Pelvic floor muscles and how to strengthen them

AndieM.Ed., RD, LDN, CLC, RYT-200

Pelvic floor strengthening exercises, also referred to as “Kegel exercises” involve a regimen of squeezing the pelvic floor muscles to maintain muscle tone and function. By working up to and maintaining a strong pelvic floor, you can promote a more efficient labor and birth, prevent tearing of the perineum (the tissue between the vaginal opening and anus) during delivery, facilitate postpartum healing, and throughout your life, avoid urinary and bowel incontinence as well as enjoy more pleasurable sex.

What to Do

Do your pelvic floor exercises correctly

It’s important to locate the correct muscles to exercise. To find them, tighten the same muscles that control your urine flow. You can practice by stopping the flow of urine the next time you are urinating, but note that this practice is to discover the correct muscles only. Once you have identified the correct muscles, your pelvic floor work exercises should not be done while urinating.

You can also insert your fingers into your vagina and squeeze the pelvic floor muscles; once your fingers feel squeezed, you’ve located the right muscles.

Perform your Kegel exercises by squeezing and releasing your pelvic floor muscles in a repetitive, rhythmic pulse, such as with your breath. For example, squeeze for 1-2 seconds as you exhale then release for 1-2 seconds as you inhale. For a deeper squeeze, hold for 10 seconds and then release for 10 seconds before engaging the pelvic floor muscles again. A combination of the two types – shorter squeezes and longer ones – may be most beneficial.

Practice 30 perineal muscle squeezes per day. You can split them up into 3 sessions of 10 squeezes each day, half of them at a rhythmic pulse and the other half with a longer squeeze and release (or 5 faster squeezes and 5 slower ones during each session). Breaking up the exercises throughout the day makes the idea of doing the exercises less overwhelming and may be more effective than just one long session of exercising.

Do your pelvic floor exercises every day – you can do them anywhere, anytime, in just a few minutes

Kegels are fairly easy to do but remembering to do them is a different story. Find creative ways to remind yourself – perhaps commit to doing your 10 squeezes with each meal or at certain landmarks during your commute to work and back or simply while looking out a window or at a favorite piece of art on the wall. One of the great things about Kegels is that you can perform them discreetly (even in public or while at the office), so if it’s easier for you to do 10 of them at spontaneous moments then go for it!

While at home, perform your pelvic floor exercises in a variety of positions such as on your hands and knees, sitting in a butterfly pose, standing, or lying on your side.

If you want to use pelvic floor exercise tools or weights first speak with your doctor

Balls or barbells can be inserted into the vagina to increase the effect of doing Kegels or as an adjunct form of pelvic floor exercise, as walking around with the weights will force the muscles to contract without any instruction (or additional effort) from you.

Use an app to help you schedule and perform your pelvic floor exercises

Consult with your gynecologist or a physical therapist specializing in women’s health and the pelvic floor for additional support

If you are unsure if you are performing Kegel exercises correctly, or if you continue to suffer from urinary incontinence despite practicing the exercises, then do not hesitate to find extra support. Your gynecologist, midwife, or nurse-practitioner may have expertise in pelvic floor therapies or they may refer you to a physical therapist or other specialist who does.