Kegel exercises are simple exercises that involve tightening the muscles of your pelvic floor. Doing Kegels regularly can help prevent incontinence, improve circulation to your pelvic area, and strengthen the muscle tone of your pelvic floor. Start slow with Kegel exercises, then build up to more repetitions a few times a day as your muscles get stronger. If you’re experiencing incontinence or pelvic floor pain, ask your healthcare provider for a referral to a physical therapist that specializes in women’s health – they can help you determine what pelvic floor treatments and exercises are best for you.
IN THIS ARTICLE
- What are Kegels?
- How to do Kegel exercises
- Different types of Kegel exercises to try
- How often should I do Kegel exercises?
- How long should I continue to do Kegel exercises for?
What are Kegels?
Kegels are exercises you can do to strengthen your pelvic floor muscles – the muscles that support your urethra, bladder, uterus, and rectum.
The exercises are named after Arnold Kegel, the gynecologist who first recommended them in the 1940s to help women with urinary incontinence, or diminished bladder control, a problem that affects up to two-thirds of women during pregnancy or after. (Kegel exercises may even reduce the risk of postpartum bowel incontinence, too.)
Kegel exercises are also safe and beneficial to practice while you’re pregnant: They may help keep hemorrhoids at bay and possibly speed healing after an episiotomy or perineal tear during childbirth because they improve circulation to your rectal and vaginal area.
Continuing to do Kegel exercises regularly after giving birth not only helps you maintain bladder control, it also improves the muscle tone of your vagina, making sex after birth more enjoyable.
How to do Kegel exercises
Whether you’re pregnant, postpartum, or neither, Kegel exercises are done the same way:
Start with an empty bladder. If you’ve never done a Kegel before, lie on your back with your knees bent, then pretend that you’re trying to stop yourself from passing gas and interrupt the flow of urine at the same time. Or, imagine that you’re sitting on a marble and trying to pull it up into your vagina – it’s a sensation of squeezing and lifting. (Don’t try doing Kegels while you’re actually urinating, however.)
If you’re not sure you’ve got it, you can check by inserting a clean finger into your vagina and then doing a Kegel. If you feel pressure around your finger, you’re on the right track. Or try a Kegel while you’re having sex or enjoying pleasure. Ask your partner if they can feel the contraction with their finger or penis. If you’re doing it correctly, your partner will notice.
Make sure you’re squeezing and lifting without pulling in your tummy, squeezing your legs together, tightening your buttocks, or holding your breath – only your pelvic floor muscles should be working. You may have trouble isolating them at first, but it gets easier with practice. It might help to place a hand on your belly while doing Kegels to make sure it stays relaxed.
If you’re just starting to do Kegels, begin with “quick flicks,” which involve contracting your pelvic floor muscles in a quick squeeze, then relaxing. Do ten repetitions of those, working up to 20 repetitions are your muscles get stronger. A second type of Kegel exercises focuses on slowly increasing your pelvic floor contractions for ten seconds, then slowly relaxing your muscles for another ten seconds. Build up to ten or more repetitions of these as you gain strength.
If you’re suffering from urinary stress incontinence, do a Kegel when you sneeze, cough, or lift something heavy. You may find that it keeps you from leaking.
If you’re still not sure if you’re doing Kegel exercises correctly, talk to your healthcare provider. They can check to see if you’re isolating the right muscles during your next physical exam.
Let your provider know if you feel like you’re experiencing pelvic floor dysfunction stemming from pregnancy or childbirth. They can refer you to a pelvic floor therapist or a physical therapist who specializes in women’s health, who can asses what’s going on and recommend the right course of exercises and treatments for your body. Some providers and therapists have treatments for pelvic floor dysfunction that can effectively help with pelvic floor weakness.
Different types of Kegel exercises to try
The muscles of your pelvic floor can become weakened due to trauma or disuse, but they can also become overworked or tense, just like any other muscle. For that reason, while it’s important to exercise these muscles to tone and strengthen them (such as by practicing traditional Kegels), it’s equally important to learn how to relax or stretch them to avoid pain or tension.
Below, you’ll find a few different types of Kegels that can help you strengthen or relax these muscles. They’re all provided by Whitney Rogers P.T., D.P.T., O.C.S., who serves as an advisor and consultant to Every Mother. If you’re unsure whether to begin with strengthening or lengthening, reach out to a pelvic floor physical therapist for guidance. Every Mother also offers a free online assessment that can help you get started with therapeutic exercises customized to your individual needs.
Endurance Kegels
The pelvic floor works to support the pelvic organs and help stabilize the spine during movement. So not only is it important for these muscles to have strength, but also endurance – and long-hold Kegels can help you practice both.
First, something to keep in mind: How long you should hold Kegels for is up for debate. It’s common to work on holding up to 10 seconds, but there is little data to support any specific length of hold. The most important thing is to start with the length you can confidently hold a strong pelvic floor contraction and then make a goal to add about 1 second more.Instructions:
- Lie on your back and fully relax your belly and pelvic floor. Take a deep breath in and allow your abdomen to expand. As you exhale, purse your lips like you’re blowing through a straw, making the exhale slow and steady.
- When you think you’ve exhaled most of the air, try exhaling more, and contract your pelvic floor muscles like you are trying to hold back gas. You’ll feel a tightening around your pelvic floor, and you should also feel a lift in your perineum, as if you’re lifting a blueberry with your vagina.
- Inhale and fully relax again, then take a few rest breaths to make sure you’re resetting your muscles. Once you have full awareness and control, start the pelvic floor muscle contraction at the beginning of your exhale and count out loud (this is to make sure you aren’t holding your breath!). Figure out the longest hold you can do with an equal amount of strength through the contraction, then challenge yourself to try to hold one second longer.
Practice this for 10 repetitions and perform two to three sets. You can do this one to three times per day while working on building up to 10 seconds.
Quick Flick Kegels
Among women with pelvic floor muscle weakness, a common complaint is experiencing urinary leakage or pelvic pressure when coughing, sneezing, or lifting. In these moments, we want the pelvic floor muscles to contract strongly and briefly – then quickly relax.
Think about this like jumping: When you jump, you need forceful leg contractions repeatedly. In order to help prepare your pelvic floor muscles for these moments, practice “quick flick” Kegels.
Instructions:
- To start, strongly contract your pelvic floor, then relax fully.
- Complete the next contraction once your pelvic floor is completely relaxed. The goal is to improve the speed of your contraction and relaxation so you can perform 10 contractions in about 15 seconds. In the beginning, it’s common for this to be slower, so start where you feel comfortable and work on speed as you gain control.
Perform two to three sets of 10 quick flicks one to three times per day while you work on mastering control. It’s also important to practice these fast contractions when you actually need them, so practice prior to a cough or sneeze, or before lifting something, for example.
Reverse Kegels (pelvic floor relaxation)
Many people forget that the pelvic floor needs to contract and relax. Practicing full pelvic floor muscle relaxation, or a reverse Kegel, may be even more important than strengthening exercises for some people.
The best way to learn pelvic floor relaxation is through diaphragmatic breathing, or deep belly breathing. When you perform a deep inhale and allow your diaphragm to descend and your abdomen expand, you should also feel a lengthening or expansion in your pelvic floor.
Instructions:
- Lie on your back. Place your hands on your belly or lower side ribs. As you inhale, feel your belly rising and your low ribs expanding out to the side like an umbrella. As you exhale, feel them return to their resting position (the exhale should be passive).
- Keep your attention on your pelvic floor, and as you inhale, see if you can feel the breath descending down into your pelvis. You may feel an expansion in the area between your sit bones, or into your tailbone.
You can also try reverse Kegels in a deep squat or child’s pose if that’s more comfortable. Practice them for 1 to 2 minutes at a time.
How often should I do Kegel exercises?
Start by doing a few Kegels at a time throughout the day. As your muscles start to feel stronger, gradually increase both the number of Kegels you do and the length of time you hold each contraction, up to ten seconds. Try to work up to two sets of ten about three times a day. More than that isn’t a good idea – overdoing it may lead to straining when you use the bathroom.
Make Kegels part of your daily routine. Once you’ve got the hang of it, it’s easy to incorporate Kegels without having to lie down. For example, you could do a few when you wake up in the morning, more while you’re watching TV, and then one last round before you go to bed. But as long as you do them regularly, it really doesn’t matter when or where you do them.
Be patient and keep at it. It may take four to six weeks of doing Kegels regularly before you notice an improvement in bladder control.
How long should I continue to do Kegel exercises for?
Don’t stop doing Kegels! Continuing the exercise maintains strength and wards off incontinence as you age, so it’s a good idea to make Kegels a lifelong habit.
Working to keep your pelvic floor muscles strong may also guard against pelvic organ prolapse, a common condition among older and some postpartum women. In pelvic organ prolapse, weakening pelvic muscles and ligaments can make the uterus, bladder, and rectal tissue sag and protrude into the vagina. This may cause incontinence as well as a sense of pelvic heaviness, lower back pain, and discomfort during sex.
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