Don’t let your pelvic floor exercise efforts go to waste.
There’s nothing more frustrating than taking Spin classes four days a week and depriving yourself of chocolate peanut butter crunch ice cream and Friday night pizza, only to notice that the scale has barely budged.
The same thing goes for those pelvic floor-strengthening Kegel muscle exercises you’ve been doing every day. “One of the biggest misconceptions are patients who believe that they’ve been doing Kegels very well for years and it’s not working at all,” says Lauri Romanzi, MD, a urogynecologist in New York City. “They’re [still] having incontinence or other problems, and you find that they’re doing them completely wrong.”
Kegel exercises, or pelvic floor muscle training exercises, are a series of exercises designed to strengthen the muscles of the pelvic floor (which live under the uterus, bladder, and large intestine). “Kegel exercises involve contracting or squeezing the pelvic floor muscles,” says Dr. Romanzi.
Pelvic floor exercises can help both men and women who have bladder issues, such as overactive bladder symptoms or stress incontinence. Kegels can also improve women’s sexual health and pleasure by increasing sexual arousal and improving a woman’s ability to reach an orgasm.
But the problem is that many women may be do Kegels incorrectly. One study conducted in the early 80s gave a group of female participants standard Kegel exercise instructions. The women were told to go home and practice, and then later were examined by pelvic floor physical therapists to see how well they were doing their Kegels. “They were not contracting the muscles, but they were straining and pushing out very hard just like you do when you have a baby,” says Dr. Romanzi. “And that not only doesn’t exercise the muscles, but it can also make incontinence worse.”
A Kegel done properly feels exactly like you’re trying to hold your urine, says Dr. Romazi. Here’s a step-by-step guide on how to do a Kegel exercise.
If you’re still not sure whether you are tightening the right muscles during your Kegels, keep in mind that all of the muscles of the pelvic floor relax and contract at the same time. To find them, insert a finger into your vagina. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down.
If you feel like you’ve tried everything and it’s still doesn’t feel right, don’t give up. “A good portion of people, up to 30 to 40%, really can’t sort [pelvic floor exercises] out on their own,” says Dr. Romanzi. There are many therapies that can help—like vaginal cones, biofeedback (a process involving electrodes that gives you a nudge of positive reinforcement if you’re doing them right), or pelvic floor physical therapy—so talk to your doctor for more help on how to properly do Kegel exercises.
Dr. Romanzi is a urogynecologist and reconstructive pelvic surgeon based in New York City.
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One of the biggest misconceptions are patients who
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believe that they've been doing kegels very well
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for years and it's not working at all,
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they're having incontinence or other problems.
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And you find that they're doing them completely wrong.
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Kegel exercises involve contracting or
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squeezing the pelvic floor muscles.
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Both men and women have pelvic floor muscles.
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One study done in the early 80s, they got women who
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claimed that they've never done kegels before and
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gave them a standardized instructions and
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they went home and practiced and they came back and
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pelvic flood physical therapists checked how well they
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were doing the kegel exercises.
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They were not contracting the muscles but
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they were straining and pushing out very hard
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just like you do when you have a baby and
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that not only doesn't exercise the muscles but
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it can make incontinence worse.
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A kegel done correctly in someone whose strong and
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coordinated will feel exactly like when one is trying to
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hold in urine or hold in gas.
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This is the exact same type of contraction.
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And it should feel that you're closing and
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pulling in, closing and pulling in,
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a clenching feeling is often described.
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A good portion of people up to 30, 40% really can't
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sort that out on their own.
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They might want to try to check themselves or
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they might want to go in and make it part of their
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checkup with their clinician.
Pelvic floor muscle training exercises. U.S. National Library of Medicine, MedlinePlus. (Accessed on January 10, 2021 at https://medlineplus.gov/ency/article/003975.htm)
Pelvic floor muscle exercises (Beyond the Basics): UpToDate. (Accessed on January 10, 2021 at https://www.uptodate.com/contents/pelvic-floor-muscle-exercises-beyond-the-basics)
Urinary incontinence treatments for women (Beyond the Basics) UpToDate. (Accessed on January 10, 2021 at https://www.uptodate.com/contents/urinary-incontinence-treatments-for-women-beyond-the-basics)