Strengthening Rectal Muscles: Simple And Effective Strategies For Improvement

how to improve rectal muscles

Bowel control problems are surprisingly common, affecting 36% of adults in the United States, and simple exercises may help improve bowel control and quality of life. The anal sphincter, a band of muscles that surrounds the entrance of the anus, is responsible for holding stool inside the body until a bowel movement occurs. These muscles can be strengthened through exercises such as Kegel or pelvic floor muscle exercises, which can be performed in various positions and at any time during the day. These exercises involve contracting and releasing the anal sphincter muscle, and one can do up to 10 repetitions, 3 times a day.

How to improve rectal muscles

Characteristics Values
Exercise type Kegel, or pelvic floor muscle exercises
Muscle group Sphincters
Muscle function Control bowel continence
Number of sets 8 to 10 sets per day
Number of repetitions 10 repetitions
Time per repetition Hold for a count of 10, relax for a count of 10
Position Sitting, standing, or lying down
Guidance Healthcare professional, continence physiotherapist, or specialist continence nurse
Additional therapies Biofeedback, electrical stimulation (sacral nerve stimulation)

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Anal sphincter exercises

The back passage or anus is encircled by two rings of muscle: the internal sphincter, which remains closed until it's time to empty the bowels, and the external sphincter, which can be consciously contracted to hold in stool or wind. While the internal sphincter cannot be controlled through exercise, the external sphincter can be strengthened and thickened through targeted exercises.

To locate the external sphincter muscle, imagine you're trying to prevent passing gas or holding in a bowel movement. This action of contracting the anal sphincter muscle is at the core of anal sphincter exercises. These exercises can be performed in various positions, including sitting, standing, or lying down, with your legs slightly apart.

Here's a step-by-step guide to performing anal sphincter exercises:

  • Assume a comfortable position—sitting, standing, or lying down—with your legs slightly apart.
  • Squeeze the anal sphincter muscle as hard as you can, pretending to hold in a bowel movement or prevent passing wind.
  • Hold the squeeze for as long as you can, aiming for up to 10 seconds.
  • Relax and release the muscle, taking a moment to rest.
  • Repeat the cycle of squeezing and relaxing up to 10 times.
  • Aim to perform these exercises 3 times a day. Start with fewer repetitions if needed and gradually increase as you build strength and comfort.

It is recommended to seek guidance from a healthcare professional, such as a continence physiotherapist or specialist nurse, who can help tailor these exercises to your specific needs and track your progress.

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Kegel exercises

For women, you can insert a finger into your vagina and squeeze the muscles around it. You should feel the muscles lift and tighten. For men, insert a finger into the rectum and squeeze the muscles. You can also try to imagine that you are trying to prevent yourself from passing gas or having a bowel movement. These are the muscles you will be working during Kegel exercises.

To perform Kegels, lift and hold, then relax your pelvic floor muscles. Start with a few Kegels at a time, then gradually increase the number of repetitions and the length of time you hold for. Aim for up to 10 repetitions, 3 times a day. You can also try holding the squeeze for up to 10 seconds, relaxing in between each squeeze.

It is important to breathe deeply and relax your body when performing these exercises. Make sure you are not tightening your stomach, thigh, buttock, or chest muscles. If you are unsure if you are doing Kegel exercises correctly, contact your healthcare provider for guidance.

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Pelvic floor muscle exercises

To perform pelvic floor muscle exercises, it is important to first identify the correct muscles. One way to do this is by pretending that you have to urinate and then trying to hold it. You can also try inserting a finger into your rectum and tightening the muscles as if you are trying to hold in your urine or prevent yourself from passing gas. These are the pelvic floor muscles.

Once you have identified the muscles, you can perform the exercises in various positions, such as sitting, standing, or lying down. A basic exercise involves tightening the pelvic floor muscles and holding for a count of 10, then relaxing the muscles completely for a count of 10. Repeat this for 10 repetitions, 3 to 5 times a day. It is important to start slowly and increase the number of repetitions as you become more comfortable.

There are also specific types of pelvic floor muscle exercises that you can incorporate into your routine. These include quick flick Kegels, marches, heel slides, the Happy Baby Pose, and diaphragmatic breathing. For example, to perform the quick flick Kegel, lie on the floor with your knees bent and feet flat on the floor, and then quickly contract and relax your pelvic floor muscles. These exercises can help improve the strength and endurance of your pelvic floor muscles.

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Biofeedback

In the context of rectal muscles, biofeedback therapy is used to treat defecatory disorders, such as dyssynergic defecation, which is characterised by paradoxical anal contraction, inadequate anal relaxation, and/or impaired push effort caused by the incoordination of abdominal, rectal, and anal muscles. This can result in symptoms like typical constipation, as well as a sensation of incomplete evacuation. Biofeedback therapy aims to strengthen the pelvic floor muscles, retrain rectal sensation, and coordinate pelvic floor muscles during evacuation.

The equipment used in biofeedback therapy consists of a sensor to detect the patient's bodily activities, an amplifier to amplify the detected signal, and a conversion device to transform the signal into visual or auditory signals that patients use to gauge their response. This allows patients to perceive their characteristics of fecal straining in real-time and learn to remember the feeling of how to strain correctly.

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Electrical stimulation

EST can be administered non-invasively using an anal plug, or more invasively through sacral nerve stimulation and intramural stimulation. The anal plug method has been used to treat urinary incontinence since the 1970s, and the other more invasive methods are regarded as more invasive.

In one study, 159 patients underwent EST, with 147 completing all treatment sessions. Each session took 24 minutes, with 12 sessions over a 2-week cycle. An anal plug was inserted into the patient's anus, with parameters including a pulse width of 360-960 µsec, a frequency of 2-110 Hz, and an amplitude of 30-35 V. The voltage was adjusted to each patient's threshold for electrical pain. The overall response to EST was 59.2% and overall satisfaction improved significantly.

Another study looked at the effect of EST on a 25-year-old female patient with chronic constipation for 10 years. After 14 sessions of EST, her symptoms improved dramatically, and her desire and urge threshold volumes were remarkably decreased.

In addition, electrical stimulation is used in pelvic floor rehabilitation to treat fecal incontinence. It can be used in conjunction with biofeedback therapy (BFT) to improve rectal sensitivity and produce an added benefit.

Frequently asked questions

Kegel exercises, also known as pelvic floor muscle exercises, are a way to strengthen the muscles that support the rectum. These exercises can be done in any position and at any time of day.

To do Kegel exercises, squeeze your sphincter muscles as if you are trying to stop a bowel movement. Hold the squeeze for as long as you can, aiming for around 10 seconds, and then relax. Repeat this up to 10 times to complete one set, and complete 8 to 10 sets per day.

If you're doing Kegel exercises correctly, you should feel the pelvic floor muscles lifting. If you're unsure, you can insert a well-lubricated finger into your rectum to identify the correct group of muscles.

It can take a few months of regular Kegel exercises to see an improvement in rectal muscle strength. Results may be visible in as little as six to twelve weeks.

If you don't see any improvement, it's important to ensure that you're doing the exercises correctly. Consult a healthcare professional, such as a physical therapist, who can guide you through the exercises and provide specialised treatment if needed.

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