A kegel is an important exercise to do both during pregnancy and postpartum. This pelvic floor contraction can help strengthen the pelvic floor muscles, support the pelvic organs (uterus, bowel, and bladder), and help reduce the chance of pelvic floor disorders such as incontinence and pelvic organ prolapse. However, 1 in 2 women do not know how to perform a kegel correctly even if given verbal directions. This is why seeing a pelvic health physical therapist is very important, as they will assess your ability to activate these muscles and provide individualized coaching to help optimize your muscle performance and eliminate/prevent symptoms.
The kegel is a two-fold exercise of contraction and relaxation; both are equally important. To do a kegel, you’ll want to contract and lift the pelvic floor, try longer holds of 5-10 seconds and shorter holds of 1-2 seconds, then fully relax.
When contracting and lifting the pelvic floor, here are a few do’s and don’ts to help you get it right.
Do:
– Do be sure you lift the pelvic muscles up and in. If you place a flat hand under your perineum (the space between the vagina and anus) either directly on skin or over your clothing, you should feel the perineum pull away from your hand. When you relax, you should feel the perineum gently rest back into your hand with the same amount of pressure you felt before starting the kegel exercise.
– Do fully relax at the end of the kegel
Don’t:
– Don’t contract surrounding muscles like your glutes, abs, or thighs
– Don’t squeeze as hard as you can. More isn’t necessarily better.
– Don’t do kegels while you are in the middle of urinating or having bowel movement unless specifically prescribed by a pelvic floor physical therapist
Having trouble with targeting the correct muscles?
– Visualization can be helpful. Imagine picking up a blueberry with your vagina. Strange, I know, but this can help you target the lifting action of the kegel as well as reminding you to lift gently.
– Check yourself. As long as you are comfortable, you can check yourself internally as you perform a kegel. Simply insert 1 clean finger into your vagina. As you perform a kegel, confirm that you feel both a contraction and a lift of muscles around your finger and that the contraction happens equally all around. Don’t feel comfortable inserting a finger? That’s OK!! You can follow the same steps over your underwear with a flat hand and fingers on your perineum (the space between the vagina and the anus). You should feel this area lift away from your hand/fingers as your squeeze and feel it fall back into your hand as you relax. Still uncomfortable? You can also check this using a hand held mirror with your underwear off. Instead of feeling, you will be watching in the mirror to see the perineum pull up and in on the squeeze and return to the starting position on the relax.
– Schedule an appointment with a pelvic floor physical therapist. They can do internal and external checks to ensure you are properly performing a kegel as well as prescribe specific kegel exercise patterns as needed.
Casey Thomas-Hardesty, MS, NTP & Jenny LaCross, PT, DPT, PhD(c), WCS, ATC, CLT-LANA
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