WHAT ARE KEGEL EXERCISES?

Pelvic Floor Muscle Exercises, also known as Kegels or Kegel exercises, are one of the best ways to improve and maintain bowel and bladder functions. Kegel exercises can be done by men or women, and can increase the strength of your pelvic floor and may improve or even eliminate bladder leakage.

Read more about kegel exercises for men here.

To understand why these exercises are so invaluable, a brief anatomy refresher course may help. 

How Kegel Exercises Work

There is a sling of muscles extending from the inside of the pubic bone to the anus and woven around the vagina, urethra, and rectum. This group of muscles help indirectly control the contractions of the detrusor muscle (bladder muscle) and the urethral pressures. The pelvic floor muscles relax to allow urination and tighten to stop the stream of urine. Contraction of the pelvic floor muscles closes the lower urethra, squeezing any remaining urine back up into the bladder. 

Pelvic floor muscle exercises can help restore muscle function as well as lessen the symptoms of incontinence. 

Who Should Do Kegel Exercises?

Kegel exercises are a great tool for many people. By increasing the strength of the pelvic floor, they can help relieve many symptoms, such as a bladder prolapse or bladder leakage. However, it’s important to note that kegels are not for everyone. In fact, some people may even do more harm than good by doing too many kegels.

Some pelvic floor disorders are a result of the pelvic floor being too tight. When this happens, it makes it hard for the pelvic floor to relax, and leads to the pelvic floor being in a continuous overactive state. Why is it bad for your pelvic floor to be so tight all the time? When your pelvic floor is continuously operating in an overactive state, it makes it harder to react when you actually need it to contract, not only because the muscle is already fatigued, but because there is little range for it to contract further. Therefore, clenching when you sneeze, or trying keep from having an accident when you really have to go results in leakage.

In these cases, doing kegels is NOT recommended. It’s hard to know if you have a weak pelvic floor, or an overactive pelvic floor without consulting a women’s health physical therapist, which is why it’s always recommended to see one prior to beginning any kegel exercise routine. A PT will help diagnose your problem, and can teach you how to properly do a kegel, and how to relax the pelvic floor. (Read more about the role of a pelvic floor PT and what to expect at an appointment here.)


HOW TO DO KEGEL EXERCISES - A Step By Step Guide

Like any exercise, it can be difficult at first to know that you are performing Kegels properly. But with a daily commitment, it becomes instinctive. Here are a few tips:

  • Which muscles? If you can stop your urination flow mid-stream, you have identified your pelvic floor muscles. That’s the most difficult part of the exercise.

  • Build up to your routine. Performing with an empty bladder, your first goal should be to tighten your pelvic floor muscles for 5 seconds. Then relax them for 5 seconds. Try to do 5 reps on your first day. As you gain confidence from your new routine, aim for for 10 seconds at a time, relaxing for 10 seconds between contractions.

  • Watch outs. Be careful not to flex the muscles in your abdomen, thighs, or buttocks. Also, avoid holding your breath. Breathe freely during the exercises to keep from stressing the rest of your body.

  • Repeat 3 times a day. Aim for at least 3 sets of 10 repetitions per day.

  • Give yourself encouragement. These exercises will feel foreign in the beginning. But the longer you stay with this, the better your bladder health will become. As a bonus, Kegels have been reported to increase sexual pleasure as well.

Work Both Your Fast Twitch And Slow Twitch Muscles

To give your pelvic floor a full workout, there are two types of exercises you should perform.

  • Fast Twitch Muscle Exercise - The first exercise is called a short contraction, and it works the fast twitch muscles that quickly shut off the flow of urine to prevent leakage. The muscles are quickly tightened, lifted up, and then released. You should contract as you exhale, then continue to breathe normally as you do the exercises.

  • Slow Twitch Muscle Exercise - The second exercise works on the supportive strength of the muscles and is referred to as a long contraction. The slow twitch muscles are gradually tightened, lifted up, and held for several seconds. At first, it may be difficult to hold the contraction for more than 1 or 2 seconds. Ultimately, the goal is to hold the contraction for 10 seconds then rest for 10 seconds between each long contraction to avoid taxing the muscles.

A solid exercise plan would be to perform 3 sets of 10 short and 10 long contractions twice per day. Remember: Quality is the more important than quantity. Doing a smaller number of exercises correctly will be far more effective than doing a whole bunch of them incorrectly. You should see improvements in 3 to 6 months. 

As a training aid for Kegels, you can use vaginal weights, wands, or other devices that provide resistance against muscle contractions. Some of these aids are prescribed by a health professional and used under professional supervision, while others are available without prescription.


SIGNS OF PELVIC FLOOR STRENGTH IMPROVEMENT

Don’t be discouraged if you are not able to control your bladder as soon as you would like, but rather look for these signs as proof that your pelvic floor muscle exercises are working and that you are on your way to better bladder health:

  • Longer time between bathroom visits

  • Fewer “accidents”

  • Ability to hold the contractions longer, or to do more repetitions

  • Drier underwear, without the feeling of always being wet

Women who have difficulty performing pelvic floor muscle exercises on their own may find biofeedback therapy helpful. With professional instruction from a nurse specialist or physical therapist, many women witness significant improvement in pelvic floor muscle strength.

It's crucial to remember that incontinence and pelvic floor symptoms almost always have solutions and shouldn’t be shrugged off as normal. Find time each day to squeeze it into your routine.


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