Pelvic Floor Muscle Exercises (Kegel): How to Do Them and Who They Are For
Pelvic floor muscle exercises (Kegel exercises) are exercises that aim to strengthen the muscles at the base of the pelvis. In women and men they can help reduce urinary leakage and support the pelvic organs. This article explains the functions of the pelvic floor muscles, how the exercises are done and what to pay attention to.
What Are the Pelvic Floor Muscles?
The pelvic floor muscles are a group of muscles that stretch like a hammock across the base of the pelvis. The urethra, the anus and, in women, the vagina pass through these muscles. Their main functions are:
- Supporting organs such as the bladder, the bowel and, in women, the womb
- Helping to control urine and stools
- Contributing to sexual function
- Supporting the trunk together with the abdominal and back muscles
These muscles can weaken because of pregnancy and childbirth, ageing, menopause, excess weight, a chronic cough or constipation. Weakness may be associated with leaking urine when coughing, sneezing or laughing, difficulty holding in wind or stools, and pelvic organ prolapse.
Who Are They Recommended For?
- People who leak urine when coughing, sneezing or exerting themselves
- During pregnancy and after childbirth
- In mild pelvic organ prolapse, together with other treatments
- Men with urinary leakage after prostate surgery
- Anyone who wants to keep their pelvic floor muscles healthy
These exercises may not be suitable for people with pelvic pain or overly tense pelvic floor muscles; in this case an assessment by a doctor or physiotherapist is needed first.
Finding the Right Muscles
For the exercise to be effective, the right muscles need to be worked. To find the pelvic floor muscles, you can try squeezing and lifting them inwards and upwards as if you were trying to hold in wind or urine. Stopping the flow while passing urine can be tried once, only to identify the muscles; repeating it as an exercise is not recommended because it can prevent the bladder from emptying fully. The abdominal, buttock and thigh muscles should stay relaxed and you should not hold your breath. If it is difficult to find the right muscles, support can be sought from a pelvic floor physiotherapist.
How Are the Exercises Done?
- In a comfortable position (lying on your back, sitting or standing), squeeze the pelvic floor muscles and lift them inwards and upwards.
- Hold the squeeze for a few seconds, then relax the muscles completely for the same length of time.
- Repeat the movement several times; also add short repetitions in which you squeeze and release the muscles quickly.
- Do the exercises several times a day.
The length of the squeeze and the number of repetitions are increased over time as the muscles become stronger; a physiotherapist or doctor can set a programme suited to the person. It usually takes a few months of regular practice for the effect to become noticeable.
Points to Pay Attention To
- Do not hold your breath during the exercises; breathe normally.
- Relaxing the muscles completely is as important as squeezing them.
- If there is pain during the exercises, stop and consult a doctor.
- During pregnancy, it is advisable to consult a doctor before starting the exercises.
When Should a Doctor Be Consulted?
A doctor should be consulted if urinary leakage continues despite regular exercise, if there is a feeling of fullness or a bulge in the vagina, if it is difficult to hold in stools, or if there is blood in the urine, pain when passing urine or fever. For vaginal prolapse you can read our article Vaginal Prolapse (Pelvic Organ Prolapse): Causes, Symptoms and Treatment, and for pelvic floor problems in men Pelvic Floor Muscle Weakness in Men: Symptoms, Causes and Treatment.
Author: Op. Dr. Yücel Sarıaltın