended from being adjacent to the vaginal opening to as high as 5 to 7 cm. above the opening.

All this could be achieved with the basic principles of effective training, visual feedback, resistive exercise and intense repetition over time.

The cure for Stress Incontinence

It was a major factor that improvement could be achieved very quickly and this, no doubt, increased motivation and compliance. In the case of stress incontinence Kegel reported:

“As some degree of awareness of function is initially present, the response to muscle education is prompt. Symptoms usually show improvement within two weeks after starting resistive exercises using the Perineometer. Lasting relief, however, depends on firm establishment of muscle reflexes and strengthening of muscular structures.”

The role of the PelvicToner

The PelvicToner is specifically designed to meet all of the principles that Arnold Kegel said were necessary for effective exercise:

•   The PelvicToner helps you confidently identify the correct muscle to squeeze and it provides a constant and clear feedback that you are squeezing the correct muscles throughout your exercise.

•   When you are exercising with the PelvicToner you are squeezing against a mild resistance to make the exercise as effective as possible.

•   Because the PelvicToner is a 'progressive resistance vaginal exerciser' it means that you can easily increase the resistance as your strength improves to make your exercises even more effective

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