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Are You Doing Your Kegels...Incorrectly?

Tighten Up

In 1948 Dr Kegel recommended an exercise of the pelvic floor muscles for women who were having bladder incontinence following childbirth. These exercises, often called “Kegels” are now recommended for women with many types of incontinence and for men as well, especially after prostate surgery. The muscles are like a hammock from pubic bone to tailbone that hold the pelvic organs in place.  

Why Should I Do Them? There are many factors that affect the pelvic floor's strength: pregnancy, childbirth, surgery, the amount of weight the upper body exerts on the muscles.

  1. Kegel exercises will help you give birth more easily and with less likelihood of tearing and episiotomy.
  2. Stronger muscles help prevent prolapse of your pelvic organs, which is a painful condition sometimes requiring invasive surgery.
  3. Strengthening your pelvic floor will reduce urinary incontinence in general or when sneezing or coughing.
  4. An added bonus and benefit from stronger muscles is better orgasms. Male partners appreciate the increase in their partner’s pleasure as well as the stronger sensations that their partner’s vagina exerts around their penis.

They are relatively simple exercises; however they are not always done, or done correctly, which can be counterproductive and even harmful.

How do I find them? The next time you are using the toilet, stop the flow of urine midstream. If you are able to stop or reduce the flow, you have found them. Alternatively if you put your fingers inside your vagina and feel it when you squeeze, you have also found them. When you are ready for your workout, empty your bladder first. It is recommended that you then practice squeezing for 5-10 seconds followed by relaxing for the same amount of time.  Try ten repetitions at a time, a few times a day to begin. If that is too hard, start with shorter and fewer contractions.

Common Mistakes:

Squeezing the wrong muscles: Over one third of women start by squeezing their butt, abdominal and/or thigh muscles, especially if their pelvic floor is weak. Place your hand on those areas while you do your squeezes and even look at your body in the mirror. If you notice those muscles contracting at the same time, you are doing them incorrectly. Focus on moving just the pelvic floor muscles. Start slowly with a few short contractions and gradually build up your strength and endurance. It is much more effective to isolate the correct muscles and do just a little to start than to try to be a heavyweight at the beginning but using the incorrect muscles and techniques. It is not a race!

Doing the wrong thing with the right muscles: If you push out and down rather than up and inwards,  you may actually make matters worse. Imagine instead that you are picking up a blueberry with your vaginal lips and that your vagina is like an elevator, bringing the blueberry to higher floors. That is the movement that you should be doing.

Stopping the flow every time: Once you have isolated the correct muscles, don’t stop your urine flow as regular exercise. You can actually weaken your muscles this way and empty your bladder incompletely, which can increase the risk of a urinary tract infection.

Contracting Without Relaxing: You don’t do any exercise routine by only contracting without relaxation. Make sure that you also relax for the same amount of time as your contraction. And if you already have a tight pelvic floor which can even be painful, then these exercises may not be recommended, or you can modify them; do a short contraction followed by  more emphasis on the relaxation part of the exercise.

Holding Your Breath: Find a rhythm, squeezing during the out-breath and relaxing during the in-breath or vice versa. Make sure that you are  breathing out completely and fully relaxing your chest.

What if it’s not working? If you're having trouble doing Kegel exercises or not feeling like you are making progress, ask your doctor, a registered pelvic-floor physiotherapist or other health care provider to help you learn to isolate and exercise the correct muscles. If you are feeling discomfort or pain in your abdomen or back, this is an indication that you may be doing them incorrectly.  

Varied exercises: Try them in different positions and while you are doing different activities. Start with sitting or lying down. Spread your knees apart to make it harder to just squeeze the pelvic muscles.  Progress to standing, squats, doing a lunge (legs spread, one in front of the other) or a bridge (lying on your back, raising your butt off the floor), the plank (elbows and toes on the ground, body hovering), the clam (on your side, legs bent and knees apart), standing on one leg. Try fluttering: squeeze for 1 second, contract for one second and repeat. Do it while at the gym, in the pool, on the tennis court. Squeeze to the rhythm of your turn signals or your favourite tune. You can purchase a “ Kegel Ball”, a small round toy that contains a smaller inner ball that moves, giving a gentle sensation.  It is placed  inside your vagina to remind you by its movements to squeeze several times a day.  The more ways that you can practice your exercises, the stronger your muscles will be.

And have sex! Try different positions and types of play.  Sex of any kind is one of the best activities for the pelvic floor. And it may be one of the most fun ways to exercise too!