“If you don’t use it, you lose it.”
When you’re thinking of starting a new workout regimen, you want to be sure you cover all the fitness bases: cardio, strength training, and stretching. Your full-body workout probably includes moves for your abs, legs, arms, butt, and back. But there’s one important not-so-obvious set of muscles you’re likely forgetting: your Kegel muscles.
The Kegel muscles, also known as the pelvic floor muscles, contribute muscle fibers to the urethral sphincter (muscles that control the exit of urine from the urethra) and wrap around it like a donut, says Lauri Romanzi, MD, a urogynecologist in New York City. These pelvic floor muscles relax to allow urination and tighten to stop the stream of urine. Contracting the pelvic floor muscles closes the lower urethra, squeezing any remaining urine back up into the bladder.
Kegels are a series of exercises designed to strengthen those pelvic floor muscles. “Kegel exercises involve contracting or squeezing the pelvic floor muscles,” says Dr. Romanzi.
The Benefits of a Strong Pelvic Floor
Sure, you can’t see your pelvic floor muscles and they won’t help you fit into your skinny jeans, but having strong pelvic floor muscles benefits your body in many other ways. Kegel 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. (Score!)
“Everyone ought to be doing Kegel muscles,” says Dr. Romanzi. “Just like any other muscle, as you get older, [if] you don’t use, it you lose it. You need to keep the muscle in shape.”
How to Do a Kegel Exercise
A Kegel done properly feels exactly like you’re trying to hold in your urine, says Dr. Romazi. So the next time you have to urinate, start to go and then stop. Feel the muscles in your vagina, bladder, or anus get tight and move up. These are the pelvic floor muscles. If you feel them tighten, you’ve done the Kegel exercise right.
If you're still not sure whether you are tightening the right muscles, keep in mind that all of the muscles of the pelvic floor relax and contract at the same time. It’s also important to keep your abdominal muscles, buttocks, and thighs relaxed, and to avoid this common Kegel exercise mistake.
What’s great about Kegel exercises is you can do them any time, any place. Most people prefer to do the exercises while lying down or sitting in a chair. “What I often tell patients is, do sustained contractions, with no break in between,” says Dr. Romanzi. “Start with a count of five, [and] see if you can of five in a row. If you can do five in a row, try to do 10 in a row.” Here’s a routine to get you started:
- Begin by emptying your bladder (after you go to the bathroom).
- Tighten the pelvic floor muscles and hold for a count of 10.
- Relax the muscles completely for a count of 10.
- Do 10 repetitions, 3 to 5 times a day (morning, afternoon, and night).
To make Kegel exercises a habit, work to fit them into your everyday life. “That could be Kegeling on your subway ride. It could be Kegeling as you’re walking your dog every morning. For people who drive and commute, it could be keeping time to music, literally,” says Dr. Romanzi.
After four to six weeks, most people notice some improvement in their pelvic floor strength and incontinence symptoms. It may take as long as a few months to see a major change, so be patient. And don’t try to speed up the progress by dramatically increasing the number of repetitions and the frequency of exercises. Over-exercising your Kegels can cause muscle fatigue and actually increase urine leakage.
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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Kegel exercises involve contracting, or squeezing,
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the pelvic floor muscles.
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Both men and women have pelvic floor muscles.
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The way kegel exercises work for bladder control,
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the kegel muscles contribute muscle fibers
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to the urethral sphincter that wrap around like a donut.
00:00:25.290 --> 00:00:27.310 line:15%
So every time you're squeezing the muscles,
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you're also exercising the muscles in the sphincter.
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This can make the urinary sphincter stronger
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and better able to control urine flow,
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including preventing incontinence.
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There is some data showing that men who are
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about to undergo cancer prostate surgery
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have much better rates of continence and sexual function
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after the surgery if they do kegel exercises,
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monitored with a pelvic floor physical therapist.
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There is some data showing that women can
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help restore continence and bladder control
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for all types of incontinence, stress incontinence,
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urge incontinence, mixed incontinence, with kegel exercises.
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Everyone really ought to be kegeling with some regularity.
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The kegel muscles, just like any other muscle,
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as you get older, if you don't use it you lose it.
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You need to keep the muscle in shape.
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A kegel, done correctly, in someone who is
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strong and coordinated will feel exactly like
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when one is trying to hold in urine or hold in gas.
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This is the exact same type of contraction.
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What I often tell patients is,
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do sustained contractions with no break in between.
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Start with a count of five, see if you can do five in a row,
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if you can do five in a row, try to do ten in a row.
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For women who are very dedicated, what I've found
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often works is to help them sort out
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how to work that into their daily life.
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That could be kegeling on your subway ride,
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it could be kegeling as
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you're walking your dog every morning.
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For people who drive and commute,
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it could be keeping time to music, literally.
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As a urogynecologist, the simple take-home message
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for kegel exercises is, they're always a good idea.
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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)