Kegels: Essential Exercises for Mamas on Bed Rest

February 16th, 2010

Most women have heard of Kegels and at one time or another have  been advised to perform Kegel exercises. But in my experience as a woman’s health professional, I find that many women have no idea what muscles are involved in Kegel exercises and as a result have no idea how to perform one properly.  So I offer here a short review.

Kegels are essential exercises for all women, but especially for pregnant women on prescribed bed rest. Mamas on bed rest, with their prolonged inactivity and growing uteri are at increased risk of weakened pelvic floor muscles which will be further stretched and potentially weakened if they vaginally deliver their babies. The results can be urinary incontinence (involuntary loss of urine with coughing, laughing, sneezing), organ prolapse (bladder, uterine or rectal prolapse (bulging or protrusion of the bladder, uterus or rectum through their respective openings to the outside), or decreased sexual sensation due to the lax musculature. But I don’t want to get ahead of myself here. Let me start with the basics and work forward.

Dr. Arnold Kegel developed “Kegel” exercises to help women strengthen the pelvic floor muscles following pregnancy. Dr. Kegel noted that women frequently became incontinent following pregnancy and found that if they could strengthen the pubococcygeus “PC” muscle (the muscle that is suspended along the pelvic floor like a hammock and holding all of the pelvic organs in place), they could often improve or reverse urinary incontinence as well as bladder, uterine or rectal prolapse. He started teaching his patients how to contract the PC muscle and Kegels were born

So how is a Kegel done? First, you have to be sure that you are working the proper muscles. If you are squeezing and releasing your buttocks, you are probably not working your pelvic floor muscles-at least not effectively. You can be sure you are working the pelvic floor muscles:

  • By stopping the flow of urine while urinating. While this is a good way to get to know the pelvic floor muscles and what they feel like when contracted, do not stop the flow of urine ROUTINELY as a way to strengthen the pelvic floor muscles. This practice will actually weaken the muscles and cause or worsen urinary incontinence.
  • You can look at your perineum and watch as you contract the muscles. If you are performing the exercises correctly, you will see the anus “wink” the perineum move up and down and the clitoris “nod” (thanks to Desiree Andrews of Prepforbirth.com for these great visuals!). This is a great way to see and learn which muscles are working. You can place a mirror on the floor and squat over it to see the muscles or hold a mirror between your legs. However, if you’re pregnant, it may be hard to hold the mirror between your legs and see and this is really hard of you are on bed rest. But for non-pregnant women, this is a good way to start learning how to Kegel.
  • You can feel for muscle contractions by placing a finger or two into your vagina and then contracting the pelvic floor muscles around your fingers. Again, once you know which muscles to contract, you can effectively perform Kegels.
  • There are devices that one can use to help stimulate the PC muscles. Physical therapists often use such devices when teaching clients how to do Kegels. Additionally, one can buy such devices and learn to Kegel using the devices.

Now once you get the basic muscle contractions down, you can then move on to some “advanced” Kegeling.

Squeeze, Hold, Release : This is just as it states. Squeeze your PC muscle, hold for a few seconds and release.

Elevators: This is an increasing contraction and likened to making floor stops while on an elevator. You begin by lightly contracting your pelvic PC muscle. After about 2-4 seconds, increase the contraction further pulling up the PC muscle. Hold for another 2-4  seconds and then tighten the contraction again. Hold for 2-4 seconds and then release. A variation is to gradually release the contractions holding for 2-4 seconds as the “elevator goes down.”

Quick Bursts: These are just what they say, quick contractions. You quickly contract the PC muscle, say 10 times. Rest for a brief moment and then repeat the series. This should be done several times over the course of about 5 minutes.

Some people recommend that women “Kegel” approximately 20o times a day-performing a variety of contractions. If you Kegel regularly, say 3-4 times a day performing 10 or more Kegels at a time, you will strengthen the PC muscle. But as the saying goes, the more you work a muscle, the stronger it becomes. So if you want to keep your PC muscle strong and have a strong pelvic floor, Kegel often, several times a day and in various situations so that you not only develop pelvic floor muscle strength, but also muscle control which can help prevent incontinence and enhance sexual pleasure.

Note: First image courtesy of Mayo foundation for Medial Education and Rsearch

Second image courtesy of www.menstruation.com.au

9 Ways a Mama on Bed Rest can Say “I Love You!” this V-Day

February 11th, 2010

Let’s face it, bed rest is a killer to your love life. All month I have been offering ways for you and your partner to “Keep the Love Alive”. Now here we are, just a few days from Valentine’s Day,  and you may be thinking, “Shoot, I’m stuck here on bed rest. How can I make this day special?”

Well, I’m glad that you asked. Sitting over breakfast I too was thinking of how to make this a special day for my own “hunny bunny”. As per usual, I am running late for the train, so I was thinking of things that I could order for quick delivery. So here are 9 ideas that I came up with over my breakfast taco and chai tea. If you use one for your “hunny” send a comment and let me know how it turned out!!

9 Valentine Ideas for Mamas on Bedrest to share with their partners

  1. Send flowers. Yeah, kinda screams “I forgot” but at least you remembered in time to order something.
  2. Edible Arrangement. The company that bears the name will deliver a beautiful arrangement composed of fruit. If you choose certain arrangements, you can have chocolate dipped fruit (strawberries, bananas, etc…) or hunks of chocolate on skewers added to the arrangements. www.ediblearrangements.com
  3. Luv’s Brownies. I add this one because it belongs to a friend out in my beloved San Jose, CA. Aundrea Lacey is the owner and founder of Luv’s brownies (www.luvsbrownies.com) and has taken brownies to another level. You can order brownie cakes, brownies in coffee mugs, she’s written a book…If it’s brownies your love likes, they will love Luv’s Brownies.
  4. Candy. Believe it or not, candy (namely chocolate) is still an all time favorite for Valentine’s Day. No longer is it just Lammes or Russell Stover’s. If you go to Candygram.com, you can order a wide range of candy items and have them shipped directly to your honey. Won’t that be a nice little “pick me up” to their day at the office??
  5. Massage. Okay, this is if you want to spend a little change. Now if you’re feeling the love, you’ll arrange to have a local massage therapist come out to your home and give your honey a relaxing massage. But if you’re like me, no one is allowed to be massaged in my home without me! Solution, order a couple’s massage. It’s really great. 2 massage therapists arrive at your home, will bring their tables and you and your honey can be massaged at the same time. If that’s too pricey, you can still have the massage therapist do you both in tandem. In any event, it’s sure to please!!
  6. Pajamagram. My husband ordered me one of these a couple of years ago, I think for my birthday and I got a real kick out of it. Pajamagram.com has a whole catalogue of pajamas that you can order and they will ship them in the cutest boxes, sometimes with cute little accessories and all. Wouldn’t your honey look cute in a pair of boxers??? You may not be able to “touch” but hey, a little eye candy never hurt anyone!
  7. Personal Chef Services. There’s nothing like a really good home cooked meal. Now that you are on bed rest, you can’t give your honey that special “luvin’ from the oven!” But a personal chef can do that and more. After a consultation (and this can be done over the phone!) the chef will go grocery shopping, arrive at your home with their own cutlery and cookware, cook a sumptuous dinner and prepare it for service. Many personal chefs will also bring table cloths, china, flatware, candles….Check in the catering sections of your local listing to see if there are personal chefs in your area and see what types of services they offer.  Bon Appetit!
  8. Portrait Photography. If this is your first baby, this will be the last time you and your partner will be a “duo” for many years to come. Why not capture the moment? There are many photographers that specialize in  pregnancy photography, of if you prefer, you can do something a bit more formal of you and your partner. If your children are anything like mine, they’ll enjoy looking at such photos of themselves in “mama’s tummy.”
  9. Write love letters to one another. With all of the hoopla surrounding your pregnancy and ensuing bed rest, it’s easy to forget that it was love that brought you to this very moment in time.  Take a moment to remember those things that made you fall in love with your partner; a smile, a laugh, special times spent together. Write them all down in a keepsake letter. Choose beautiful paper and perhaps a spritz of your favorite perfume or oil. It’s guaranteed to be something they’ll cherish.

Image courtesy of PublicDomainPictures.net

Words of Wisdom from Mamas on Bed Rest

February 10th, 2010

I was working in my own little funk the other day when I decided to take a break. I went over to the online message boards that I frequent to see how the mamas on bed rest are doing, how they are supporting one another and to learn any new information or tips.

One post in particular really touched my heart. A mama-to-be had finally gotten pregnant after 2 years of trying. Now it seems that her cervix is shortening and is a centimeter shorter than where it should be for this point in her pregnancy (second trimester about 22 or 24 weeks). She was asking anyone who read her post to please pray for her health and for the health of her baby,  for her cervix to stop shrinking, for preterm labor not to occur and for her baby to be born healthy. She was starting bed rest.

Bed rest sucks! No doubt about it. But I am constantly amazed and humbled at how mamas on bed rest stay focused, stay positive and stay supportive of one another. I am honored that I get to work with and support such incredible women. The beauty that I have seen is that women on bed rest, after the initial shock and anxiety, really pull it together and make it through. At the same time they support one another, encourage one another and are invaluable resources for one another – all while on bed rest!

After reading through the responses to her post, I compiled this list of tips mamas on bed rest recommend to help keep your spirits up and to help you to press forward when your situation is scary and out of control. Strangely enough, this list can be applied to any situation that is difficult, not just being on bed rest, and I find myself drawing strength from their words.  Here are words of wisdom from mamas on bed rest how about how to survive and beat bed rest.

  • It’s okay to be sad. All the mamas agreed that their initial response to their bed rest prescription was anxiety and sadness. They were all very concerned about the health of their babies and sad that there was little else that they could do to make the situation better. They acknowledged the sadness but quickly moved on.
  • Steel your resolve. As one mama put it, “I just told myself, whatever I have to do to get this baby here I will do!” All of these mamas fully intend to bring home healthy babies and have set their minds to do so. As so many psychologists and coaches say, “the mind directs the body. ” These kids are well on their way.
  • Perk up. The mamas all recommended that you surround yourself with positive things while you are on bed rest. Make sure your “living space” is cheerful and that you have all you need handy. As much as possible engage in activities that keep your spirits up. Invite people to come and visit you. Watch movies and do crafts with your children. If it makes you happy and content, do it.
  • Get Support. Along the same lines, mamas on bed rest recommend that you get support. Get help with the household duties, your children and your pets.  Arrange to get those things that must be done done and forget the rest!
  • It’s not over ’til it’s over! One mama said, (and I’m paraphrasing) “I am going to do all that I can to hold my baby in my arms. I’m not giving up, no way! As long as I am here and my baby is inside me, I’m going to keep going. It’s not over ’til it’s over!” We all know that sometimes things don’t turn out well for mamas on bed rest and babies don’t make it. But I really liked this mamas attitude. She wasn’t going to give in to negativity and she wasn’t going to give up until she had a clear reason to so. Now that’s strength.

These mamas on bed rest showed me that situations are what they are,  but we don’t have to let them rule us. You can become very sad and give in to the fear or you can acknowledge that the situation is tough and then do all that you can to press on towards your goal. If mind over matter can be applied to mamas on bed rest, we’re going to be welcoming many babies in the very near future.

(Photo courtesy of PregnancyToday.com)

Post a comment on how to stay positive while on bed rest.