Kegel Exercises (+ Better Exercises for Pelvic Floor Health)

Should you do Kegel Exercises-it depends

Oh Kegels … these pelvic floor exercises certainly get a lot of press, but do they work? And are they actually helpful?

I recently saw a specialist to get my pelvic floor evaluated after six pregnancies. One of those oh-so-fun things we get to do as women. The good news? Shockingly – no diastasis or pelvic floor problems for me. But I had a fascinating conversation with the therapist about Kegel exercises and what actually works to improve pelvic floor health.

Turns out that Kegels have their place, but they aren’t for everyone and they were never intended to be a stand alone exercise as many women use them today. Strengthening the pelvic floor is important, but Kegels may not be the best way.

What Are Kegels?

stretching for healthKegel exercises are one of the many exercises that can strengthen the pelvic floor (also known as the pelvic diaphragm). These exercises are named after gynecologist Dr. Arnold Kegel who published a paper in 1942 explaining the benefits of strengthening the pelvic floor. He found that improving muscle tone in this area helped stop urinary incontinence but also seemed to improve orgasm in women.

Dr. Kegel’s also invented a device for measuring pelvic floor strength. The original exercises he recommended included the use of a resistance aid (like these) and were not just simple contract and release exercises.

This is the reason that many pelvic floor therapists recommend Kegel exercise weights or even stone eggs in conjunction with Kegel exercises. My physical therapist explained that Kegels without weights are somewhat like just squeezing your arm muscle, while adding the weight is like using a dumbbell in arm exercises. Both can be effective, but adding a weight will provide better results over the long term.

Benefits of Kegel Exercises?

The pelvic floor is actually composed of several layers of muscles that connect in opposite directions. Many people envision the vagina as a tube that simply squeezes and releases, but the pelvic floor is much more complex and has several layers that all work together. In some cases, Kegels are helpful to tighten the pelvic floor. But some women have a pelvic floor that is too tight and needs to be relaxed.

As Dr. Brianne Grogan, DPT, explains:

Kegels are not for everyone. Some women hold chronic tension in the pelvic floor muscles and their muscles are short and tight most of the day. This often results in pain with intercourse, difficulty initiating urination, a feeling of tension or pain in the pelvic area, and the feeling that “no matter how many kegels I do I still don’t see results!”

For these individuals, kegels should be avoided.

I recommend seeking the care of a women’s health physical therapist who can help you release the pelvic floor muscles and re-balance pelvic floor length and tension using other, more appropriate, exercises.

Now before we throw out kegels altogether, we need to remember: kegels are not “bad.” They are simply an isolated contraction and relaxation of a muscle group, similar to a biceps curl or a hip extension! And for many women (barring the women described above), knowing how to “kegel” can be a great way to improve body awareness and even to spice up one’s sex life.

Successful isolation and contraction of the pelvic floor muscles helps functionally, as a “back-up” to prepare for a big cough/sneeze, when you really have to hold your bladder because there’s no bathroom nearby, or when lifting/pushing/pulling something heavy.

If you’re wondering what category you fall in, Dr. Brianne talks you through a step-by-step self assessment of the core and pelvic floor in this YouTube video.

Do Kegels Work?

This is where things get a little more confusing. The answer really depends on what is actually causing the pelvic floor problem, how the Kegel exercises are being performed, and a variety of other factors. Dr. Grogan’s experience indicates some of the times these exercise are appropriate and when they aren’t:

When I was in clinical practice as a women’s health physical therapist, I had the distinct advantage of being able to physically examine my patients to determine their level of pelvic floor strength and muscular control. Most of the women who presented with complaints of incontinence truly did have weak, uncoordinated pelvic floor muscles and responded well to kegels. I saw some amazing results in women who practiced kegels as part of a total core strengthening program.

However, there was definitely a subset of women for whom kegels were NOT appropriate. Luckily, I was able to identify these women during their physical exam, and my focus with these patients was to teach them how to relax and release the pelvic floor muscles.

How to Do Kegel Exercises:

Dr. Grogan offers this advice for doing a proper Kegel exercise:

  1. Lie on your back or on your side. Lying down takes gravity out of the picture and gives your pelvic floor muscles the greatest advantage for a strong contraction.
  2. Visualize your pelvic floor muscles. They sit at the base of your pelvis and surround your vagina and your anus. Try to squeeze and lift these muscles toward your head. Imagine that you’re using these muscles to pull a marble into your vagina. I know, I know … it sounds strange. But this visualization works.
  3. Now relax the muscles and imagine that you’re letting the marble roll out. You just completed a kegel!
  4. Do another kegel, but this time hold the contraction for 5-8 seconds before relaxing. Complete 5 to 10 repetitions. These “slow hold” kegels are great for increasing strength and endurance of the pelvic floor muscles. This is important for preventing incontinence and prolapse, and – bonus – can amp up your sex life as well.

If a weight or stone egg is added, the same process is followed, but with the weight or egg inserted vaginally during the exercise.

How to Improve Pelvic Floor Strength (With or Without Kegels)

For women without pelvic floor dysfunction, there are more ways—better ways—than isolated kegels to keep your pelvic floor muscles strong and supple.

Note: If you have a specific women’s health condition or concern such as incontinence or pelvic organ prolapse, please seek the care of a licensed women’s health physical therapist who can help identify your particular needs and come up with an individualized plan of care which may—or may not—include kegel exercises.

Here are three ideas Dr. Brianne suggests for optimal pelvic floor and core exercises (that don’t involve Kegels):

Move More Throughout the Day, Every Day

Humans were designed to MOVE … not sit in front of a computer all day long (I’m guilty of this myself!). Thus, first and foremost, we ALL must focus on increasing the quantity and quality of our movement throughout the day. Take movement breaks. Stand up, sit down, bend, get high, get low, lift things, and carry things. Just move! Park in the farthest parking spaces. Walk whenever possible. Take the stairs! Go for a hike!

And add more total-body strengthening into your daily life by attaching a quick fitness routine to something you already do multiple times a day, every day. I call this “Bathroom Fitness.” Give it a try!

Squat!

Squats are finally getting the attention they deserve. Biomechanists like Katy Bowman are helping spread the word about the many benefits of squats and why we should all be squatting more.

Moving into and out of a squat naturally activates your pelvic floor and core muscles, and most importantly strengthens the booty (thereby balancing the length and the work of the pelvic floor muscles). I like doing air squats (these are also described in the “Bathroom Fitness” video above) and deep squats. Particularly great when folding laundry!

Move Like a Lady

From Dr. Grogan: “Those who know me well know there’s nothing I like better than shakin’ my booty and moving my hips. Talk about a great total core exercise … And fun! Hip circles, figure 8’s, etc., activate all of the muscles in your core including the pelvic floor, hips, back, and abs. Side benefit? Daily gentle hip circles keep the hip and spinal joints lubricated and pain free.”

Of course all of these exercises must be done with the foundation of proper posture and alignment. There are other great strengtheners including core breathing, planks, and more.

Zip It Up

Often, when we think of both posture and core strength we focus on the abdominal muscles. We stand tall and “suck in” our bellies. But in order to truly and safely engage the muscles of the core (which helps protect your back, prevent prolapse, and keep you looking trim) you need to start at the base of the core—the pelvic floor.

Instead of isolated crunches or Kegels, the key is to engage the entire core as a whole.

Imagine a zipper that starts at the pelvic floor. Think of engaging—or starting—the zipper and begin a gentle Kegel. Next, think of pulling the zipper up as you contract your abdominal muscles, gently drawing your belly button in and up. Finally, stand tall with your shoulders drawn gently back. (Don’t let them round/hunch forward!)

Remember to zip up before you prepare to do a task that requires extra balance, control, or spinal support. A few examples: Vacuuming, taking out the garbage, and lifting weights at the gym. Zip up to prepare for the challenging task, and hold the “zipped” position while you’re completing the task. After you have completed done the task, relax! But remember to “zip it up” when you need an extra dose of deep core control.

Kegels & Pelvic Floor: Bottom Line

Plugging away on the elliptical is fine, going for a walk or a run is great, lifting weights is fantastic, but strengthening and toning the middle part of the body—the core—is just as important as exercising the arms and legs.

As females, it is essential to incorporate the muscles of the core and pelvic floor into our fitness routines. This may mean using Kegels with or without weights, but it also means moving more, squatting, walking, stretching and moving our bodies as a whole.

This post was co-written by Wellness Mama and Dr. Brianne Grogan. Brianne is a doctor of physical therapy and the founder of FemFusion Fitness.

Do you do Kegels? How have they worked for you? Ready to try these tips instead? Share below!

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Reader Comments

  1. Katie, thanks again for allowing me to follow up on my previous guest post! I’m so glad I could come back to clarify… And to provide the caveat… That I neglected to state two years ago. 😉

    • This I is wonderful! Thank you Katie and Brianne. I have been doing kegels for much of my life, yes even in early teens. I do believe my problem is more with tension and needing to relax. This explains a lot and I will do more research.

  2. I’m planning on giving birth to my first child in April.. I’ve been reading up a little on natural childbirth and part of what I’ve chosen (the Bradley method.. though honestly I haven’t gotten very far yet with my reading/research) is that one should practice these kegel exercises to prepare your body for labor and delivery. I really don’t like doing kegels, I’d rather squat or do anything else.

    • Hi Bethany! To be honest, I’m not familiar with the Bradley method although I’ve definitely heard of it. Kegels are not for everyone, but two variations that can be helpful for pregnancy are the “elevator kegel” and the “reverse kegel.” Both variations promote a focus on the RELAXATION phase, because ultimately you want the pelvic floor muscles to be strong and supple throughout the duration of your pregnancy (and after) but you also need to be able to quickly and easily RELEASE the muscles during childbirth. I’ll link to these kegel varations below. But I agree with you that a great, safe, and always-effective bet is squatting regularly (air squats, deep squats, etc)! Also, watch your posture and alignment! Stand tall and KEEP MOVING. I walked every day throughout my pregnancy, hiking up to the day I gave birth, and I truly believe it made all of the difference. I hope that helps! http://femfusionfitness.com/the-reverse-kegel-for-relaxation/ and http://femfusionfitness.com/kegel-variation-the-elevator/

    • Hi, Bethany!

      I’m also doing the Bradley Method for childbirth. My instructor talked about the importance of squatting to strengthen the pelvic floor muscle. Kegels essentially start to pull together your whole pelvic area, so if you do too many, you can actually make your opening smaller. You pelvic floor muscle needs to be strong but also long and flexible. Squats are the PERFECT exercise to do this. So keep at them! There are so many benefits to squats, so you definitely shouldn’t throw them out to do kegels instead. 🙂

      Hope that helps!

  3. As a woman with Pelvic Floor syndrome I would love to find a way to help with the “sneeze” control other than kegels. PVS is not fun and can be a real issue if you don’t have an understanding patient partner.

  4. I totally swear by replacing the kegels with Saida Desilets excercises with a jade egg. I always had a hard time doing kegels because it is just so boring.. 😉 And I always wondered what on earth they were doing, cause I didn’t notice anything ^^ But omg, the difference I noticed after starting using the egg, made me a very happy girl :)) Used to have big incontinence problems, especially when jumping/being scared, but after a few weeks they went away. Also helped ease my period cramps a bit, which I was not prepared for.

  5. I had some limited success with my Kegel8 but was never able to reach the level of stimulation suggested in the instructions. After a while I got worse than I had been at the start – I rang their helpline (UK) and was told I’d been over-using it (2-3 times a week) and to take a break. I did this and slowly re-introduced the Kegel exercises and each time I used it I had a really bad day – so I stopped. I have tried many exercises over a 10 year period – none of which have really helped. I have been examined by a specialist whilst doing the exercises and so feel confident that I have been using the correct muscles. The only thing that has worked has been the topical application of hormone cream (having avoided all HRT through the menopause – grrr!) I reluctantly continue to use this because it works! I will try the squats – I can probably do them now that I have lost 33 lbs (partly thanks to WellnessMama website), although my knees are still quite wobbly.
    I wonder if I have such poor results from exercising because of 2 episiotomies and a rushed delivery (cord round neck) of my second child (9lb 3oz).

  6. Have been advised kegel excercises frequently for my prolapsed bladder . Advised not to squat at all . Please advise if I can still do mild yoga . I walk almost daily . Thanx.

    • Abida, kegel exercises are often appropriate for a prolapsed bladder, but it really depends on the person. If your pelvic floor muscles are too tight/overly active, then kegels may actually be counterproductive. And if your prolapse is too far advanced, kegel exercises (even for a weak/underactive pelvic floor) aren’t going to be able to reverse the condition. I encourage you to seek an evaluation from a pelvic floor physical therapist (physio), if you haven’t already. She can help you determine the best course of action! As far as yoga, I think that should be fine… And walking is always great. I also think squatting is great as long as you engage your pelvic floor and core muscles and EXHALE on the way up to stand.

  7. Great post! I am a fitness class instructor and mom of 7 and have been looking to heal my core(prolapse), along with my diastasis recti (split tummy muscles). Thanks!

    • Thank YOU, KA!

    • And PS, keep your eye on my blog (at femfusionfitness.com). Within the next few weeks I’m going to post an article and video that’s all about safe ab exercises for diastasis recti!

  8. I’ve been doing kegels on and off for almost 60 years and they helped to keep my bladder in check most of the time although I’ve recently found out that I have a prolapsed bladder. However I also include many other exercises. For example I include them in my daily activities, like squatting instead of bending to pull a weed and so on. That’s why I like femfusion fitness with all those great ideas.

    • Alice – that seems like a great, balanced approach! Thanks for the love!

    • Such a balanced approach — keep it up, Alice!

    • Hi Shannon! Katy Bowman is great and has really changed the way the world thinks about kegels. I offer a balanced approach, stating that for some people, kegels are potentially harmful and should NOT be done. For other women, the occasional kegel session can be a great way to improve body awareness and total core strength. And for other women (a third group), kegels can be quite helpful when it comes to treating issues such as bladder control. It really just depends on the individual! But one commonality among almost all women (I would say “all women” but it seems like there are always exceptions to any “rule!”) is that kegels are NOT the only way — or even the best way — to keep your pelvic floor muscles supple, healthy, and strong. That’s why my focus in this article is on MOVING MORE, SQUATTING, and “MOVING LIKE A LADY” rather than doing kegels.

  9. The exercises that Brianne teaches in her book femfusion for intimacy, are they helpful during pregnancy?

    • Hi Evalina! I just happened to check back in and saw this post… Sorry I’m so late in responding! It really depends on the trimester you’re in as far as exercises in the “inner core energizer.” Most of them should be safe, but I’d talk to your doc just to be sure based on your particular needs! That being said, the exercises in the RELAXATION portion of the book would be wonderful for you, along with the core breathing and the love and light meditation. What a wonderful way to treat yourself (and your little baby inside)!

  10. I like to use yoni eggs (Jade eggs) for pelvic strengthening. I also enjoy squats, I believe I benefit from both

  11. I just began physical therapy for strengthening my pelvic floor, and the only thing she wants me to do are Kegels. Doing these has given me an extremely painful back. Am I doing them wrong? Or are Kegels not for me? I have a history of back problems and have been to therapy several times for it. I have asked the therapist about the back pain I’m experiencing, and she has not been helpful. I’m thinking your alternative suggestions might be best for me.

    • Steph, it’s definitely a concern that you’re starting to develop back pain! Definitely talk to your physical therapist about this and ask if she’d be willing to explore some of the alternative suggestions (as noted in the article). If she’s not open to this, consider seeking a second opinion. Good luck!

      • Thank you!

  12. After my pregnancy I was having pelvic floor weakness and it leads to various health problems such as urinary stress incontinence, which meansurine leaks when I laugh, sneeze, cough, jog or do similar activities. So to avoid these problems doctor recommended me kegel exercises to strengthen pelvic floor muscles. recently I bought Kegel exercise product from Amazon and its providing me good results. http://amzn.to/1PpImf3

  13. When you first start doing Kegel exercises, tense the muscles in your pelvic floor for a count of three, then relax them for a count of three.

  14. I read that bladder prolapse and the weakening of pelvic floor muscles are a result of ‘good’ posture. standing straight and sitting up straight is all fine and dandy for a man but not fora lady. As a mother of 3 with a prolapsed bladder I have done my fair share of kegels. If you want better sex they work for that. But to repair pelvic floor muscles a lot more needs to be done. Most importantly learning about posture. This helped me a lot because kegels weren’t the answer for me and a lot of other woman.

  15. Great article on pelvic floor. I had some urinary incontinence years ago, only at night. I googled and found the kegel master. It is pricey but last forever. Used the same concept of the weights as you increase the tension as you develop the muscles. I did used it every night for a few weeks until I got up to the highest level. Still use it once a week or so. I work out now more than I did in my 20’s and I have no issues with pelvic floor. I am now 52.

  16. Thank you for this post. I have IC and suffer from my pelvic floor muscles being way too tight. The doctor compares my pelvic floor muscles to bricks. I was wondering what types of excersises I can do for help with this?

  17. Great info, Katie and Briane! I dealt with prolapse issues for years after the birth of my 5th. I, too, am a Katy Bowman fan, and somewhere on her site, I found mention of Maya Abdominal Massage…for me, it was the magic bullet!! No more sneeze pee, I can run again without that yucky dribble, and best of all, it doesn’t feel as though the whole works are ready to slip out unannounced! I tried various Kegels and Kegel products previously, but am likely in that group with a too-tight pf. Thanks again, for getting these great conversations going!

  18. Ok so this is great if you work in a office or at home. I drive a Taxi for a living and I sit in a car from 6am to 6pm what can I do?? Help!!!!!

  19. I had no idea that Kegel exercises can do so much to our body. Thanks, Kate fo sharing this article. I have done all the above exercises but I reckon today I have realized the real essence.

    Much Thanks

  20. Great article!!!

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