Kegel exercises: how to do them and what they are for

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Kegel exercises are one of the most effective ways to improve pelvic floor health. As midwives, we have seen first-hand how they can help prevent and treat common problems after birth, such as urinary incontinence and pelvic organ prolapse.

What are Kegel exercises and what are they for?

Kegel exercises are a series of muscle contractions and relaxations performed to strengthen the muscles of the pelvic floor. These muscles sit at the base of the pelvis and are responsible for holding the bladder, the uterus and the rectum in place. Kegel exercises are safe, effective and can be done at any time and anywhere, with no special equipment.

What are Kegel exercises and what are they for?

Kegel exercises are a series of muscle contractions and relaxations performed to strengthen the muscles of the pelvic floor. These muscles sit at the base of the pelvis and are responsible for holding the bladder, the uterus and the rectum in place. Kegel exercises are safe, effective and can be done at any time and anywhere, with no special equipment.

The aim of these Kegel exercises (pelvic floor exercises) is to strengthen the pelvic floor muscles. If you are experiencing problems related to your pelvic floor, such as urinary incontinence or muscle weakness, doing exercises to strengthen it can be beneficial for improving your symptoms.

However, these exercises have not consistently been shown to prevent new problems from developing. It is important that you talk to your midwife before starting any exercise programme for your pelvic floor muscles, as there may be situations in which they are not recommended, such as injuries that need to heal before the exercise can be beneficial.

In addition, people with myofascial pelvic pain syndrome may find that their symptoms get worse when doing these exercises, and in this case they may need a physiotherapist with specialist training for treatment. Your midwife can help you determine whether pelvic floor muscle exercises are suitable for your situation, teach you how to do them correctly and, if necessary, refer you to a specialist physiotherapist.

Urinary incontinence and Kegel exercises

Urinary incontinence happens when a person leaks urine or loses control of their bladder. There are different types, including:

• “Stress incontinence”, which happens when the muscles and tissues around the urethra do not stay properly closed when there is an increase in pressure in the abdomen (for example, when the person coughs, sneezes or does something strenuous).
• Stress incontinence, which is common in people who have given birth. It can also occur after surgery to treat prostate cancer or an enlarged prostate.
• Another type is called “urge incontinence”; it is when a person regularly feels a sudden, urgent need to urinate.

Faecal incontinence and Kegel exercises

Faecal incontinence refers to the involuntary loss of liquid or solid stools. “Anal incontinence” can also mean the involuntary passing of wind. During a vaginal birth, injuries to the pelvic floor muscles can occur and contribute to incontinence.

Pelvic organ prolapse and Kegel exercises

Another problem is pelvic organ prolapse, which happens when the bladder, rectum or uterus descends and bulges out through the vagina. This can happen if the pelvic floor is weakened and unable to support the organs. While some women with pelvic organ prolapse have no symptoms, others notice a feeling of fullness or a lump in the vagina.

How do you do Kegel exercises?

In short, Kegel exercises consist of squeezing, holding and relaxing the pelvic floor muscles. Bear in mind that it is not recommended to practise Kegel exercises by actually stopping your urine flow on the toilet, because it can cause a urinary tract infection.

To do them, it can help to imagine that you are really sitting on a marble (do not use a real marble) and to imagine that you are trying to lift the marble off the chair with your pelvic floor muscles, squeezing the muscles closest to your vagina and anus.

It can be difficult to learn to do Kegel exercises without using your abdominal muscles, buttocks or thighs. But it is important to learn how to do them correctly so that your Kegel exercises are effective. This is a normal part of learning that will become easier with practice and time.

How do I know if my pelvic floor is in good shape?

You will know you are doing Kegel exercises correctly once you manage to isolate the right muscles to squeeze during the exercise. That way you will achieve:

• Squeeze: Tighten your pelvic floor muscles
• Hold: Keep squeezing your muscles for between eight and ten seconds. You may not be able to hold the contraction for that long at first, but over time you will develop the strength you need
• Relax: Relax your pelvic floor muscles completely. This step is very important, just as important as knowing how to squeeze your muscles.

After a period of pelvic floor training, try to hold your pelvic floor contraction more strongly and for longer before relaxing it.

To do Kegel exercises, having your midwife's support can help you a great deal to identify which muscles to squeeze so you do them correctly. She will show you by inserting a finger into your vagina and asking you to squeeze your pelvic floor muscles. Tighten the muscles as if you were trying to stop your urine flow or hold in wind (farts).

Position for Kegel exercises

Kegel exercises can be done in any position (standing, sitting or lying down) and you can even build them into your daily routine, as you feel more comfortable and get used to doing them.

How many times can I do Kegel exercises?

Kegel exercises normally consist of doing these exercises (squeezing the pelvic floor, holding the squeeze and relaxing) eight to twelve times per session, over three sessions a day. It is true that this is the best option, although the number of repetitions will depend on each case, so discussing it with your midwife can be ideal.

The most important thing, as well as doing them well, is to keep up the exercises for at least 15 to 20 weeks. As we know, it takes time to strengthen the pelvic floor muscles, especially if they have been weakened or injured after birth.

What are the benefits of Kegel exercises?

The benefits you get from Kegel exercises come from strengthening your pelvic floor muscles, and they are useful in the following situations.

• Prevention of urine leaks in stress incontinence: Stress incontinence is urine leakage when doing certain things that overload the pelvic muscles, and it is common. Once you know how to squeeze your pelvic floor muscles effectively, you can get into the habit of doing it whenever you are going to laugh, cough, sneeze, lift something heavy or do anything else that could cause leaks.
• Managing sudden urges to urinate: People with urge incontinence feel a strong need to urinate suddenly. If you get this urge, instead of running to the toilet, sit down or stay still and squeeze your pelvic muscles. Once the urge eases, you can go to the toilet.
• Improvement of faecal and anal incontinence (involuntary loss of stools or wind).
• Relief of the symptoms of pelvic organ prolapse, such as the feeling of fullness or pressure in the vagina.

If you have any of these problems and pelvic floor muscle exercises do not seem to help after several months, talk to your midwife or your doctor. They may recommend changing the way you do the exercises or trying other methods. Although pelvic floor muscle exercises can be beneficial, many people with incontinence or pelvic organ prolapse also need other treatments.

Conclusion: Kegel exercises

In short, Kegel exercises are an effective and safe way to strengthen the pelvic floor muscles, which can help prevent and treat problems such as urinary incontinence, pelvic organ prolapse and sexual dysfunction. It is important to learn to do the exercises correctly and to do them regularly to get the most benefit.

If you have problems related to your pelvic floor, it is advisable to talk to a health professional for a proper assessment and treatment. With regular practice of Kegel exercises, you can improve the health of your pelvic floor and enjoy a better quality of life.

Bibliography: Kegel exercises

Facog LBM. Patient education: Pelvic floor muscle exercises (Beyond the Basics) . Uptodate.com. . Available here: