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What You Need to Know About Kegels


Why these exercises that work out your pelvic floor can help you during sex and pregnancy — and how to do them

By Melanie Burke


You’ve probably heard of Kegels (pronounced KEY-gulls), those pelvic floor exercises frequently recommended to women (and sometimes men) to strengthen that somewhat mysterious group of muscles called the pelvic floor. This leads to the obvious question: what exactly is your pelvic floor? 

This muscle group runs beneath the lower part of your body, known as the pelvis. “Pelvic floor muscles, in addition to being useful for continence [the ability to control your bladder], are used for additional roles of sexual pleasure and sexual functioning, as well as stability of our spine and our posture,” says Lizanne Pastore, PT, MA, a certified orthopedic manual therapist in San Francisco with a specialty in the pelvic floor. “These muscles support our internal organs, the uterus, bladder and rectum, and prostate in men.” 

Pelvic floor muscles are also helpful in the births of babies. In fact, a 2004 study that sampled more than 300 women reported that strengthening your pelvic floor muscles may even decrease the amount of time you spend actively pushing during the second stage of labor. This may be why pelvic floor exercises or Kegels are frequently recommended to pregnant and postpartum women, as well as anyone with issues holding in their urine (or feces), or to aid in recovery after surgery to the pelvic area.  

When and How to Do Kegels

As with any new exercise routine (especially if you’re pregnant), consult a doctor or physical therapist (PT) before you start doing Kegels, Pastore suggests. They can identify what kind of weakness you may have in your pelvic floor. While this muscle group can be loose, Pastore explains that some patients actually suffer from too much tightness — an opposite, yet equally important, issue that can cause constipation, pain during sex, nerve damage, or “urge” incontinence, in which the already-tightened muscles have trouble tightening more to hold the urine in. “These are people who should not be performing strengthening exercises — at least not right away,” Pastore cautions.  

Once you get signed off on a Kegels regimen, here are what steps to take before, during and after exercise, so you can properly strengthen your pelvic floor.

1. Identify your pelvic floor muscles.

The most common way to find this muscle group is what’s called the “stop urine test,” which is exactly what it sounds like. While relieving yourself, try to stop the stream. You won’t have to do this test every time you perform a Kegel exercise, but the muscles that you squeeze to perform this action are the ones you’ll be working once you do begin your Kegel routine. 

Try not to hold your breath, Pastore notes, adding: “You're trying to pull your vagina up into your body, not to squeeze your butt.” In fact, it’s crucial to keep the muscles in your abdomen, thighs and butt relaxed while doing Kegels; instead, the upward movement and contraction should be felt in your rectum (anus) and vagina. 

2. Squeeze and release.

Once you’ve located your pelvic floor muscles and emptied your bladder, you’re ready to squeeze, then hold, your pelvic floor. Depending on your individual needs and progress, hold this squeeze for anywhere from 3 to 8 seconds. Then release the hold and let the muscles completely relax for the same amount of time that you were squeezing. 

“The healthiest muscle will be able to completely, fully come to a resting position, and the person should be able to feel that those muscles have relaxed,” Pastore says. So, while the Kegel itself is important, the relaxation period that follows is equally important, if not more so. 

Remember, as with any new exercise, it will take time and practice to be able to hold Kegels for longer periods of time.

3. Repeat.

The usual recommended regimen is 4 or 5 repetitions of Kegels, 2 or 3 times a day, but your PT will tell you what’s best for your muscles. If the routine you choose is more than just a few Kegels every morning, find a clean, comfortable space where you can relax and do them (in your car, in a parking lot, is a good spot; in the grocery store checkout line, not so much).

With practice, you’ll notice the benefits of exercising this often-ignored area — whether it’s improved urine retention, better sex or even just better posture. 

Published on January 20, 2016.

Melanie Burke is a lifestyle and culture writer in San Francisco, CA.

Reviewed by Shira Goldenholz, MD, MPH on December 16, 2015.
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