If you’ve never thought twice about your pelvic floor, now’s the time, These muscles support your bladder, small intestine, rectum, and, for women, uterus. Kegel exercises, which serve as a series of tightening and releasing movements, are commonly suggested as a way to strengthen your pelvic floor muscles. This way, you can control your ability to go to the bathroom. But there’s a bit of controversy around the safety of Kegels during pregnancy. Namely, whether they cause issues during labor and delivery or truly strengthen the pelvic floor in the long run. Our experts break down what Kegels are and how to do them properly, as well as share the benefits for pregnant and non-pregnant women alike.
What are Kegels and are they beneficial?
“Kegel exercises help to make the muscles in your pelvic and vaginal area strong,” explains Sherry Ross, M.D., an OB-GYN and a women’s health expert at Providence Saint John’s Health Center in Santa Monica, California. “These pelvic floor muscles support the uterus, bladder, and bowels, which control bladder and bowel function. Finding the right muscles to tighten or squeeze at first can be tricky, but with practice, you will find success.”
They help build strength.
According to Aaptiv trainer Kira Kohrherr, a Kegel is basically a repetitive contraction of the pelvic muscles that helps build strength. Like any other muscle in the body, notes pelvic floor therapist Lindsey Vestal, it needs balance—a good mix of tightening and relaxing—for both daily functioning and an experience such as childbirth.
“Optimal pelvic health is a balance between strength and suppleness,” Vestal says. “For example, in order to tone your bicep, you would bend your elbow and then straighten it while holding your dumbbell. Without even thinking twice, you know that full range of motion is important to build strength. You also know that having an overly tight bicep wouldn’t serve you. It is not ideal (or functional) to walk around with your bicep stiff and rigid and held tightly contracted. In order to strengthen our pelvic floor muscles fully, they need to be able to relax so that we can gather them or flex them again.”
Each woman is different.
While Kegels can certainly help with conditions such as urinary incontinence, that may not be the case for every woman. Some women could do a million Kegel exercises a day and still pee when they sneeze, Kohrherr says. Whereas others may not do a single one and skip any pelvic floor issues as a whole. But for those with weak pelvic floor muscles due to pregnancy, childbirth, aging, or being overweight, Kegels can help prevent annoyances (such as leaking urine) or serious issues (such as pelvic organ prolapse), Ross says.
How do you properly perform a Kegel?
“The easiest way to identify your pelvic floor muscles is to pee, and while doing so, stop the flow of urine midstream and hold it,” Ross says. “Hold the contraction for three seconds, then relax, allowing the flow of urine to continue. Repeat this a couple of times to identify your Kegel muscles. Or, insert your first two fingers in your vagina, and squeeze your pelvic muscles as if you are holding urine. You should feel your vagina tighten and your pelvic floor move upward. Then relax your muscles and feel your pelvic floor return to the starting position.”
After you have a good sense of what those muscles feel like, Kohrherr says you can start performing Kegels while sitting, standing, or lying down. Most experts suggest contracting the pelvic floor muscles for about five seconds and relaxing for the same amount of time. Then repeat that tighten-and-release pattern a few consecutive times. Ross recommends working up to at least three sets of ten to 12 repetitions a day.
A tricky element of Kegels is that you can’t actually see your pelvic floor muscles move, Vestal notes. “Unlike the other muscles in our body, they don’t move a joint,” she says. “When we bend our arm, we see our elbow move. This doesn’t happen with the pelvic floor, so it becomes a bit mysterious to evaluate, and we wonder how it’s working. When something in our pelvic floor isn’t working for us (like leaking urine), we immediately think we need to tighten it. This may not be the case. When we see dysfunction in our pelvic floor, it’s not a clear-cut sign of being tight or loose. It’s a sign that the muscle isn’t coordinated or moving through a full range of motion.”
Should women do Kegels during pregnancy?
Here’s where it gets more complicated. Again, experts generally agree that when performed properly, Kegels are good for strengthening your pelvic floor muscles. Still, it’s not always that straightforward. If you already have tight pelvic floor muscles or undiagnosed pelvic pain, or you can’t quite figure out how to do a Kegel, then continually trying to contract those muscles can create more tension in your pelvic floor. This does not help during childbirth when you need to shift back and forth between tightening and releasing such muscles.
Full range of motion is key.
“Whether pregnant women should be doing Kegels is challenging to answer in a black-or-white manner,” Vestal agrees. “Unfortunately, pelvic health is not one size fits all. So much depends on your body’s needs. There are certainly benefits for a pregnant mom to strengthen her inner core (which the pelvic floor is a part of) for delivery and postpartum recovery. However, delivering a baby is an act of release and letting go. Your pelvic floor needs to move through full range of motion. Our general understanding of Kegels focuses more on tightening. If a pregnant mom just focuses on tightening her inner core, this could be an extra challenge for her when it comes to delivery. It really is all about balance in all things—including the pelvic floor!”
In Kohrherr’s opinion, at the beginning of the second trimester, pregnant women should shift from Kegels to squats. The former consistently pulls your sacrum inward and may promote pelvic floor weakness. But squats pull your sacrum back and stretch your pelvic floor to optimal length and strength. Conversely, Ross says there are absolutely no downsides to doing Kegels during pregnancy. They do not increase your risk of complications or your chance of having a C-section.
Kegels help with healing after delivery.
“Since pregnancy is one of the reasons the pelvic floor muscles can be weakened, Kegels can help strengthen these muscles and delay symptoms of loss of urine and pelvic organ prolapse caused by a vaginal delivery,” she advises. “Having the knowledge of your pelvic floor and vaginal muscles helps you better control the pushing phase of labor. Kegels also help with the healing of the vagina and control of the bladder following a vaginal delivery. If you have a shorter labor and faster postpartum recovery, Kegel exercises are well worth the effort.”
All in all, Kegels are one of those exercises best done in moderation. If you ever feel pelvic pain while performing them, reach out to your doctor. For those curious about strengthening pelvic floor muscles in general, Vestal advises it’s best to get a professional assessment from a pelvic floor therapist who can create a unique program for your needs.