Kegel Exercises Guidelines for Strengthening Episode 3

Kegel Exercises guidelines for how to strengthen your pelvic floor are outlined in this Physical Therapist video.

This Kegel exercise video teaches you:

  • How to Kegel with correct technique in upright sitting; and
  • How many Kegel exercises you need to do to strengthen your pelvic floor muscles.

Video duration: 5 minutes

Kegel Exercises Video Episodes

Benefits of Kegel Exercises

Knowing these exercise guidelines can help women improve:

  • Prolapse symptoms
  • Bladder control problems (bladder incontinence)
  • Bowel control problems (faecal incontinence)
  • Sexual sensation and response problems.



 

Why do Kegel Exercises in Upright Positions?

It is important to progress your Kegel exercises from lying down positions into upright when you feel confident in your technique. When your body is upright, your pelvic floor muscles are required to support the weight of your abdomen and lift up against the added downward force of gravity. The additional load upon your pelvic floor when you are upright means that upright positions can help you to increase the strength of your pelvic floor muscles.

Your pelvic floor muscles will strengthen and work best for you in those specific positions you train your muscles in. If you do all your Kegels lying down, then your pelvic floor will become stronger when activated lying down. Most of us need our pelvic floor muscles to work well for us in upright sitting and standing, so it makes good sense to practice Kegels in these upright positions.

How to do Seated Kegel Exercises

Kegel exercises in upright positions involve the same basic underlying principles as lying down:

A. Correct Your Posture

Correct posture for Kegel exercises involves finding your neutral spine posture and maintaining it throughout your exercises.

  • Sit with your body weight evenly distributed between your sit bones
  • Lengthen your spine so that you sit tall (lift the crown of your head to the ceiling)
  • Bring your shoulder blades back and slightly down and lift your chest
  • Maintain the small inward curve in your lower back throughout your Kegel exercises

B. Contract Your Pelvic Floor Muscles

Contract your pelvic floor muscles by lifting and squeezing in and around all three pelvic openings together. Continue to lift and squeeze your pelvic floor muscles for 3-10 seconds breathing normally throughout.

C. Relax Your Pelvic Floor Muscles

Relax your pelvic floor muscles back to their normal resting position. Rest sufficiently to allow your pelvic floor muscles to recover before your next attempt.

Guidelines for Kegel Exercises to Strengthen Your Pelvic Floor

To strengthen your pelvic floor muscles with Kegel exercises:

  • Ideally try to do your Kegel exercises every day
  • Maintain each exercise for up to 10 seconds
  • Relax your pelvic floor muscles and rest for 15-45 seconds before your next attempt
  • Repeat up to 8-12 Kegel exercises in a row
  • Aim to complete your exercises 3 times a day
  • When you are confident in your correct Kegel exercise technique, contract your pelvic floor muscles with your strongest possible effort
  • Progress your Kegels from lying down into upright sitting and standing.

When Will Kegel Exercises Make a Difference?

Some women notice that their pelvic floor condition improves within a couple of weeks of starting their exercises. Studies have shown that for weak pelvic floor muscles it can take up to 5-6 months of effective Kegel exercises to fully strengthen pelvic floor muscles.


INSIDE OUT – PELVIC FLOOR SAFE EXERCISES

Inside Out Book & DVD

with Pelvic Floor Physiotherapist
Michelle Kenway

Learn how to exercise and avoid exercises that overload the pelvic floor causing pelvic floor problems.

Inside Out book and DVD is a complete exercise solution for women seeking to exercise safely and protect their pelvic floor.

READ MORE NOW

 

Comments

  1. After giving birth to triplets almost 2 years ago, I am finally addressing weakness of my pelvic floor which has caused bladder incontinence. I also have diastasis recti. Is there an order to which I do these exercises in terms of correcting one area first and then the other? Or does strengthening the pelvic floor also help correct DR which I understand is the separation of the Abdominis Recti and the focus is more to get the TA activated and strong to help repair this area. If you have additional information or proven techniques to help with DR can you please point me in the right direction? Thank you so much for such an informative website. Is your book for purchase here in the USA where it is actually shipped from the US?

    • Michelle Kenway says:

      Hi Tanya

      There is no specific order for contracting in and around the pelvic openings – it is usually recommended to try to contract all 3 pelvic openings together. I think some women have trouble at first achieving this so sometimes especially with decreased sensation in the pelvic floor muscles and it can help to try to feel the muscles around different openings by attempting to contract them seperately. If sensation through the pelvic floor is decreased after childbirth sometimes it can help to focus on contracting that area that you can feel contracting best – for many women I have found that this is around the anus however this is just my own observation and not a scientific finding.

      Regarding rectus diastasis – pelvic floor exercises won’t necesarily address this problem. Abdominal exercise need to be more specific for the Transverse Abdominis or deep abdominal muscles with appropropriate core abdominal activation and deep core abdominal exercises you can see in these links. It is important to avoid intense upper abdominal core exercises such as abdominal curl exercises with a diastasis.

      Inside Out is shipped from Australia to the US every week – we send air mail direct to your preferred address.

      I hope this helps give you some direction Tanya and best of luck.

  2. What is your opinion on the use of Ben Wa balls for pelvic floor strengthening and when or under what conditions would you recommend or not recommend use?

    Thank you!

    • Michelle Kenway says:

      Hi Lynda

      Kegel balls including Ben Wa balls can be used to assist pelvic floor strengthening in some women. Currently they are recommended with an insert and wait for some reflex muscle reponse to srengthen the pelvic floor which is inconsistent with the way we know pelvic floor muscles (and other skeletal muscles) strengthen – with repeated contractions that cause muscle fatigue. So they really need to be lifted and lowered using the pelvic floor muscles – just like training in the gym.

      When not to use Kegel balls?
      -During pregnancy
      -During early recovery from childbirth
      -During recovery from gynaecological surgery
      -With pelvic pain conditions
      -With active pelvic infection
      -When starting out with pelvic floor exercises
      -Some manufacturers recommend that balls are not used with prolapse

      Cheers
      Michelle

  3. Val Brown says:

    Thanks for your video and this website. I need to do my pf exercises but never remember! Do you have any tips on how to remember to do them and when? I’ve tried stickers on the mirror, they don’t work.

    Regards
    Val

    • Michelle Kenway says:

      Hi Val

      What a great question! I agree stickers don’t work for longer than a couple of weeks. Some ladies tell me they do their exercises when driving, however I don’t believe you can concentrate on a maximal contraction and drive, I know wome can do more than one thing at a time but this isn’t one of them as PF exercises need complete focus. Perhaps at the traffic lights …

      I think it works differently for different women – some women prefer structure so that every morning before they get out of bed they do a set of pelvic floor exercises, then sitting at morning tea another set and so forth. Other women find incidental pelvic exercise works better for them for example:

      – every time you stand in a queue
      – every time you get into a lift
      – waiting for an appointment
      – sitting on a bus every stop
      – in the train every stop
      – waiting for something to cook on stove top that requires watching
      – waiting for the jug to boil
      – every time you feel the urge to empty the bladder
      – always before and during cough, sneeze or lift.

      Maybe other ladies have some good ideas to help, for me the reminder is that waiting in the queue at the supermarket so that I feel as though I am doing something useful and takes away the frustration of waiting. Hope this gives you some ideas, all other ideas most welcome!
      Michelle

      • every time you turn on a tap is also a good one – we girls are the queens of clean! and you’ll get lots of kegels done during any day

  4. Eileen says:

    HI Michelle

    I was doing really well with some PT for uterine prolapse. I was doing a total of 16 kegels a day in 2 sessions I upped it to 20 in 2 sessions and was fine Then my PT told me to try sitting and doing them. I am much worse now. I was wondering if you have ever seen someone do really well with the kegels lying down and then feel terrible when doing them sitting. I feel like switching to sitting has really set me back. Do you think it is ok to just do them lying down?? I was doing SO WELL. Thank you Michelle. -Eileen

    • Michelle Kenway says:

      Hi Eileen
      Do you mean your prolapse is worse doing your Kegels sitting? If this is the case my guess is you are using the wrong technique – possibly bulging down rather than lifting up. Try not to feel disheartened Eileen, you just need to check this with your PT and maybe return to your lying down exercises until you have this checked. Knowing how to do your Kegels upright is really important and is a normal progression from lying down exercises so this is worth getting right, hope this helps & good luck Michelle

  5. Hi Michelle,
    I love looking up your information.I learn so much and keep logging to see what else is going to help me. Thanks Michelle. 10/5/13.

  6. Hi Michelle,
    My pelvic floor is very weak after having 3 children although the youngest is now 6 years old. I can lift my pelvic floor but it flickers on and off and I cannot hold it for more than 3 or so seconds. I was reading recently about a device called Jopen Intensity and also the Kegalmaster and was wondering what your thoughts are on using these devices? I do pilates x 2 a week and my core is strong and I think that has helped the Pelvic Floor but I need to do more.
    Thank you

    • Michelle Kenway says:

      Hi Georgie
      Thanks for your qn. While I can’t comment on brands, I can say that E stim or electrical stimulation therapy can help some women with weak pelvic floor muscles. Basically the stimulating device contracts the pelvic floor muscles, and then the idea is to start to practice pelvic floor contractions with the device. Just a thought from your comment…ensure that core exercises are not so intense that they overload the pelvic floor, since strong abs doesn’t mean strong pelvic floor, in fact this can have the opposite effect if your PF is weak. Make sure you match your Pilates exercises to your PF strength.
      Michelle

  7. hi michelle im a 27 yr old male n underwent fistulotomy + haemorrhoidectomy [laser] 20 days back resulting in severe anal incontinenence….what might be d reason for incontinence ….will kegels exercises help and how long will the recovery take…pls help thanks

    • Michelle Kenway says:

      Hi
      Thank you for your question. Unfortunately I cannot answer why your anal incontinence has occurred post op or how long it will last – the best person to answer this is your surgeon. I would think that Kegel exercises would be a good to perform, when you have your surgeon’s approval to commence Kegel exercises. I think a good place to start for self management would be to manage your stool consistency, the looser the stool the more prone peole are to anal incontinence and often stool management is a good starting point when other causes have been excluded by your doctor. There are a number of foods that help to firm the stool including: bananas, white pasta, potatoes, boiled white rice, white bread, cheese and peanut butter. Foods that make the stool softer include fruit vegetables, spices such as chilli or curries, caffeine, alcohol, bran, garlic greasy foods, prune, orange and grape juices. Your doctor may also be able to assist you with medication to firm your stool. It would be beneficial to seek a referral to a pelvic floor physio if you have access to one to assist with your Kegel exercises, and scheduled bowel emptying. Associate Professor Pauline Chiarelli has an excellent DVD for men Pelvic Floor Exercises for Men which teaches Kegels (pelvic floor exercises) and is well worth watching for this information if you don’t have access to Physiotherapy.

      I hope this gives you a starting point, wishing you all the best for your recovery
      Michelle

  8. Karen Widjaja says:

    Dear Michelle, thanks for all the details you had explained on your web regarding porolapse uterus.My questions, is it ok to wear corset or girdle for prolapse uterus for support? or Faja a cotton cloth under lower abdomen? Which one you recommend? I am going to Sydney and Melbourne in a couple of weeks, where can i buy the good support for prolapse uterus? Once again thank you. God bless you.
    Karen

    • Michelle Kenway says:

      Hi Karen
      When you go to Sydnyy or Melbourne checkout the Triumph range of support briefs. They are usually in major deparetmant stores. They have some excellent support briefs with abdominal support panels – the waist elastic is trim so doesn’t cinch you in at the waist but reinforced to support the lower belly. The Jolly Comfort are an extra strength support but they have a good range – steer clear of the lacy ones if you are aiming specifically at support and let me know how you go.
      Kindest regards
      Michelle

  9. Hi Michelle, I have seen a pelvic floor & incontinence trained physio on my prolapse & given specific exercises (not kegel) to perform. It has been over a year & I am finding my pelvic floor is not getting stronger. I would appreciate your thoughts on: 1) physio advised to perform pelvic floor exercises at night only & fatigue them (maximum 3 minutes); 2) contraction of pelvic floor should be the internal vaginal muscles only. I should not be feeling the anus engage as part of the contraction; 3) to not perform any Pilates or weight bearing exercises, swimming only. Many thanks for any advice. Lee

    • Michelle Kenway says:

      Hi Lee
      Hmmm sounds disheartening, thank you for writing. I am not sure exactly what type of exercises you have been given by your physio, Kegels are the same as pelvic floor exercises – just in the US a specialist called Arnold Kegel first recommended them to his patients and that name caught on.

      I can’t comment on what your physio has prescribed for you and it is worth discussing your specific questions with your physio so you understand the reasoning behind your exercise prescription. Having said that I can give you some general information on pelvic floor strengthening to improve your overall understanding of how we strengthen pelvic floor muscles.

      *Pelvic floor exercises for strengthening are usually performed in sets or groups of exercises 3 times throughout the day, aiming for 3 sets of up to 8-10 contractions in total/day
      *A correct pelvic floor muscle contraction involves lifting and squeezing in and around all 3 pelvic openings at once (sometimes there might be more focus on one of the openings for example anal squeeze in the case of faecal incontinence)
      *Pelvic floor strengthening is like strengthening in the gym in that strong repetitions are required aiming for a maximal contraction with each exercise when you have the technique correct
      *Pelvic floor strengthening is usually progressive in that exercises are progressed over time
      *The pelvic floor muscles fatigue during the course of the day, basically because they carry around the load of your abdomen all day. For many women their pelvic floor muscles are fatigued by the end of the day, and many notice prolapse symptoms more at this time partly due to this fact. If you think about strength training, ideally the training would be at the outset of the day when the muscles are rested and can be activated. Many women find that by the end of the day their pelvic floor is so fatigued they are unable to elicit a good contraction.
      *There are a number of Pilates exercises that can be chosen with weak pelvic floor muscles and a number to avoid that involve intense core strengthening. You can read more about unsafe Pilates exercises here.
      *The weightbearing exercises for women with mild to moderate prolapse to avoid are high impact exercises where 2 feet are off the ground simultaneously (e.g. jump, run, skip). Low impact weight bearing exercise such as walking is excellent for general health and is usually well reasonably well tolerated in the morning except in cases of severe pelvic prolapse.

      I hope this provides you with some of the information you are seeking Lee, feel most welcome to comment further.

      Michelle

  10. Allan Bobis says:

    I want to learn more about pelvic floor muscle exercise

    • Michelle Kenway says:

      Hi Allan
      Are you looking for pelvic floor muscle exercises for men?
      Michelle

  11. I really can’t feel my pelvic floor muscles when sitting upright. But lying down is so much easier because my weight isn’t on them. Can’t I sit on an easy chair and tilt so my weight is on one buttock taking the pressure off my pelvic floor? At least this way I can distinguish which muscles I’m contracting.

    • Michelle Kenway says:

      Hi Pauline

      Yes lying down position is much easier when starting out. Sitting is also a fantastic position as well as standing, in fact sitting and standing upright train the pelvic floor muscles to work against gravity and strengthen them more effectively than lying down.

      As your pelvic floor muscles get stronger lying down you may find you can activate your muscles sitting. If you try sitting on a towel roll this can help feel the pelvic floor too.

      No need to sit on one buttock in fact much better to sit on both and lift your pelvic floor muscles against gravity.

      Let me know how this works for you an whether you have any difficulty with this position.

      All the best
      Michelle

  12. Hi. Are you still running this website? I noticed there are no comments after 2014. I hope so because it is a great site!

    • Michelle Kenway Physiotherapist says:

      Hi Linda
      Yes I’m still here – just a little snowed under with hundreds of comments so it takes me a little time …my apologies
      Michelle