This blog is an addendum to our 11-part article series of 11 New Year’s resolutions that actually work and WILL improve your pelvic health. We thought it relevant to add this blog post since the first 2 New Year’s Resolutions are all about Kegels and pelvic floor muscle exercises! Get the full list of all 11 New Year’s resolutions HERE.
Do You Know How to Do a Kegel, Really?
For many women, this sounds like a silly question. Of course women know how to do a Kegel. After all, women are often handed direction sheets on how to do a Kegel–whether post-partum or as an alternative therapy for symptoms such as urinary leakage. Just in case you’re not sure about the vocabulary we are using here, a Kegel is a pelvic floor muscle contraction developed by Dr. Arnold Kegel to help women improve their pelvic floor.
So who doesn’t know how to do a Kegel, right?
Wrong.
It turns out that about 50% of women cannot do a Kegel (or contraction of the pelvic floor muscles) correctly. What do these women do wrong?
- contract the wrong muscles (such as the thigh or buttock muscles)
- contract no muscles (including the pelvic floor muscles)
- forget to release the muscles between contractions
- push the pelvic floor muscles downward and outward rather than pulling them up and in
And these are just a few of the possible problems that women could encounter when learning how to do a Kegel based on written instructions alone. The negative result is that women who do Kegels incorrectly then assume that Kegels do not work for alleviating symptoms of urinary incontinence, pelvic organ prolapse, or decreased sexual sensation. They could not be more wrong! If you don’t believe us, check out the statistics on how well Kegels work to alleviate these types of symptoms.
How to Do a Kegel Correctly
So if at least 50% of women are doing Kegels incorrectly based on written instructions alone, what should those women do? Simple: troubleshoot the Kegel. This exercise for your pelvic floor muscles is simple to troubleshoot if you can create about 45 minutes of quiet time in your house … alone! Do whatever you have to do to get the kids, hubby, and pets out of the way. Turn off your phone ringers and pager sounds. This may seem like a lot of work just to troubleshoot the Kegel, but you’ll find this small investment of time well worth it!
Once you’ve created an oasis of quiet in your home, follow these steps to troubleshoot your Kegel. Be aware that you will need to be willing to touch yourself in your pelvic region. If you are unwilling to do this, then please refer to our blog post on getting help from a physical therapist specializing in women’s pelvic health.
How to Do a Kegel
- To prepare yourself, wash your hands thoroughly, and then remove your pants and underwear (if you feel comfortable doing so). Lie on your bed (or the floor, if you prefer) face up with your legs straight out in a relaxed position. You may want to cover yourself with a light blanket for comfort.
- Place two fingertips of one hand between your legs on the perineum, which is the space between your vagina and your anus. You will be using these two fingers to feel whether your pelvic floor muscles pull up and in when you do a Kegel. Place your other hand under your buttock, slightly toward the outside edge. With this hand, you will be testing whether you tighten your buttock muscles when you do a Kegel contraction. Note that you want to avoid tightening your buttock muscles when you do a Kegel.
- Now do a Kegel (or pelvic floor muscle contraction). Not sure how to do this? No worries. Just picture that you are in a crowded elevator and you have intestinal gas. To prevent yourself from passing gas, you tighten certain muscles in your pelvic region, right? These are the same muscles you tighten to do a correct Kegel. As you do so, feel whether there is an inward and upward contraction where you have your two fingers (on the perineum). If you are doing a correct Kegel, you should feel this slight “in and up” sensation. At the same time, you should feel NO tightening of your buttock muscles. Now release the contraction. Releasing your muscles between contractions is VERY important because a lack of release can lead to over-tightening of the pelvic floor muscles, as well as pelvic pain and other unwanted side effects.
- Now repeat the process, this time moving the hand that was on your buttock to your inner thigh. Keep your other hand on your perineum, between your legs. Do another Kegel contraction, checking again that the perineum has a slight inward and upward pull, while your thigh muscle remains relaxed. Release the contraction.
- Finally, move your hand from your inner thigh to your abdomen. Repeat the process and ensure that your abdominal muscles do not push outwards as you do your Kegel. Again release the contraction.
If you were able to follow these instructions on how to do a Kegel without tightening your thigh or buttock muscles, and without pushing out your abdominal muscles, during each contraction, then you DO know how to do a Kegel. If, on the other hand you felt your thigh or buttock muscles tightening (or your abdominals pushing outward), you need to slow down and retrain yourself how to do a Kegel.
Taking Your Time Doing Pelvic Floor Muscle Exercises
If you found yourself doing your Kegels incorrectly based on the above instructions, then you have two options: you can retrain yourself to do a correct Kegel or you can get help from a specialist in women’s pelvic health. If you want to try to retrain your pelvic floor muscles yourself, simply follow the instructions given above. As you do each Kegel, consciously focus on contracting your pelvic floor muscles while keeping your thigh and buttock muscles relaxed. If you tend to push your abdominal muscles outward, focus on using them to help you pull your pelvic floor muscles inward and upward.
Take your time practicing these contractions. You may need to move your hand from thigh to buttock to abdominal muscles. Touching these muscles can help you consciously relax them even as you tighten your pelvic muscles. At first it may take you up to 10 slow practice contractions to do a correct Kegel. Don’t worry. Be patient with yourself. Remember that you don’t spend a lot of time thinking about your pelvic floor muscles, so it may take a while for your brain and body to make the proper connections necessary to do a correct Kegel.
If you try to retrain your pelvic muscles yourself but are unsuccessful, we suggest you seek the help of a women’s pelvic health specialist right away. Not only will this save you a lot of frustration, but getting help means that you will have far less to “unlearn” than if you keep trying to troubleshoot the Kegel by yourself.
Don’t worry! Learning how to do a kegel isn’t rocket science … sometimes you just need to take a little time to learn how to do it right or get some help. Either option is perfectly wonderful, and we applaud you for your focus on your pelvic health!
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