How To Do Kegel Exercises
Kegels are all the rage these days.
Well, maybe not. But they should be. We exercise every other muscle of our body, but no matter how much we workout, the only way to strengthen our pelvic floor is with kegel exercises (aka a pelvic floor muscle contraction). The pelvic floor deserves to get more love and attention. I mean really, these muscles are responsible for the most important things in life – peeing, pooping, and sexual function. Seriously! Give your pelvic floor the love that it deserves.
Welcome to Kegel 101 - Your introduction to performing the perfect kegel exercise and training your pelvic floor the same way you would train any other muscle in your body.
But first, a huge disclaimer that kegels are not for everybody. If you are having pelvic pain, pain with sex, or even low back or hip pain that won’t budge, it might be that your pelvic floor is holding too much tension. If that is the case, your focus might not be to start kegels right away. I encourage anybody experiencing any of the above to pay a visit to a pelvic floor physical therapist who can tell you the state of your pelvic floor and which treatment route would be best for you, whether or not that includes kegels.
But, we will continue on. Let’s do an exercise that will get you out of your head and into your pelvis.
Step 1 is awareness >> Step 2 is activation >> Step 3 is practice
1. Take 5 deep breaths // Lie down on your back with your knees bent and feet planted on the ground. Place both hands lightly on your low belly, right at the top of your hip bones. Take a few deep breaths in through your nose and out through your mouth. Taking these deep breaths in and out will warm up the diaphragm, one of your most important core muscles.
2. Create awareness in your pelvic floor // Imagine your pelvic floor muscles sitting at the bottom of your pelvis - a hammock running from your pubic bone to your tailbone. Imagine this deep breath filling up the body all the way down into your pelvic floor. On each inhale, the muscles slightly stretch and lengthen. On each exhale, these muscles lightly spring back up to their resting position. Release any tension that is present in these muscles. You might notice that you were tensing and holding these muscles without realizing it.
3. Learn how to activate these muscles // On your exhale, think about one of the following cues to contract your pelvic floor:
Squeeze the muscles that stop the flow of urine.
Squeeze the muscles that prevent you from passing gas.
Tighten the muscles around the vagina and imagine pulling it up and into the body.
Imagine lifting a blueberry with the vagina.
You’re thinking about a blueberry because it is small and does not require that much force to lift - just like the pelvic floor. They are small muscles and you do not need to be doing a crazy hard contraction to turn them on. Try NOT to squeeze your glutes or hold your breath with this exercise.
4. Practice // Once you have found these muscles and feel that squeeze and lift, practice 10 times, squeezing the muscles for 5-10 seconds. Relax completely (about 5-10 seconds) between each squeeze. Do NOT skip the relaxation. The relaxation is super important so that you can let the pelvic floor come back down to it’s resting position. You wouldn’t do a biceps curl and only lower to 90 degrees if you were trying to train the biceps through their full range of motion.
Sets & Reps
The recommendation above of 1 set, 10 reps, holding 5-10 seconds, is a general starting point. This prescription will vary from person to person based on your symptoms. This guideline is similar to finding a workout program online - it’s a starting point. If you feel like it is not effective, you’re not getting stronger, and you’re not noticing improvement in your symptoms, then you need personal adjustments made.
Frequency
If your muscles are weak, you’ll want to do this at least 3 times a day. Specifically, if you are postpartum, have any form of incontinence or prolapse.
If your muscles are stronger, begin your pelvic floor strengthening at 1 time per day.
Remember, you want QUALITY over quantity.
Duration
Most research studies recommend a strict program of 12-20 weeks to build up your strength, progressing from low load positions to dynamic pelvic floor strengthening. After you have achieved your strength goal and are able to do what you want to do symptom-free, you will enter a maintenance program doing your exercises a couple times a week.
Spicing It Up
You will not be doing kegel exercises lying on your back forever. The goal is to transition from supine on your back, to sitting, to standing, to squatting, lunging, jumping, walking, everything. Your pelvic floor muscles work in coordination with the rest of your body - but you have to start somewhere.
Once you have mastered these in supine, there are many, many ways to spice it up. You can do kegels whenever and wherever and however you want. I give my clients a specific plan to load the pelvic floor based on the goal that they are training for: running a marathon, going back to yoga, jumping around with their kids, you name it.
What If I’m Not Improving?
If your symptoms are not improving OR they are worsening, seek professional help. There are probably other things going on with those muscles that need to be addressed whether those muscles are holding too much tension or not coordinating well with the rest of your body.
I hope this guide helps you to create more awareness of your pelvic floor as you begin to strengthen. To be completely honest, pelvic floor muscle contractions aren’t always as easy as 1-2-3. It can take a bit of practice to activate the right muscles, especially in the presence of injury or postpartum. Give yourself a few sessions to get used to it. As always, is best to see a pelvic health PT who can assess your contraction and help you find ways to activate and load your own muscles in a way that is unique to you.
- Mar