What is a Kegel?

Kegel exercises are named after the gynecologist, Dr. Arnold Kegel, who discovered them in his research. A kegel exercise is the contraction (squeezing) of the pelvic floor muscles to help increase strength and endurance. Strength and endurance of the pelvic floor muscles are key factors in pain management, continence of bladder & bowel, and even breathing function.

What are the pelvic floor muscles?

The pelvic floor muscles are a group of muscles that attach from your pubic bone to your tailbone and consist of three different muscles that contract together. These muscles create the walls of the vaginal and rectal canals, and support the abdominal and pelvic organs. Over the years, these muscles endure many different stressors, such as constipation, pregnancy/childbirth, cancer treatments, menopause, surgery, or even coughing and sneezing. These events can weaken the pelvic floor muscles and cause symptoms such as urinary or fecal incontinence, pelvic pain, or sexual dysfunction.

Getting it right

To perform a Kegel exercise, you are often advised to squeeze or tighten the pelvic floor muscles as if you are trying to stop the flow of urine or stop yourself from passing gas. You can also visualize closing a zipper from your tailbone to your pubic bone, or visualize the pelvic floor as an elevator, lifting from the first floor to the tenth floor as you squeeze. If you are unable to feel yourself squeezing, you may insert a finger vaginally to see if you are contracting the muscles correctly, however, it is suggested that a trained professional (i.e. pelvic PT, urologist, gynecologist) assess your pelvic floor and give you advice on proper technique before you continue with an exercise program.

How often should you kegel?

Typically, patients can expect to see improvements within 6-12 weeks of starting a kegel exercise program. If you feel that your symptoms are worsening, or that there is no noticeable improvement within this time, you may be doing your exercises incorrectly. Please remember that YOU ARE NOT ALONE! Many patients, upwards of 50%, tend to perform kegels incorrectly, even after being taught. Even after your pelvic floor strength has returned and your symptoms have resolved, it is important to continue performing your kegel exercises. As with any other voluntary muscle, like your biceps or quadriceps, “if you don’t use it, you lose it”. This is a lifelong program!

Helpful hints:

  • Do not perform kegels during urination, as this can cause damage to your urinary tract or potentially create problems with urinary retention.

  • Once you are confident with your kegel, DO try them throughout the day during your regular activities like walking, exercising, or brushing your teeth

  • Quality over quantity. It is more beneficial to perform 5 kegels, holding for 10 seconds & relaxing for 10 seconds between contractions, 3 times per day, than to do 200 kegels everyday.

  • Relaxation is JUST as important as squeezing! Please give yourself time to relax between kegel contractions.

  • SQUEEZE BEFORE YOU SNEEZE, COUGH, OR LIFT HEAVY OBJECTS.

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References:

Bø, K (2006). "Can pelvic floor muscle training prevent and treat pelvic organ prolapse?” Acta Obstet Gynecol Scand 85 (3): 263–8.

Hay-Smith EJ, Dumoulin C (2006). "Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women". Cochrane database of systematic reviews (Online) (1): CD005654.

Herderschee, R; Hay-Smith, EJ; Herbison, GP; Roovers, JP; Heineman, MJ (Jul 6, 2011). "Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women.". The Cochrane database of systematic reviews (7): CD009252.

Kenway M. and Goh J. (2009) Inside Out - The essential women's guide to pelvic support

Stein, Amy. Healing Pelvic Pain. McGraw Hill; 2009.

"Kegel exercises: A how-to guide for women". Mayo Clinic. July 10, 2010. Retrieved July 4, 2012.

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Holly Horikawa PT, DPT, CLT

Owner and Founder

Dr. Horikawa received her Doctorate in physical therapy from Duke University in 2005 and founded Lokahi Physical Therapy & Wellness in 2013.

R.A. Sovilla

Patient Advocate

R.A. Sovilla suffered with pelvic pain due to endometriosis for over a decade. She is currently living pain-free post surgery and co-leads the OC Chronic Pelvic Pain Support Group with Dr. Horikawa.

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