How To Do a Kegel, and Why!

The kegel is a great tool that can be used to help with decreasing symptoms of incontinence and improving the strength of your orgasm! But what exactly is a kegel? And how do you know if you’re doing it correctly? 

A kegel is a pelvic floor exercise. Named for the gynecologist Dr. Arnold H. Kegel who popularized it, the kegel is simply a pelvic floor muscle contraction. The pelvic floor is a system of muscles in your pelvis that form a sling from the tailbone to the pubic bone. Both men and women have a pelvic floor, though there are some key anatomical differences. This muscle system has roles in sexual function, bowel and bladder function, trunk stabilization, and pressure regulation within the torso. 

Mechanical dysfunction of the pelvic floor can play a role in various conditions such as: urinary incontinence, pelvic organ prolapse, vaginismus, or dyspareunia. What is that in laymen’s terms? Urine leakage, pelvic organs pressing on the vagina, chronic muscle spasming of the pelvic floor, or painful sexual intercourse. It is important to note that a kegel will not be an appropriate tool for all those conditions. Experiencing any of the aforementioned symptoms would be a reason to visit your physician and pelvic floor physical therapist for a plan of care that is specific to your needs.

Kegel & the Pelvic Floor

As a example, many female can experience symptoms of urinary incontinence with sports activities that cause increases in intra-abdominal pressure such as running, jumping, or weight lifting. If these symptoms are correlated to an overactive pelvic floor, meaning the pelvic floor system is operating with an abundance of muscle tone, performing kegels with an intention to strengthen would not be appropriate. This is known as stress incontinence. In that scenario, the athlete would benefit from learning how to relax the pelvic floor.

However, performing kegels regularly will help to increase resting tone of the pelvic floor musculature. Over time, this can help to decrease urinary leakage that occurs with activities that cause increased intra-abdominal pressure. 

Once mastered, kegels can be combined with other functional movements like this hemi-bridge to increase demand on the pelvic floor.

Now, while the kegel can be a helpful tool in addressing some kinds of pelvic floor dysfunction, you don’t have to be experiencing pelvic floor problems to benefit from performing kegels. In addition, pelvic floor contractions are involved during orgasm. Adding kegels to your weekly practice, may help you increase the intensity and/or duration of your orgasm! Now that I have your attention, let’s get into the specifics. 

Performing a Pelvic Floor Contraction for the First Time 

pelvic floor
This model shows how the pelvic floor works to provide structural support to our internal organs. 

If you’ve never performed a pelvic floor contraction, here is an easy way to figure out how to do one. The next time you use the toilet to urinate, try stopping the flow of urine midstream. This is a pelvic floor contraction, or kegel. However, only use this strategy the first time to help you feel the muscles you are trying to control. Using this strategy repeatedly can affect your ability to empty the bladder fully, and potentially cause bladder infection. 

Practicing Your Kegels 

To perform a kegel, lie on your back with your knees bent and your feet flat on the bed or floor. Start with a few restful breaths, in through the nose and out through the mouth. Notice how your ribcage expands and contracts with your breath. After three restful breath cycles, perform a pelvic floor contraction on your next exhale. Hold the contraction for 3-5 seconds. Then, release as you inhale. Take care that you are not squeezing your buttocks, abdomen, or thighs. Try to perform 4-6 repetitions in a row. As you gain more control, attempt to increase the time that you can hold the contraction. A good goal is to aim for a 10 second hold, followed by 10 seconds of a relaxed pelvic floor. 

It is important to have a quiet and private environment so that you can concentrate. Too many distractions can affect your ability to feel what you are doing. As your motor control improves, you can try performing kegels in a sitting or standing position. These are more challenging than performing a pelvic floor contraction while lying down. 

Contraindication for Pelvic Floor Contractions 

For those experiencing dysfunction linked to an overactive pelvic floor, you do not want to be practicing contracting the pelvic floor. In those cases, learning how to relax the pelvic floor is more important. This is an important distinction. A pelvic floor physical therapist will customize a treatment plan specific to your condition and needs. 

For More Information 

At Symmetry Physical Therapy, we are committed to helping our patients live their best lives. If you think you might benefit from Pelvic Health Physical Therapy, make an appointment today! Click here to verify your insurance benefits and schedule an appointment.

Looking for more information on pelvic floor physical therapy? Click here to see what the Academy of Pelvic Health Physical Therapy has to say.

Written By: Dr. Nicole Ramos, PT, DPT

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