Why Kegels are important, the controversy over Kegels, best techniques for doing them, PLUS tips for fitting them into your routine.
Even if you are planning to have a C-section, please keep reading! Heck, even if you are the Grandmother-to-be, keep reading!
How important are Kegels?
If by some unrealistic set of circumstances I was told I could only do one exercise while I was pregnant, with the wisdom of hindsight, the one I’d choose is the Kegel.
Our pelvic floor muscles can be ‘out of site, out of mind’ but consider for a moment that they serve 3 vital purposes1:
1) Uphold and cushion the organs within the pelvis and lower abdomen (that’s a pretty big deal!)
2) Control continence (that’s bladder AND bowel)
3) Mechanism for sexual function (arousal and enhanced appreciation-pretty important stuff!)
Whether you are preparing to become pregnant, you are pregnant, or you’ve already had your baby, consider incorporating Kegels into your regular routine.
It never dawned on me that kegels could become controversial, but when I started researching and talking about this article, I was surprised to find out they are.
Contention #1: “Kegel was a man”
While I suspect that human intuition guided many of our ancestors to do similar exercises; in today’s era, Dr. Kegel was an important figure in raising awareness for the benefits of pelvic floor health.
Wish these exercises weren’t named for a man?
We are in luck! Today we have access to the wonderful Amy Stein, DPT, BCB-PMD. Amy is a well-respected expert in the field of pelvic health. So if you want to read about pelvic floor muscles from a woman, you can pick up her book.
Another great resource, also written by a woman, is Baby Weight, by Mickey Marie Morrison, PT, ICPFE
Contention #2: “Doing Kegels is no guarantee”
It is true that doing kegels in no guarantee that you will avoid post-pregnancy incontinence. Does that mean you should not do them? It’s an individual choice. For me, I agree with The Mayo Clinic and the many other reputable sources that recommend doing Kegel exercises. The one thing that I would add to the articles posted on the pages of those reputable sources is this: BE SURE you are doing the Kegel exercises correctly (read on for tips about that).
Why Kegels are important when you are Training for Labor
Kegels are important for your short-term and long-term vaginal and pelvic floor health.
Why?… It is hard to decide the order of these statements since they are both super important for different reasons. I’ll start with incontinence since if you just gave birth, you may not be thinking about sex again quite yet.
Peeing in your pants sucks!
Sadly, I speak from experience. You will want to start your kegels as early as possible so you can avoid the dreaded “I wear a pad to workout so I don’t accidentally pee in my pants”.
If you think I am kidding, I am not. If you are already there and you haven’t started your Kegels yet, don’t worry, it is not too late to improve your pelvic health. There is a light at the end of the tunnel… there is a good chance (depending on the actual cause of your incontinence) that by doing pelvic floor muscle training you will no longer need that pad.
If you are grappling with stress incontinence now, imagine what it will be like when you are older. Kegels are just as important for the pregnant mom as they are for the grandmom. It is never too late to get started. Be patient with yourself, and bare in mind that the weaker the muscles, the more patience and persistence you will need to have, but like all other training– the rewards at the end of the training are earned through time and practice.
One day you’ll want to have awesome sex again
Great sex is good for your wellness for so many reasons.
If you just gave birth, you may not be thinking about sex at the moment. But for the rest of us… when you have sex with your partner, why wouldn’t you want amazing sex? Your own pleasure, and your partner’s, will be amplified if your vaginal muscles are healthy.
Best techniques for doing Kegels
Position and technique for doing Kegels…
Identify the right muscles
First of all, doesn’t it seem silly that we have to “check” that we are doing this correctly. It seems like it shouldn’t be that challenging. But it really is (at least it was for me when I first started, and I imagine I am not the only one).
So how do you check? You can find a lot of advice about stopping the flow of your urine mid-stream. But as most athletic women have experienced at some point, when we are sweaty and we impede the flow of our urine, we expose ourselves to the risk of urinary tract infection. In my opinion (which is not a medical opinion, so use this opinion as a starting point for your own research), the best way to check if you are doing your kegels correctly is to use your finger.
Lie on your back in a comfortable and safe place. Then use one or two fingers to make sure you are engaging your muscles. Be sure you are pulling up and in with your pelvic floor muscles and not pushing out with your abdominal or glute muscles.
“I don’t masturbate”
When I was describing this technique in a conversation recently the person I was speaking to said, “that won’t work for me, I don’t masturbate”. Since she expressed that concern, it seems to merit a mention in this article… exercising your pelvic floor muscles, including the muscles of your vagina is not masturbating, it is working out.
Whatever your perspective is on masturbation, try your best not to attach emotional meanings to these exercises even though we are exercising very personal muscles.
Acknowledge the laws of gravity
If you are new to Kegels, try by starting on your back. As Mickey Marie Morrison describes in her book, Baby Weight, the easiest position for beginners is lying down, where gravity has little effect. You can work your way up to sitting, standing, and eventually even squatting as you develop strength and control.
Clench and Relax
The “exercise” does not just happen during the act of clenching. Both the clenching and the unclenching (aka relaxing) are important.
In her book Heal Pelvic Pain, Amy Stein recommends training both your slow-twitch and fast-twitch fibers. These are terms you focus on when training your muscles to race in marathons or triathlons, it is super-cool to apply these terms to our Kegel exercises…. A nice little reminder that we are training for labor like the endurance event that it is.
Here’s the formula Amy suggests in her book:
- Tighten the muscles and hold for 10 seconds, relax for 10 seconds. Do 10 repetitions to strengthen your slow-twitch pelvic floor muscles
- Tighten and hold for 2 seconds, relax for 2 seconds. Do 10 repetitions to strengthen fast-twitch fiber muscles
The book also provides exercises to tighten the abdominal muscles that work in conjunction with the pelvic floor muscles for maximum benefit.
Fitting Kegels into your routine
Most of us are more likely to do something every day if we see the benefit. AND we are even more likely to stick with it if we are good at it. Hopefully by now you see there are many important benefits for doing kegels.
But here’s the bad news, it takes practice to get good at these. Doesn’t it seem like something we should just be able to do? Well, if you are among the very few that find it easy, count yourself lucky! For the rest of us, my best advice is to just do them. Day after day until one day you realize you’ve built a habit.
It may take several weeks, but just take one day at a time.
Once you have the hang of them and you are more confident that you’re getting to the correct muscles, you can do them discreetly anywhere. At a stop light. Waiting in line. While reading a blogpost.
There are so many clever and resourceful little ways you can squeeze in your kegels (pun intended).
If you have additional questions about pelvic floor muscles, I highly encourage you to check out the resources below.
- Amy Stein , MPT : Healing Pelvic Pain. A proven stretching, strengthening, and nutrition program for relieving pain, incontinence, IBS, and other symptoms without surgery
- Micky Marie Morrison, PT, ICPFE : Baby Weight, the complete guide to prenatal & postpartum fitness
- For those that live near NYC, you can check out Amy Stein’s holistic physical therapy practice in mid-town, New York
- Weekend Retreat (March 2014) for more information check out the Alliance for Pelvic Pain
May you always sneeze with confidence!!!
1: from page 7 of Amy Stein’s book Heal Pelvic Pain