Kegel exercise

Kegel exercises or pelvic floor exercises are a type of workout which involves alternatively squeezing and releasing your pelvic floor muscles. It is done to strengthen the muscles of the pelvic floor. 

The pelvic floor consists of the muscles between your tailbone (coccyx) and pubic bone or in simple words the muscles beneath your hip bones. These muscles support various organs like urinary bladder, rectum, anus, uterus and vagina in women and bladder, rectum and anus in men.

Various groups of muscles (sphincters) which surrounds the urethral, vaginal and anal opening pass through the pelvic floor. When these muscles contract, the respective internal organ moves upward and sphincters tighten to close the openings of vagina, urethra and anus. For passing urine or stool you have to relax these muscles.

Quite obviously, when these muscles get weak the respective organ loses its control and can not function properly, resulting in loss of control on urine, stool as well as gas discharge. 

Exercising all of these muscles via Kegel or pelvic floor exercises will help you regain control over defecation, urination and passing wind.

Kegel exercises are generally suggested in case of the following conditions:

• After gynaecological surgery
• After vaginal childbirth (Natural childbirth)
• After prostate surgery
• Long-standing constipation
• Excessive weight gain
• Ageing
• Constant and heavy coughing
• Drop in estrogen level after menopause
• Brain and nerve disorders

All of the above-mentioned conditions are usually associated with weakening of pelvic floor muscles and loss of bowel control (faecal incontinence) and urine control (urine incontinence). Regular practice of Kegel exercises not only helps in the restoration of normal bowel and bladder functioning but also aids in eliminating the need for corrective surgery.

A pregnant woman can get utmost benefits of Kegel exercise if she practices it regularly. During pregnancy, pelvic floor muscles are under much strain due to the weight of the growing baby. In addition to this, pregnancy hormones also soften this group of muscles. All of this can be minimized by doing Kegel exercises regularly. Kegel exercise also reduces post-pregnancy healing time significantly.

Kegel exercises are quite simple and can be performed in a sitting or lying position. You can even do it while eating, sitting in your chair, driving, watching television or while resting. 

This exercise is therefore quite versatile and easy. But to do it right you first need to identfiy your pelvic floor muscles. Once you have done that, you can follow our step-by-step guide to the exercise.

Finding your pelvic floor muscles is not as difficult as it seems. Try pretending to stop urination, you will feel certain muscles in your vagina, rectum and anus move up, these are the pelvic floor muscles you have to work on. Make sure that your thighs, abdomen and hips are not tensed. Even if it does not make sense to you right now, try one of the following steps and see if they work for you:

For women: Insert a finger in your vagina and tighten, contract or squeeze the muscle as if you are trying to hold urine and then relax. You will feel your muscle movement (upward and downward) inside there. That's the muscle that needs to be strengthened.

Read more: Know your vagina

For men: Put your finger inside your rectum and tighten the muscles as if you are trying to hold urine and then relax. If you feel muscle movement (upward and downward) inside the rectum, you have got the right muscle.

Both men and women: Pretend you are stopping yourself from passing gas voluntarily, the same group of muscles helping you do that comprises the pelvic floor.

Once you get to know the concerned muscles, it's time to know how to do the Kegel exercise. Let's get into it stepwise:

Step 1: Make sure your bladder is empty and you don't feel like passing stool

Step 2: Sit in a chair or on your bed wherever you are comfortable. You can even lie down on bed or floor

Step 3: Tighten or contract your pelvic floor muscles and count for 3 to 5 seconds. Make sure your abdomen, buttocks, thighs and chest muscles are relaxed

Step 4: Relax the muscles and count upto 3-5 seconds again

Step 5: Once you are comfortable with the 5-second duration, extend it to 10 seconds of contraction followed by 10 seconds of relaxation

According to the National Association of Continence, there are two types of Kegel exercise:

Fast-twitch Kegel exercise: This form of Kegel exercise focuses on the fast-twitch muscles which rapidly stop the urine flow to prevent leakage. To work on this muscle, you should squeeze or contract the muscle as you exhale. After that your breathing should be normal as you continue with the exercise. The muscles are promptly squeezed, moved up and released.

Slow-twitch Kegel exercise: This form of Kegel exercise is directed to provide supporting strength to pelvic floor muscles. During this exercise, the slow-twitch muscles are squeezed, moved up, held for few seconds and then released. It is totally alright if you find it difficult to hold in the beginning for even 1 to 2 seconds, but you will pick up speed after a while. 

If you are not able to perform kegel exercises or are unsure if you should do it on your own, you can take help from professionals to get yourself trained. A physical therapist or nurse might be your trainer. Never hesitate to consult an expert. It is always a wiser decision to seek help rather than doing it wrong. 

Pregnant women should consult their doctor before going for Kegel exercises.

For training pelvic floor muscles, resistance training with vaginal weights, wands or other devices might also be helpful. These equipment should ideally be recommended by health professionals.

• For effective results, Kegel exercises should be performed at least 3 times a day or to a maximum of 5 times per day (morning, afternoon and night)
• Every session should include minimum of 10 episodes of contraction and relaxation

It would take about 4 to 6 weeks of regular kegel exercise to notice any apparent results 

Remember, it's not the quantity or the number of times you do the exercise every day, but the quality that matters the most.

Kegel exercises have enormous benefits in strengthening pelvic muscles. However, while doing these exercises, you need to be aware of certain red flags which can do more harm than good. Few of them are mentioned below:

• After getting a basic idea about Kegel exercise, don't deliberately employ them while urinating. Even if you do, it should not exceed more than two times a month. If you regularly try Kegel exercise while urinating, it might lead to the weakening of pelvic floor muscles, which can eventually lead to urinary, bladder and kidney malfunction.
• Forceful or inaccurate practise of Kegel exercise might cause excessive tightening of vagina muscles in women, leading to pain during intercourse
• Increasing the frequency of Kegel exercise would not accelerate muscle tightening or toning process. In fact, excessive load on pelvic floor muscles will lead to muscle fatigue which might just increase urine leakage
• Urinary or faecal incontinence can recur if you stop practising Kegels. You need to do it for whole life to maintain muscle tone and strength
• Don't expect to gain control over your pelvic muscles within a week of starting Kegel exercise. It might take months to see apparent results. Have patience while adopting Kegel to master control over pelvic floor muscles.

Just after a few days or weeks of pelvic floor muscle training with Kegel exercise, you will see some changes in the behavioural pattern of these muscles, which may manifest in the form of the following effects:

• Long interval between bathroom visits
• Minimal urinary leakage 
• Ability to do more repetitions
• Your innerwear will also reflect your improvement by being dry for a longer period of time
• Childbirth becomes comparatively easier
• Pregnant women develop more control over pelvic floor muscles during labour and delivery
• Regular practice of Kegel exercises accelerates perineal healing, helps regain bladder control, and strengthens pelvic floor muscles post-pregnancy