Is this commonly recommended pelvic floor exercise all it’s cracked up to be?
Kegels! Kegels! Kegels! For a while it seemed like they were the answer to everything. We were supposed to do them in the grocery store, at red lights, the second we conceived and smack in the middle of sex. If you just squeezed and squeezed, you’d be happier, healthier, happier in bed. Your baby would fly out of you and your vagina would be nice and perky quick after.
But is that the case? Are kegels always the answer and are kegels after birth good for you? Let’s break down what they are and if they’re worth doing.
What is a kegel exercise anyway?
Let’s start by asking what a kegel exercise even is.
A kegel exercise is when you contract (squeeze) the muscles of your vagina (that’s the internal bits, not your labia). Men can do kegels too by contracting their perineal muscles.
The ideal kegel is when you can squeeze and release your vaginal muscles without engaging the muscles around your anus and when you can gently outwardly release the vaginal muscles beyond their normal resting spot. Often it is taught to imagine there are ten rings on a ladder you are walking up and climbing down – with an extra floor at the base while you contract and release. If you are going to do kegels, you can work up to this amount. Working slowly, with control, and with a gentle breath rather than just doing pulsing squeezes, or squeezing for as long as you can. And don’t hold your breath while you do them!
Side note: Like most things in women’s health, this exercise is named after a dude. Go figure.
What are kegels good for?
If you combine this exercise with trying to become more aware of the sensations in your vagina, trying to have more control over when you pee, trying to connect with the muscles and organs in your pelvic area before birth, healing from prolapse, and/or reconnecting with your body with control and confidence after birth they can be a useful tool.
The most important thing to keep in mind with kegels is not to think of them as isolated little squeezes. Rather, they are part of a bigger picture of well-being integral to your core strength, emotional and sexual health, and your self-confidence. You can’t just squeeze your way out of these parts of yourself.
Is doing kegels during pregnancy worth it? Understanding the benefits for birth
Can you do kegels whilst pregnant? Yes they can be a good exercise to practice in preparation for birthing unless you typically have a tight pelvic floor. Just as much as having physical strength in this area is great for birth, being able to be aware of how these muscles work and feel like you have some control over them can be a great tool when it comes time to push your baby out.
If you are planning on having a cesarean birth, kegels can still be helpful for reducing your chances of post-surgery complications and the pelvic floor strain that happens during pregnancy.
Are kegels after birth good? And can kegels postpartum be a healthy part of your recovery?
If done correctly, kegels after birth can be a healthy part of postpartum recovery. For a lot of women, it can feel good to connect with your vagina through these exercises, but there isn’t a huge rush to start squeezing yourself to ‘bounce back’ if you feel like you can’t do kegels after birth.
If you had stitches or a birth with forceps or a vacuum, make sure to check in with your care provider about when you can safely start kegels.
Can kegels be bad for you? Risks and considerations you should know
Kegels can be bad for you if you find yourself doing them frequently enough that you feel too tight in your pelvic floor. You’d know this if sex becomes painful, if you have difficulties starting a stream of pee, you are maybe having more UTIs, or if you are starting to have pelvic muscle spasms. What’s happening is that you are over-pulling the tissues in your pelvic brim, which shortens them and can actually make them weaker.
If you know you have a tight pelvic floor, it could be more helpful to practice relaxing, breathing, and stretching your pelvic floor muscles before birth instead of doing a lot of squeezing. Sitting in a low squat, using your breath to relax your pelvic floor, and visualizing more space and openness there can do a surprising lot to help! It sounds a little woo-woo, but it’s backed by evidence.
Kegels are not recommended if you have Hypertonic Pelvic Floor disorder. Check out this article on hypertonic pelvic floor to learn about the symptoms, causes, and treatments for this issue.
How to do kegels like a pro: Tips for a proper technique
One of the most common questions we get asked here at MUTU is, “How do I know if I’m doing kegels correctly?”
The truth is there’s a lot more to kegels than ‘squeezing as if you’re trying not to urinate’. The odd squeeze while you’re waiting at the bus stop is not going to cut it. Not only that, but squeeze too much and squeeze wrong and you will actually make it weaker. Seriously.
If you keep tucking your butt and shortening the distance from tailbone to the front of your pubis (kinda like placing those 2 trees closer together) the effect is a shorter, too tight / hypertonic pelvic floor. It will seem ‘stronger’ for a while, but a shortened muscle isn’t an effective muscle. Weak isn’t always too loose. It can also be too tight/short.
You need to breathe right too. Seriously… the breathing matters.
You need to focus and connect with your body. Maybe this sounds a little ‘far out’ for you, but many women cut off emotionally and physically from certain parts of their body after childbirth because it doesn’t feel as sensitive, as sexy or fun as it used to be… if you don’t like the way parts of your body look right now, or how they make you feel, then you’re going to find it much harder to reconnect those nerve pathways and make the muscles do their job.
The most important part of doing your pelvic floor exercises is not to think of them as isolated little squeezes, but as integral to your core strength, emotional and sexual well-being, as well as your self-confidence. Incontinence or prolapse are no fun at all 🙁
So please feel free to ask questions as frank or as intimate as you like and we’ll do our best to give you the straight answers you’re after!
Exploring non-kegel options for pelvic floor health : What are the alternatives to kegels after birth?
The body is incredibly resilient and may move back to its pre-pregnancy feeling (more or less) after birth even without kegels or other specific exercises for some. For most, though, pelvic floor exercises (done with care) are a normal and recommended part of postpartum healing.
Despite the hype, kegels aren’t necessarily crucial to do. If you feel like you have a strong pelvic floor already, it’s fine to skip them. And again, if you are experiencing a tight pelvic floor or don’t feel ready after birth or surgery or injury, it’s okay to wait till your body is ready or just start slowly.
This exercise isn’t the only way to strengthen a weak pelvic floor. Walking, yoga, squatting, and exercises focused on aligning your core can help a lot. Read our article taking a deeper look at pelvic floor exercises that aren’t kegels here.
How will I know if they are helping?
Like any exercise, you’re probably not going to notice a difference right away. It usually takes a few months for pelvic floor exercises such as kegels to really make a difference.
You may see a change in the general sensations around your vagina after doing these exercises. Less pain, more sexual pleasure, and having more control over urination are usually the biggest signs that kegels are working well for you.
What if kegels aren’t working for me?
If you feel that these exercises are making things worse for you, you might have a hypertonic pelvic floor issue, an infection, or something more serious. Kegels can help with incontinence and other pelvic floor dysfunction, but sometimes it’s necessary to seek more specialized care.
Your pelvic floor therapist, midwife, OBGYN, gastroenterologist, urologist, or GP might suggest something more than kegels if you’re not finding them helpful enough.
Learn more about the pelvic floor in our comprehensive overview here.