Kegels and Kegel Breathing
By Sherrie Palm

There’s so much controversy over Kegel exercises, do they work or not and what’s the point of doing Kegels if they won’t effectively address pelvic organ prolapse and related symptoms such as incontinence. I thought I would throw my two cents in for whatever it’s worth. I’ll give an explanation on technique at the end of this article for those of you who are confused about Kegel method.

Part of the problem with how effective Kegels can be is that many women are not familiar with the proper technique. The pelvic floor or PC muscle is similar to other muscle tissue, use it or lose it. There isn't much value in exercising any muscle, whether strength training external muscles like biceps, quads, or glutes, or internal muscles like the PC, unless you are going to do it properly. Utilizing the wrong Kegel technique is about as beneficial as going to a fitness club and just standing around looking at the weight machines.

Every woman should have a pelvic floor exercise regimen; that being said, it is often beneficial for women to seek guidance by a physiotherapist to assure proper method. Additionally, women with a tight pelvic floor (the PC muscle can be both tight and weak at the same time) have a more difficult time navigating technique, and guidance by a healthcare professional can be very beneficial. 

Whether you are in early stages of POP and are trying to avoid surgery, or you’ve already had surgery and have shifted to the maintenance mode (all women who’ve had surgery for POP should continue with maintenance for life, similar to continuing to brush your teeth post cavity repair), Kegels are pivotal for life-long pelvic floor health.  Women who are waiting to make the decision whether or not to move forward with surgery should utilize treatments & exercise routines to optimize their pelvic health.

On top of a reduction in leakage and bulging Kegel's may provide is the possible added benefit of increased sexual sensation; who doesn’t want that? Recapturing PC muscle strength also has the potential to “bring back that loving feeling”. Relationships frequently shift sideways as a result of bedroom difficulties where you “weren’t that into it” because you’ve lost sexual sensation. Since most women are continuously multi-tasking and are running on empty, engaging in intimacy when there is no physical satisfaction can be just one more job to do. 

Some women with POP will struggle with Kegels because a rectocele can impact your ability to effectively contract. Constipation is both a cause and a symptom of POP women commonly experience. When your bowels are full of fecal material, your ability to contract your PC is radically reduced. As a woman with long term IBS issues, believe me when I say that some days it is simply impossible to get much contraction if any at all. It gets a bit frustrating, and at times I’ve wondered if I was losing PC contraction strength, but as soon as I have one of those lucky days where everything “comes out OK”, my ability to contract is fully restored. Rest assured ladies, you should continue to Kegel even on the days when you feel like nothing is happening.


 Here’s a how-to for Kegel exercises; once you have mastered the technique and understand the sensations, you can do them anywhere/anytime. Your PC muscle is like a trampoline that sits below your pelvic organs. When you stop the flow of pee, the muscle you are contracting is the PC muscle. Empty your bladder if possible prior to doing Kegels. When you are initially trying to figure out proper Kegel technique, do them lying down. Once you have your technique perfected, you can do them lying down, sitting, or standing.

Take a full breath in and let it out completely; the more you relax prior to doing Kegels, especially when first trying to figure out technique, the more you will be in touch with the sensations you experience. Most people contract the stomach when breathing in and you may need to retrain this habit. As you let the air out, let your tummy go flat and slowly contract the muscle that causes the same sensation as when you stop the flow of pee, contracting it up as tightly as you can. If you have difficulty with this, watch how a baby breathes when sleeping, breath in expands the baby belly, breath out contracts the baby belly. Contract slowly, deliberately, trying to pull your belly button up and in while tightening the PC muscle up and in within first your vagina and then the rectal sphincter. Try to hold this contraction as tightly as you can for as long as you can; it may only be a very short time initially but your ability to contract should improve with time and practice. Release and repeat 5-10 more times. Do not go beyond 10 contractions; fatiguing your PC muscle is not beneficial. You can alternate between sustained contractions and quick fluttering contractions (contract, release, contract, release) once you have some control of your PC muscle. After you understand the sensations, you can advance to doing Kegels at a time and place that is easy to remember. 

Kegel Breathing is a technique to incorporate breathing and pelvic floor contraction patterns to benefit PC muscle strength while engaging in normal daily routine activities. This is a tool you can build into nearly any daily ritual, so think about it related to daily behaviors you perform often, or regularly enough that you will have many opportunities to repeat the practice so it sticks in your memory and becomes a habit. Simply take in a long, deep, relaxed breath with your belly loose and sticking out, then on the exhale contract your PC or pelvic floor up and belly in. Be aware of the muscle contraction sensation, you want to contract as tightly as you can and hold the contraction for as long as you can. That’s it, not much to it! Every time you contract your PC regardless of where or when, you are helping establish the subliminal habit. Do it often enough and you will start to do it without conscious thought.

We all have so much on our plates today; who has time for an extra workout? The great thing about Kegels or Kegel breathing is you can practice anytime, anywhere; you can adapt the technique to fit your personal needs. You can Kegel or Kegel Breathe when brushing your teeth, when pushing a shopping cart, during commercials when you are sitting on the couch watching TV. How about when you are sitting at your computer; we certainly do that often enough! The list of potential times to Kegel or Kegel Breathe is endless. Incorporating Kegel breathing into your walk is a win/win for pelvic floor health. It doesn’t matter when you Kegel or Kegel Breathe, what matters is that you do it consistently. As you establish a core/floor strengthening habit into your daily routine, you will find Kegels and Kegel Breathing become a subliminal ritual in a very short period of time.

Kegel on!

Every Voice Matters

February 2012