Kegel Exercises – Am I Doing It Right?

How to do Kegel Exercises Correctly.

Kegel exercises are exercises that have been historically recommended for any and all girl garage problems. It all started back in the 1940s with a great American gynecologist named Dr.Arnold Kegel. Dr.Kegel discovered that there are actually muscles in and around the vagina. He also discovered addressing these muscles can be an effective non-surgical tool to solve leakage issues in women. The muscles in the pelvis ( pelvic muscles)  were thus named Kegel muscles and exercising these muscles or squeezing them is called Kegel exercise. While Kegel exercises are simple, finding the right Kegel ( pelvic ) muscle is harder than one might think!

What’s A Kegel Exercise?

Kegel exercise is the word used for exercising or squeezing your pelvic muscles. Pelvic muscles are like a muscular underwear inside the body holding our bladder, bowel and uterus. This muscle underwear has three holes in a person with a uterus- pee hole, vagina hole and butt hole. Squeezing pelvic muscles to close the holes is called a Kegel squeeze. 

If you have ever tried to “pucker up” to hold a fart you have done a kegel squeeze. If you ever tried to stop urine mid-way..you have tried a kegel squeeze.  

Who Should Be Doing Kegel Exercises?

Kegel exercises help us work on pelvic muscle squeezes. These are very helpful exercises for pelvic muscle weakness. However, it’s important to note kegel exercises are not for everyone. In fact, Kegel exercises might be doing more harm than help in some cases. 

Leaking urine? Try some kegels. 

Having a baby? Better start your kegels..

Had a baby? Kegels to the rescue to keep things “nice and tight” <patriarchy calling>…

Have pain with sex? Try Kegels!!!! 

<insert any down-there problem>..try some..

…you guessed it..

… Kegels!!

Sound familiar? For wayyyyy too long any and all girl problems are prescribed kegel cure. Perhaps we didn’t know any better back then but now we do! We now know that many pelvic problems including urine leakage, constipation, painful sex , postpartum issues etc can be arising from an overactive pelvic muscle. If our muscles are tight or overactive, doing kegels will make the problem worse and yet that is the advice most women receive from their sources.

It is hard to know if your pelvic floor will benefit from Kegels or worsen with Kegels without consulting a pelvic floor physical Therapist. That is why it is recommended to talk to an expert before starting any pelvic muscle exercise routine.

Whether or not Kegel exercise is a good idea…that’s a blog for another day! But today I want to talk about what kegel exercises and how to perform them correctly. 

How to – Kegel Manual 

Kegel exercises once learnt can be fairly simple but the real challenge is finding the correct muscles. So let’s talk about locating the correct muscles first.

Kegel muscle has layers- superficial and deep layers. Superficial muscles are small and act fast. Squeeze = Superficial. Thinking about squeezing the holes will engage the superficial muscles. Whether you are squeezing the vagina hole or pee hole or butthole.. Doesn’t matter the front or the back passage! Just simply squeeze and release. 

Remember superficial muscles are small and quick. Often the biggest mistake we make is trying to squeeze hard and be a hulk! All that does is make our body cheat ! The brain recruits some neighboring muscles to generate more force and loses out on muscle isolation. 

In order to make the squeeze isolated and specific, think about precision and not force. Imagine if you were squeezing a small kidney bean and pulling it inside your vaginal canal using the vaginal muscles. OR imagine you were cutting off the flow of urine  OR pulling a kidney bean inside the rare passage with your anus.

Sometimes it helps to look at your anatomy in a mirror and move the muscles while looking for cues on your vulva. Think about moving the clitoral hood and you should see a tiny nod. Think about moving the labia together like closing the vagina..notice if there is any movement in the inner labial folds. Think about squeezing the anus and look for a pucked up movement at the butthole. 

Moving on to the deeper layer of pelvic muscles – these are deep muscles and help support our organs. They are big and slow. Engaging these muscles starts with a squeeze and ends with a lift. Go back to a kidney bean. Think about pulling the kidney bean with your pelvic  muscles slowly up..up and further up inside your body ..like an elevator moving higher.

If you are looking at your anatomy you will notice the perineum slightly moving inwards.With your finger placed inside the vagina you will feel a sensation of puckering up and being pulled or lifted inside the body. 

Putting it all together- If your finger feels the tug at the opening those are your superficial muscles. If your finger then feels being pulled or lifted inside those are the deeper muscles. 

Some other CUES I us with my patients- 

Imagine using the muscles of your bottom as if-

• Pulling your underwear inside your body.
• Like vending machine claw..close the openings and pick them up inside your body
• Like an elevator door closing and then the elevator moving up all the way to the penthouse level
• Lips placed around a straw with a gentle “closure”. Using the deeper muscles as if pulling the last drop of your slurpy form the bottom of your drink cup.

How do you know you are doing it correctly?

Position – Name of the game is gravity. If you are learning to do a kegel squeeze, lying down is the easiest position. Horizontal positions take away the effect of gravity making it easier to squeeze pelvic muscles. Upright positions like standing introduce the resistance of gravity making the exercise harder. If you are a beginner stick to horizontal positions like lying down. If you are looking for challenging or functional positions then you are only limited by your imagination! 

Feedback – Our brain learns best with feedback. A handheld mirror can provide visual feedback  (or a phone in selfie mode if you don’t own a small mirror ). Your  finger can be used for tactile feedback. You can also use a rolled up towel under your perineum like a bike seat for feedback. A tampon can also act as a feedback and so can a sex toy  placed inside the vagina. There is no right or wrong kind of feedback. It all depends on your preference and learning style. If you need to watch, go for visual feedback. If you like to feel tactile feedback is a better path for you and of course you can mix and match! 

Kegel balls, Yoni eggs, Vagina weights, and biofeedback are all different ways of providing feedback to pelvic muscle squeezes.

Breathing – It is interesting how many of us hold our breaths whenever we are concentrating on something! Sometimes it is a habit and other times it is a way to generate more force. Either way breath-holding is best preserved for truly hard muscle challenges and Kegel is NOT one of them. I often advise my patients to count out loud or sing or talk to themselves through exercise to avoid breath-holding. When you are speaking ..you are breathing 😀

What next?

Once you have identified the correct muscle and ensured that you are consistently able to isolate the muscle then try the following kind of kegel squeezes- 

• Quick squeezes– How many can you do in 10 seconds?
• Endurance holds- how long can you hold a squeeze ?
• Resistance- With your finger placed inside the vagina check for resistance. Can you squeeze strongly while you are trying to pull your finger out? Is your pelvic muscle putting up a fight?
• Pressure- can you maintain the squeeze as you cough ? Are you able to hold up against the downward pressure of a cough on your bottom?

How do you know it’s working ?

One of these should be happening-

• It will get easier to squeeze
• You can hold the squeeze for longer time
• It will feel stronger
• You are no longer holding your breath
• You can squeeze the muscle correctly in different postures and positions
• The original reason why you started doing kegels ( like leakage or weakness) will get resolved. If it didn’t- Kegel is not your answer.

If you are struggling with finding the right Kegel, let’s chat. If you have mastered Kegels but are still dealing with your pelvic issues, let’s chat sooner. 

Namaste,

Darshana