Kegels: R U Doing Them Right?

Our friends at The National Association for Continence recently reported that fully 40 percent of women are doing Kegel exercises incorrectly.

Oh dear.

We want to do our part to correct that, because for one thing, it’s not really that hard to do them right. But most especially because, you really can’t do a single solitary thing to help you maintain pelvic health throughout your life that is more beneficial than Kegels. To avoid incontinence, pelvic organ prolapse, uncomfortable sex, urinary tract infections, a host of difficulties as we age.

Not. One. Thing.

And that goes for your mom. And your daughter.

And guess what? For any man in your life, too.

Yeah! Everybody!

Everybody! Do the Kegels!

But, well, we have a focus here at MiddlesexMD, so our links and discussion might be a bit more female-anatomy-ish. But here’s a very specific link for the men, just so you know I’m quite bullish about Kegels for men, too.

Okay. Let’s get our Kegels on. 

First, if you need a refresher, on your the pelvic floor muscles, I wrote all about that here. I encourage you to review that post so you can envision the lovely figure-eight sling of muscles that hold all of your important organs in their proper places, happily chugging along as you move through your busy day. 

Once you have a clear sense of that pelvic sling of yours, find a place to sit quietly, feet on the floor, straight out from your hips, hands just folded quietly in your lap, eyes closed, breathing softly, with the space and time to give this practice a little focus. 

Are you there? Good. Now, as if you were stopping the flow of urine mid-stream, tighten the muscles around your vagina. That’s all, just as if you were stopping the flow. 

And there they are! Those are the primary muscles we will be working!  Well done, you!

Let’s take it another step. Working just a little harder, imagine that you are sucking a heavy, marble ball into your vagina. But, let’s make it a warm one, and well lubricated! 

As you develop your sense of your inner landscape, try tightening your inner pelvic muscles to draw your pubic bones and tailbone together or imagine trying to draw your “sit bones” toward one another.

But! And here is where things can go wrong, and where people tend to run off the tracks. When you are doing your Kegels, you should not be tightening your buttocks. Let those stay relaxed. Don’t tighten your inner thigh muscles, either. Let those stay soft.

Definitely don’t hold your breath. Breathe softly. Do not suck in your gut. All is soft except that sling under your organs. Focus. And breathe. This thing that takes some concentration at first will become so natural with practice you will be able to do it while waiting in line at the grocery store. 

Here are further ways you can help yourself really refine your practice, and I love these recommendations, and very much encourage you to actually do them!

First, get up close and personal. Use a hand mirror and a good light to watch what happens when you contract these muscles. That’s right—look in the mirror at your pelvic floor in action. It’s pretty cool to see what you can do when you are working those muscles!

Second. Remember they are muscles, and like all muscles, they have a full range of motion that should be worked. Most of us do our Kegels just contracting them. But it’s good practice also to stretch, or elongate them. And one of the best ways to think about that is the Elevator visualization. It goes like this:

Think of your relaxed pelvic muscles as the first floor. Contracting your Kegels as we did for the urine-stop visualization is like taking them to the second or third floor. The marble sucking exercise is maybe the fourth floor. And if you use actual Kegel weights or barbells you can go to the higher floors still. But elongating, or stretching the muscles, is taking your pelvic floor to the basement. Something that’s very good for them. Elongation tends to happen naturally when you yawn. But it’s a nice thing to do for them at the beginning and end of your Kegel sessions. Stretching is a kind of pushing action, a little bit of a bearing down, to stretch the connecting ligaments a little bit, get the blood flowing. 

So, I hope that clears thing up. Don’t be among the 40 percent. And don’t let anyone you love be, either. Good pelvic health is everyone’s right. We ought to be the generation that ensures this for everyone.