You may or may not have heard of Kegels, the pelvic floor muscle exercise made famous by gynecologist Dr. Arnold Kegel to reduce leaking, pelvic organ prolapse, and assist in pregnancy. Your pelvic floor muscles act during orgasm, hold in your pelvic organs, stabilize your pelvis and back, relax during toileting, sex, and childbirth, and keep you from leaking at all other times. There is some controversy over whether people should perform Kegels. Today, we will clear up some misconceptions!
Myth #1 — Kegels are a squeeze of the vagina
Kegels engage more than just the vagina. To understand the Kegel we first must understand the pelvic floor muscles. This group of muscles acts like a sling or hammock running from your pubic bone to your tailbone and to each side of your sitting bones (those two bony knobs under your butt when you sit down). The pelvic floor muscles run under and around the vagina or penis, urethra, and anus making figure 8’s. A good Kegel should squeeze and lift the whole hammock of muscles. Then relax, let the hammock hang down and open for at least as long as you squeeze. The relaxation is just as important at the squeeze. Women can feel the contraction at the opening of the vagina and near the anus. Men can do Kegels as well, they may notice a lift and pulling in of the penis.
Myth #2 Kegels can make you constipated
Kegels will not make you constipated. If you are squeezing to avoid a bowel movement then yes, constipation can occur. Don’t hold it in. To avoid constipation go as soon as you feel an urge. The longer the rectum sits full, the longer your body ignores the call to use the toilet, the drier and harder your poop becomes. If constipation is an issue for you, properly performed Kegels will not make things worse. In fact, as you increase the range of motion for your pelvic muscles, you may find it easier to have a bowel movement. During a bowel movement you should perform a reverse Kegel, completely relaxing the pelvic floor muscles. I describe some techniques in Myth #4 below. For those struggling with constipation, consider increasing your warm fluids, fiber, and fun exercise to get things moving. Also do not squeeze to push poop out. You are likely tightening and making it harder for yourself. Instead, lean forward or squat, breathe deep and easy into your belly, and let your gut do the work.
Myth #3 Kegels make it harder to give birth
Women hear that strengthening their pelvic floor will make it harder for the baby to come out. Properly performed Kegels also tone the abdominal muscles which can make pushing easier, decrease back pain, and prevent leaking during pregnancy . Each squeeze and lift should completely relax. Starting in the 3rd trimester, I suggest women begin to train relaxing their pelvic floor muscles with an abdominal contraction to simulate muscle activity during delivery.
Myth #4 Kegels can lead to pelvic pain and nerve entrapment.
Some folks might get only half the message about Kegels, the squeeze. They might go around all day squeezing without relaxation because of habit, stress, or anxiety. Improperly performed exercise of any kind can unfortunately lead to pain. Try it: Squeeze your hand into a fist, hold it as tight as you can for as long as is comfortable. You end up on the verge of pain right? Notice your hand is pale when you open it. A constant squeeze limits the blood and nerve flow to the area which can increase pain or dysfunction. Some people may have a weak and tight pelvic floor and not know it. These folks need to focus on the relaxation, not the squeeze. If you are having trouble relaxing your Kegel try a flat foot squat, or child’s pose. Visualize your pelvic hammock hanging down and open with deep belly breathing. As your belly fills with air, imagine the air filling your pelvic hammock.
Myth #5 Kegels take too much time
A Pelvic Floor Exercise program takes only a few minutes of your day. The beauty of the Kegel is you can do it any time anywhere, and no one knows except for you! Squeeze and lift every time you cough, sneeze, bend over, or stand up. Squeeze in a few while waiting, brushing your teeth, or after using the toilet. Never Kegel while peeing or pooping; it sends the wrong signal to your nervous system and increases urinary retention and UTIs. I do not recommend Kegels while driving, as it is not safe to multitask while behind the wheel. For strengthening: perform 50-80 squeezes daily For maintenance: 30 squeezes should be enough. Use both quick contractions, and longer holds. A good goal is to work your way up to ten ten-second holds, and ten quick one-second holds. Be sure to relax between for at least as long as you squeeze.
Kegels are important to do every day. If you are old enough to vote, Kegels should be a daily part of your life, like flossing your teeth! Up to 40% of women do not do Kegels properly on their own. If you are at all unsure, have difficulty starting the stream of urine, or performing Kegels causes you discomfort, stop trying, then see your physician or local Pelvic Physical Therapist!