Performing pelvic floor exercises can benefit males and females alike and can be carried out at almost any time. These exercises are of particular benefit to people who are affected by urinary incontinence or bowel problems.
Contents of this article:
Here are some key points about Kegel exercises. More detail and supporting information is in the main article.
- Pelvic floor exercises are also known as Kegels
- Kegel exercises can be carried out while sitting down, standing up, walking and lying down
- Kegels can also be carried out during pregnancy and following childbirth
- The pelvic floor is comprised of many different muscles
- Symptoms of pelvic floor dysfunction include urinary leakage and difficulty emptying the bowel
- The pelvic floor can be weakened by gynecological and prostate surgery
- The pelvic floor muscles can also be weakened by chronic sneezing caused by allergies
- Performing Kegels while urinating could lead to bladder infection
- Kegel exercises may improve sexual performance in males.
What are pelvic floor muscles?
The pelvic floor muscles are a vital set of muscles that assist both men and women maintain urinary and fecal continence, impact orgasm, provide stabilization to connecting joints, aid in pelvic, venous and lymphatic drainage and, when working in conjunction with the abdominal and back muscles, provide spinal stabilization.1,2
In addition to the aforementioned functions, the pelvic floor muscles aid in controlling abdominal pressure during movements that cause a strain - during exercise, for example.2
The pelvic floor is comprised of several different muscles:1
- Superficial transverse perineal
- External anal sphincter (EAS)
- Compressor urethera
- Uretrovaginal sphincter
- Deep transverse perineal
- Levator ani: pubococcygeus (pubovaginalis, puborectalis), iliococcygeus
- Obturator internus.
Symptoms of pelvic floor dysfunction
There are a variety of symptoms associated with pelvic floor dysfunction, many of which are vague and associated with other medical conditions.
Symptoms associated with pelvic floor dysfunction include:2
- Urinary incontinence (leaking) with laughing, coughing, sneezing or exercising
- Urinary urgency or frequency
- Difficulty with bladder or bowel emptying
- Accidental flatulence
- Pelvic pain
- Painful intercourse
- Organ prolapse.
Causes of pelvic floor dysfunction
Pelvic floor dysfunction occurs when the pelvic floor muscles are weakened, stretched or too tight. Pelvic floor muscles can be weak from an early age, gradually weaken over time or be weakened by a single event.
As with many other medical conditions, there are certain situations and conditions which place a person at a higher risk for developing pelvic floor dysfunction. 2,4
Pelvic floor dysfunction can result from a variety of factors, ranging from childbirth to chronic sneezing.
Factors that can increase the risk of pelvic floor dysfunction include:
- Pregnancy and childbirth
- Overuse or underuse of the muscle groups
- Back pain
- Constipation or straining with bowel movements
- Being overweight or obese
- Heavy lifting
- Conditions such as asthma and allergies that cause chronic coughing or sneezing
- Injury to the pelvis
- Surgery such as gynecological or prostate surgery.
Elite athletes such as runners and gymnasts have an increased risk of pelvic floor dysfunction, as have older individuals as their muscles weaken over time.
How to do Kegels
Both men and women can benefit from performing exercises to work and strengthen the muscles of the pelvic floor. Pelvic floor dysfunction can be greatly improved with regular exercises targeting these muscle groups.2,3
Kegel exercises for females
How to do a proper Kegel is vital to the success of the treatment. These exercises can be done anywhere and at any time and are beneficial in strengthening the muscles of the pelvic floor.5
Your health care provider or physical therapist can instruct you on how to perform a proper Kegel while in their office, at which time proper technique can be evaluated. Pelvic floor exercises can also be done during pregnancy and after childbirth.5
At times, a technique called biofeedback may be necessary. During biofeedback treatment, a device will monitor proper muscle contraction, the strength of the pelvic floor and timing of Kegels. Biofeedback reinforces proper technique of the exercises.3-5
Kegel exercises can be carried out discreetly in any location; even while at work in an office.
In order to perform a proper Kegel, you will need to:2-5
- Relax the abdomen, chest, thighs and buttocks
- Tighten the pelvic floor muscles, as if you are attempting to stop urinating, and hold for 5-10 seconds. If you are able to feel an upward movement and tightening of the vagina, anus or bladder, you have successfully completed a Kegel.
Take a 5-10 second break and repeat for three sets, 10 times per day. The ultimate goal is to hold the contraction for 10 seconds each time the exercise is performed.
To be sure you have correctly identified the pelvic floor muscles and performed a Kegel, some women find it helpful to insert a finger into the vagina and perform the Kegel; if performed correctly, the muscles will tighten and move upward.3. Additionally, some women may also benefit from using a weighted vaginal cone, attempting to hold the cone in place within the vagina while performing a Kegel exercise.3,4
It is not advised to frequently perform Kegel exercises when urinating; this technique can increase the risk of incomplete bladder emptying and urinary tract infections.2,4
Additionally, Kegels should be done as recommended; overexercising of the pelvic floor muscles can worsen pelvic floor dysfunction symptoms due to muscle fatigue. Positive results can be expected within a few weeks to months of Kegel exercise practice.3,4
Kegel exercises for males
Men are not immune to the effects of a weak pelvic floor and may benefit from performing Kegel exercises. As well as improving bladder and bowel control, pelvic floor exercises may also improve sexual performance.6
The surgical removal of the prostate (radical prostatectomy) is another factor that can weaken the pelvic floor muscles.
It may be necessary to have a health care provider offer proper instruction or biofeedback techniques; biofeedback will use sensors placed in the anus to provide a visual graph showing muscle contraction and relaxation.3,6
Men can also benefit from performing Kegel exercises if they have a weak pelvic floor.
Additionally, it may be helpful to self-identify the muscles of the pelvic floor used during a Kegel. In order to do this, men can insert a finger into the rectum while tightening and relaxing the pelvic floor muscles (as if you were holding or stopping the urine stream).3
In order to perform a Kegel properly, you will need to:6
- Relax the muscles of the abdomen, thighs and buttocks while breathing normally
- Locate the pelvic floor muscles as above
- Tighten the pelvic floor muscles as if you are attempting to stop urinating, hold for 3 seconds and then relax for 3 seconds. Repeat in sets of 10, three times per day.
As above, it is not advised to frequently perform Kegel exercises when urinating; this technique can increase the risk of incomplete bladder emptying and urinary tract infections.2,4
Additionally, Kegels should be done as recommended; over-exercising of the pelvic floor muscles can worsen pelvic floor dysfunction symptoms due to muscle fatigue.3,6 Positive results can be expected within a few weeks to months of Kegel exercise practice.6
Speak with your health care provider if you have symptoms of or are at risk of developing pelvic floor dysfunction, or if you need additional instruction on how to perform pelvic floor exercises. At times, evaluation with a pelvic floor physiotherapist may be recommended.2
Video: How to do Kegel exercises
The video below provides guidance for women on how to do Kegel exercises. Separate videos providing guidance for men are also available.