Here Is the Right Way to Do Kegel Exercises
Doing Kegel exercises is a bit like flossing—it’s a tiny little thing that you know you should be doing regularly to keep a crucial part of your body healthy, but for some reason, it just completely slips your mind until the next time someone asks you about your track record. (Or, more likely, the next time you click an article like this one.)
And, hey, that’s not your fault. Unlike brushing your teeth, washing your face, and wiping front-to-back, doing Kegel exercises probably isn’t something that was drilled into you growing up...or even as an adult. Instead, most people don’t even hear about the importance of Kegels until after having a child or winding up in a pelvic floor physical therapist’s office with a health issue to solve. While these pelvic floor exercises (first introduced to the world by gynecologist Arthur Kegel in 1948) are often associated with postpartum recovery, they’re definitely not just for new parents. In fact, almost everyone can benefit from making them part of their daily fitness routine. Plus, you can do them pretty much anytime and anywhere (yes, even while on a boring Zoom call that could have been an email). Below, we asked an ob-gyn and a pelvic floor physical therapist to tell us all about Kegels, what they can do for you, and how to know if you’re even doing them the right way.
What are Kegel exercises?
So, what is a Kegel exercise, exactly? Quite simply, a Kegel is a contraction of the pelvic floor muscles. “We have approximately 24 pelvic floor muscles located in the pelvis, arranged in three layers,” says Amy Hill Fife, a pelvic health physical therapist with a private practice in Grand Junction, Colorado. All those muscles have pretty important jobs, which is why strengthening these muscles can benefit you in a variety of ways.
What do Kegel exercises do?
When done correctly and consistently, Kegel exercises can strengthen your pelvic floor muscles, which have four primary functions. The first role is to help support all of your abdominal organs, including the small and large intestine, the uterus, the liver, and the kidneys. The pelvic floor muscles also provide sphincteric control for your bladder and bowels, which basically means they keep you from leaking stool or urine, Fife explains.
There’s also a sexual function. “Some of the pelvic floor muscles go into a rhythmic contraction when you climax,” Fife explains. And the final function is core stability—the Kegels work together with abdominal muscles, hip muscles, and back muscles to help you maintain core balance and strength.
People may have a weak pelvic floor for various reasons, like pregnancy and childbirth. A weakening of these muscles is also a common part of aging.
Weak pelvic floor muscles present just like any other muscle weakness in your body, explains Fife. Typically, the muscles will either lack strength, endurance, or both. “Common signs of a weak pelvic floor include leaking urine with cough, sneeze, or exercise, inability to control sudden bladder urges (so you rush to the bathroom), pelvic pressure, difficulty holding back gas, decreased ability to achieve an orgasm, and decreased sensation when having penetrative intercourse,” explains Fife.
“In serious cases, a weakening of the pelvic floor could eventually result in your pelvic organs dropping and creating a bulge into your vagina, rectum, or bladder—known as pelvic organ prolapse,” says Sherry Ross, M.D., ob-gyn and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California.
Symptoms of a prolapse range from uncomfortable pressure in the pelvic area to leakage of urine. Fortunately, Kegels can help delay or even prevent pelvic organ prolapse and other symptoms related to a weak pelvic floor. According to Dr. Ross, doing Kegels consistently can lead to noticeable changes to your pelvic floor strength in about eight to 12 weeks.
Since pregnancy is one of the reasons the pelvic floor muscles can weaken, Dr. Ross recommends all pregnant people do Kegel exercises for pregnancy. By helping to strengthen these muscles, they can prevent symptoms such as urine leakage and pelvic organ prolapse caused by a vaginal delivery. A 2020 Cochrane Review1 of 46 trials involving 10,832 women concluded that starting a structured pelvic floor therapy practice early in pregnancy may help prevent urinary incontinence later in pregnancy and after delivery.
Experts also recommend a better knowledge of your pelvic floor to give you better control during the pushing phase of a vaginal delivery. (Also, you don't have to actually give vaginal birth to affect pelvic floor muscles—simply being pregnant, especially multiple times, can affect your pelvic floor's strength.)
Worth noting: While Kegels can help weak pelvic floor muscles, they can actually exacerbate pelvic floor muscles that are too tight. While consistently working out these muscles—just like any other muscle in the body—is beneficial for most people, stop and check in with a health care provider if you ever experience any pain with Kegels. “Some people’s pelvic muscles are too tight or they have pelvic pain due to muscle tightness, and if they do more Kegels they will likely make their problems worse,” warns Fife. In these cases, a pelvic floor physical therapy can actually help you learn how to “un-Kegel.”
How do you know if you are doing Kegels correctly?
If you’re new to this, it’s important to make sure you learn how to do Kegel exercises properly before you start pumping out a bunch of reps. It starts with figuring out where those pelvic floor muscles are—because they’re internal, you can’t actually see what happens when you tighten or relax them. The easiest way to identify them is to stop the flow of urine while you’re peeing, says Dr. Ross. “Hold the contraction for three seconds then relax, allowing the flow of urine to continue,” she says. “Repeat this a couple of times and you’ll have identified your Kegel muscles.” (That said, you don’t actually want to perform Kegels regularly while you’re peeing, so once you’ve identified these muscles, find another time to do them.)
Another way to identify your pelvic floor muscles is by feeling inside your vagina while you perform Kegel exercises. Dr. Ross suggests inserting a finger or two into your vagina and then squeezing your pelvic muscles as if you’re trying to hold in urine. You should feel your vagina tighten and your pelvic floor move upward. To return to the starting position, simply relax your muscles. You can even ask your gynecologist if you're doing Kegels correctly at your next exam—they can insert a finger into your vagina, have you flex and relax, and give you feedback.
If you can feel a lift of the pelvic floor muscles (i.e., your anus moves up and in and there’s a tightening around your urethra and your vagina, predominantly in the front area of your pelvis near your pubic bone), you’re doing your Kegels correctly, says Fife. You should also be able to feel those same muscles completely relax, she adds. Don’t worry if you find this tricky at first—it’s all about practice.
What is the best position for Kegel exercises?
Now that you know where your pelvic muscles are, how do you give them a good workout? Before you start, empty your bladder and get into a comfortable position—Dr. Ross suggests sitting or lying down.
Fife also recommends lying down to do your Kegels when you’re starting out, with the aim of progressing to a seated position, then standing. The ultimate goal is to be able to do your pelvic floor exercises wherever you are, whatever you’re doing.
“Eventually, you’ll be able to do your Kegel exercises while you’re working out, lifting weights, lifting your children, or doing household chores,” says Fife. The goal is that if Kegels are a priority to you for health reasons, you'll still be able to fit them in even if you have a busy schedule. The beauty of them is that you can do them anywhere, without anybody knowing—at your desk in the office, on the bus, or in the line at the supermarket.
Do Kegel weights "tighten" your vagina?
You might have heard about Kegel weights, which are inserted into the vagina with the aim of helping you work your pelvic floor. They come in all sorts of shapes and sizes, and some even connect to an app and let you play video games while you’re doing the exercises. But do these Kegel ball exercises and vagina weights actually work, or are they just a marketing ploy?
“Kegel weights don’t directly tighten the vagina because the vaginal tissue is a completely different type of tissue. It's not muscle tissue, like the pelvic muscles are,” says Fife.
However, doing more Kegel exercises (with or without a Kegel trainer or similar tool) can help to strengthen the pelvic floor muscles, which surround the vagina—so it may feel like you have more tightness in that area. For emphasis, though, this would only be a potential effect of really doing Kegels consistently and correctly! And also, there are lots of myths about it being common for vaginas to be “too loose," especially after vaginal childbirth. These myths can cause a lot of unnecessary fear and urges to “tighten” your vagina, so here's what to know about how your vagina may actually change after childbirth—including when it comes to tightness.
How many Kegels should you do per day?
When you're in position and ready to knock out some Kegels, contract your pelvic floor muscles and hold for five seconds, then relax for five seconds. “Try it four or five times in a row, working up to keeping the muscles contracted for 10 seconds at a time and relaxing for 10 seconds between contractions,” says Dr. Ross. “Aim for at least three sets of 10 to 15 repetitions a day.”
Ideally, anything from 30 to 80 Kegels per day is optimum, says Fife. (But if you have a pelvic health issue that Kegels may help, some are better than none, especially as you first start getting used to them!) However, Fife recommends varying the type of exercise you do. “Some of them should be done as quick flicks and others as endurance contractions,” she says.
Think of it like running—a quick flick works the fast-twitch muscle fibers, like a sprint. “It's a real quick contraction of the Kegel, like a ‘wink’ of the muscles,” Fife explains. On the other hand, an endurance contraction is for slow-twitch muscle fibers, like a long run. For this, you hold your Kegel for five to 10 seconds, then completely relax. Fife recommends doing half of your Kegel exercises as quick flicks and the other half as endurance contractions. Just like the other muscles in your body, those in your pelvic floor may benefit from a balanced, well-rounded exercise routine.