History of Kegels
Invented by American gynecologist Arnold Kegel in the 1940s as a nonsurgical treatment for incontinence, the exercise has become a first-line treatment for urinary stress incontinence; vaginal, bladder, or uterine prolapse (sagging); and other pelvic health concerns. Additionally, Kegels can also be used to prevent these issues, which is why many healthy women, especially in mid-life and later are encouraged by their doctors and other health professionals to perform them regularly.
Why Kegel Exercises Are Important
Kegel exercises target the pelvic floor, which is a set of muscles in the pelvic region running from the tailbone to the pubic bone like a hammock. The primary muscle of the pelvic floor is the pubococcygeus (PC), which runs along and around the openings of the urethra, vagina, and rectum. This layer of muscles supports the organs in the pelvis, which include the uterus, bladder, and bowel. These muscles span the base of the pelvis to keep your organs in place and strengthen the bladder and rectal sphincters, which give us conscious control over the bladder and rectum and the release of urine, feces, and flatulence. A strong pelvic floor can help prevent and/or treat the following:
Leaking a few drops of urine while coughing, exercising, laughing, or sneezing (stress urinary incontinence)Strong, sudden urges to urinate (urgency urinary incontinence)HemorrhoidsUnexpected stool leakage (fecal incontinence)Pelvic organ prolapse
Exercising your pelvic floor muscles also helps to tone the muscles of the vagina, which can enhance sexual health and enjoyment. In fact, research has shown a strong link between weakened pelvic floor muscles and sexual dysfunction.
Pregnancy and Pelvic Floor Muscles
Pregnancy and childbirth can put a lot of strain on the pelvic floor muscles, particularly due to the weight of the pregnant belly, changes in posture and body alignment, and all the stretching and compacting that happens in a pregnant person’s pelvic and abdominal regions while growing a baby. The birth itself can also cause damage to these muscles, resulting in common pelvic floor disorders. Vaginal childbirth, particularly subsequent births, can significantly weaken the muscles of the pelvic floor, as can a cesarean section. Research overwhelmingly demonstrates a relationship between pregnancy and diminished pelvic floor strength. Other factors, like trauma, abdominal surgery, repeated straining from constipation, aging, and being overweight or obese can also weaken the pelvic floor muscles. Even if you don’t have clinically diagnosed pelvic floor dysfunction, Kegel exercises can help reverse, improve, or prevent a variety of pelvic health symptoms that commonly arise during or after pregnancy, including:
Constipation or pain with bowel movements Feeling like you aren’t “done” during a bowel movement Leakage of stool Lower back pain Painful urination Pain with intercourse Postpartum incontinence (stress urinary incontinence, urgency urinary incontinence, mixed incontinence)
Your doctor may want you to wait until you’ve recovered from childbirth before starting treatment to see if any of the symptoms have changed, or if they are a sign of another condition unrelated to your pregnancy.
How to Practice Kegel Exercises
Luckily, Kegels are a relatively simple and effective exercise that most people can do to dramatically improve their pelvic floor muscle tone. Kegels are essentially repetitive squeezes of the pelvic floor muscles. You don’t need any special equipment to perform these exercises, and they can be done anywhere. All you do is locate the right muscles, tighten, hold, release, rest, and repeat. Sometimes this is easier said than done. It can be a bit tricky to get the hang of where the muscles are and what exactly to do. However, rest assured that once you do, the actual exercises are straightforward—even easy. The key is to isolate the correct muscles to focus on and learn how to perform them correctly.
Identifying the Right Muscles
In order to find the correct muscles, there are some things you can try:
Imagine that you are sitting on a marble. Now, pretend you are trying to pick up the marble with your vagina, “sucking” it into your vagina. Insert a clean finger into your vagina. Squeeze your muscles as if you were holding in urine. If you feel a tightening around your finger, you’ve got the right muscles. Stop urinating mid-stream, and hold. These are the muscles you will use during Kegels. If needed, squeeze and hold a few times to tap into how to isolate these muscles. However, don’t make a habit of doing your Kegels while you urinate, as doing so increases the risk of urinary tract infections (UTIs). Use weighted vaginal cones (which are shaped like a rounder, smaller computer mouse) that you insert like a tampon and squeeze. These can be helpful tools to show you which muscles to use and keep you on track while doing your Kegels.
If you’re having difficulty isolating your pelvic floor muscles, ask your doctor or gynecologist for guidance. They may refer you to a physical therapist who specializes in pelvic health and can teach you proper Kegel techniques. Some doctors also use biofeedback with Kegel exercises in order to monitor pelvic floor activity.
Performing Kegel Exercises
Proper technique is vital but once you get the hang of doing Kegel exercises, you can do them in any position and in any place. Here are four comfortable positions to begin with:
Kneeling on all foursLying downSittingStanding
Ideally, you should do all four positions each day for maximum strength. One way to think about doing Kegels is to squeeze and lift from the vaginal opening up toward the cervix. Some describe this tightening motion as like riding an elevator up as far as it will go. Then, as you let the muscles relax, take the elevator all the way back down. Other variations of Kegel exercises include:
Fast, tight holds or a series of longer, progressively stronger squeezesCustomized holds that target specific concerns, such as leaking when exercising, coughing, laughing, or yellingIncorporating different letters or words or simulating coughs while performing Kegels
Mistakes to Avoid
Relaxing the pelvic floor muscles between Kegels is just as crucial to improvement as the squeezing motions, so it’s vital not to skimp on this part. Think of it this way. When doing Kegels you are getting those muscles strong enough to, for instance, clamp down on command to prevent accidents. However, if you are always clamping down, your muscles will have a hard time clenching further in times of need. Another way to imagine this is that if you always keep your hand in a fist, it becomes difficult to grasp on to something when needed. Additionally, to avoid using the wrong muscles when doing your Kegels, try not to squeeze or tighten any of the adjacent muscles, such as those in your stomach, buttocks, or legs. Doing so can interfere with the action of the pelvic muscles. Also, it can put pressure on your bladder if you’re tightening the muscles around the pelvic floor instead of the actual pelvic floor muscles.
A Word From Verywell
Like any workout regimen, it takes some time to see a significant muscle strength improvement from doing Kegels. Many people start to notice a change in their bladder strength (with fewer “accidents” and longer times between trips to the bathroom) within three to six weeks of regularly doing these exercises, but results vary a great deal from person to person. These exercises are commonly recommended as the initial line of treatment but if Kegels alone don’t resolve your symptoms, then other treatments, such as physical therapy or surgery, may be suggested. However, this relatively simple exercise can make a big difference for most people, and once you get the hang of it, Kegels tend to be easy to fit into your everyday life.
