Kegel Exercises: What You Should Know

Posted on Updated on 18 December, 2018

Kegel exercise, also known as pelvic muscle exercise and pelvic floor exercise, is a specific workout involving repetitive contraction and relaxation of the pelvic muscles. The pelvic muscles are often informally called Kegel muscles for this correlation. Kegel exercises were developed for a precise purpose of strengthening the pelvic floor muscles and they should be performed a few times every day for a brief span of time. These exercises usually take a month to more than two months to have the expected effects. Kegel exercises have several benefits and they are as effective for women as they are for men. Women have an additional health benefit of such exercises as they can tighten the vagina and effectively counter vaginal relaxation.

History of Kegel Exercises

Kegel exercises were initially developed and described to prevent and manage urinary stress incontinence. Older men suffer from varying degrees of incontinence. Urinary stress incontinence is not the same condition as it is usually more common in women after childbirth. Kegel exercises can not only reduce the severity of urinary stress incontinence but also reduce chances of premature ejaculation in males and vaginal relaxation in females.

Dr. Arnold Kegel, an American gynecologist, described these exercises quite thoroughly in 1948. Dr. Kegel was an OB/GYN specialist who wanted to find a potential remedy for urinary incontinence his patients were suffering from. He developed these exercises to help the pelvic muscles to heal after the natural process of childbirth. The exercises were also found to be effective at strengthening the pelvic floor and by that virtue provide stronger support to the various organs that rely on the pelvic floor, its position, contract and relaxation. While Kegel exercises are quite popular today, they were not deemed to be as effective in the initial days. These exercises did not capture the imagination or interest of public until much after the death of Dr. Kegel in 1981.

It should be noted that Dr. Kegel did not really invent these exercises. Different versions of the same exercises have been practiced across civilizations for many centuries. Yoga has many postures and specific contractions of muscles followed by relaxing them targeting the pelvic floor. Many modern workouts also involve the contraction and relaxation of pelvic muscles and these predate Dr. Kegel. Owing to the nature of the workout and the degree of control needed, Kegels are referred to as resistive exercise. You have to deliberately regulate the movement of a muscle and exert greater control as you get habituated. The scientific foundation of Kegel exercises is simple and the same that applies to all other muscle workouts. Muscles tend to get stronger as they are put to better and more frequent use. Muscles develop when they are contracted and relaxed more often than not. This is why all exercises have repetitions. Even yoga has repetitions in regards to the time and how you go for the same charts of postures every few days or daily.

Anatomy of the Pelvic Floor

Pelvic floor or muscles is basically the pelvic diaphragm. It has muscle fibers, coccygeus muscle and connective tissue. The diaphragm is under the pelvis. The entire pelvic diaphragm serves as the muscular partition. It has two major parts, levatores ani and coccygei. The diaphragm is responsible to keep the pelvic cavity separated from the perineum or perineal region. The left and right levator ani are horizontal and have gap between them to transmit urethra, anal canal and vagina. The structure has three parts, namely pubococcygeus, iliococcygeus and puborectalis. The most significant part is the pubococcygeus which can get damaged while birthing. Fibers from this part extend to the urethra, vagina and prostrate. The coccygeus is also muscular and it extends from ischial spine to the coccyx and sacrum.

Pelvic diaphragm, floor or muscle supports multiple organs including the intestines, the bladder, the uterus in women and plays a role in continence. The pelvic floor is used during the birthing process to facilitate the descent and rotation of the fetus. The diaphragm also maintains the ideal intra-abdominal pressure. Changes in strength, form or position of the pelvic floor can lead to anterior vaginal wall prolapse, cystocele, urethrocele, cystourethrocele, posterior vaginal wall prolapse, enterocele, rectocele, apical vaginal prolapse, vaginal vault prolapse, uterine prolapse and dysfunction of the diaphragm. Most of these conditions involve shifting of organs and them colliding or moving into and pushing other organs. There can be severe complications if the pelvic floor does not function at all, albeit it is a rare condition.

Most women and many men have a weak pelvic floor. Men may have weak pelvic muscles due to obesity, lack of exercise, sedentary lifestyle and other physiological conditions. Women can have weak pelvic muscles for the same reasons but also due to childbirth. Women who have given birth to more than two kids are particularly vulnerable. Ageing or old women will have weaker pelvic muscles than younger women unless they are extremely fit and maintain a healthy lifestyle. Vaginal relaxation is not always caused by a weak pelvic floor but it is one of the most common factors. This is why Kegel exercises are often the default option for women who have a loosened or looser vagina.

Women who have a weak pelvic floor or if the diaphragm is failing to function at its optimal best, there can be quite a few complications including some organs protruding into and at times outside the vagina. Pelvic organ prolapse is a serious condition and urinary incontinence is one of the earliest symptoms. Pregnancy, ageing, hormonal problems and family history influence the chances of pelvic organ prolapse.  If the posterior pelvic muscle is weak or suffers some misalignment, then one is vulnerable to rectal prolapse, perineal hernia, rectocele and anismus among other disorders. Constipation or functional constipation is a common condition in people suffering from any of these disorders.

Pelvic floor exercise or Kegel exercise can strengthen and improve the function and tone of the muscles. Women suffering from stress urinary incontinence are recommended to do Kegel exercises every day. Women who have a relaxed and hence loose vagina should also do Kegel exercises at least twice daily. It should be noted that Kegel exercises cannot remedy any severe condition or disorder of the pelvic organs. Such serious conditions require extensive medical diagnoses and other treatments. The exercises can only improve the strength of the muscles, help one exert better control and regulate the floor and keep the organs in their right places without being stressed. As a result, the pelvic organs also function more normally.

How to do Kegel Exercises

Kegels are clenching exercises. They help the pelvic floor grow thicker and broader. You have to basically tighten your core and abdominal muscles so you can exert greater control and regulate the movement of the pelvic floor as you choose to. Women who have given birth to several kids and those who are older than forty will often have a lowered pelvic floor. This leads to a shift in the positions of the various organs. You have to get the pelvic floor to retake its original place and be strong enough to hold all the organs in their natural places without stressing or pressuring any of them.

  • First, you should decide how many times you want to do Kegel exercises. If you are unsure, then you can start with two sessions and these can be in the morning and evening or noon and night. One session will be futile as you cannot prolong the exercises for several minutes. Kegel exercises should be done for five minutes or so in every session. The longest you can work out is ten minutes. The reps actually matter more than the time and there is no proven harmful effect of such exercises. However, you should not do Kegel for half an hour. It is needless. The best results are obtained when you go for at least three sessions every day and continue it for a minimum period of six weeks.
  • You must be able to work your pelvic muscles and for that you must first find them. You have to feel the pelvic floor. The easiest way to feel the pelvic floor is trying to urinate but not actually urinating. The pelvic floor is put into action if you stop urinating midway. You will clearly feel the muscles close to the vagina. Not everyone can feel their bladder unless it is fully loaded. Since you are unlikely to work out with a full bladder, it is best to feel the pelvic floor by trying to exert some pressure down the abdomen to an extent of the vagina and anus. Both men and women can use their fingers to feel the bladder. Move a little upward and you will find the pelvic floor. Women can feel the vaginal muscles and then gradually move up to find the pelvic muscles.
  • Empty your bladder and excrete before you perform Kegel exercises. You cannot have a full bladder or a loaded rectum when you have to exert pressure and control your pelvic floor. It is also common to pass gas during such a workout. To begin your Kegel exercises, you can lay down or sit after emptying your bladder and rectum. Exert some strength to tighten the pelvic floor. You will feel the muscles contract and you must hold them in that position for at least ten seconds. It may be difficult initially so you can aim for five seconds. Gradually you can aim for eight seconds and then ten seconds. You can also count to five, eight or ten. Let the muscles relax and let them be for the same period of time. So if you are contracting the muscles for eight seconds, the relaxation should also last eight seconds. You must repeat this for ten times. This is the least. The total duration of the exercise should not exceed five minutes if you are contracting for ten seconds and then relaxing for ten seconds. You may take a few seconds break between these reps during the first week.
  • The ten reps should be repeated at least twice a day. You can go for three sets at three different times. Four times a day is not really necessary. Many women find it easier to do the Kegel exercises when they get their breathing right. You can breathe in before or just as you contract the pelvic muscles. You can hold the breath as the muscles remain contracted for up to ten seconds or longer and then you can exhale as you let the muscles to relax. When the muscles are relaxed, you can breathe in and out normally. You may have your own preferred breathing pattern but this rhythm works for most women and also men.

Common Mistakes during Kegel Exercises

Millions of women have benefited and there are many who have not experienced any positive impact of Kegel exercises. Any exercise is designed for a particular purpose and it will work only when the method is right. Doing it in a wrong way will not have much benefit. Many women and also men tend to exert pressure and regulate the wrong muscle. It is very easy to confuse other muscles in the core, abdomen and even hips. These are not to be worked or regulated when you do Kegel exercises.

You must contract and relax the pelvic floor. You should not tighten your chest muscles. You must not exert any pressure on your stomach or even belly. Your buttock should be rested normally. Your thighs should not be rigid or clenched. No muscle but the pelvic floor should be worked on during these exercises or reps. You can keep doing this exercise for weeks and experience no changes to vaginal tightness or firmness if you are actually working on any other muscle than the pelvic floor.

Some women may try to perform Kegel exercises at wrong times, such as after eating a heavy meal or just after waking up when the bladder is full. Those who have constipation or do not get rid of all the waste in the rectum should try to find a remedy. Those who have a gas problem should not try to hold back anything during the exercises. It is always wise to just continue the exercise after passing gas, urinating or excreting.

Working on the pelvic floor when it is already tasked to support the organs when the bladder or rectum is full, when there is substantial food being processed in the large intestine or colon and other situations when you are not at your lightest has serious side effects. You can actually weaken your pelvic floor if you work on it during urinating or before when the bladder is full. It is also possible to cause damage to kidneys and bladder if you choose to feel the pelvic floor and work on it instead of urinating.

Women should not exert too much force on the pelvic floor during any of the reps. Clenching the muscle excessively or to an unnatural extent is not going to make it stronger any faster. Also, there is only so much strength the muscle can muster. It is not one of the larger or bulkier muscles in the body that are expected to bear scores of pounds of weight. The pelvic floor is only designed and purposed to support the organs, most of which weigh much less or a fraction of the kinds of weights other muscles have to bear.

Women who have hernia, those who have undergone surgeries, if there are stitches in the abdominal area, if there is any kind of pain in the abdomen or even in the belly and other abnormal symptoms, even if it is subtle discomfort, should not continue doing Kegel exercises without consulting a doctor. It is not always necessary to consult a gynecologist. Consulting a physician may also help. As long as there is nothing wrong in the abdominal region already other than weakened muscles, Kegel exercises are safe and healthy.

Tips to Get the Best Results with Kegel Exercises

Always perform Kegel exercises when you are lighter, that is a few hours after having a heavy meal or before you have breakfast, lunch or dinner. You will be able to feel the muscles more conveniently and assuredly when there isn’t enough food in your stomach or intestines. You should also relieve yourself before every workout session.

Wear comfortable clothes. You may be comfortable in tights so that is fine. Whatever helps you to feel the pelvic floor muscles easily and effectively works as long as it does not exert unnecessary pressure. You can increase the reps but it is pointless to go for twenty or more at a time. Your pelvic muscle does not need to be worked on a hundred times in a day. If done right, ten times in each session and having three such workouts a day should be sufficient. Kegel exercises are not a substitute for healthy diet, weight loss and an overall fitness routine.