Kegel Exercises 101

Kegel Exercises 101

Kegel Exercise and what it can do for those with a vagina!

Pelvic floor exercises, also known as Kegel exercises or Kegels strengthen the muscles around your bladder, vagina or penis and back passage.  These exercises are one of the very best ways to improve and maintain strong bowel and bladder functions. They can be done by both men and women, increasing the strength of your pelvic floor and can even improve or eliminate bladder leakage, they can even improve sex too!

How Kegels work

There are a number of muscles extending from inside of the public bone to the anus and for women also woven around the vagina, urethra and rectum.  These muscles help to indirectly control contractions of the detrusor muscle (primary muscle controlling the bladder) and the urethra pressures.  The pelvic floor muscles relax allowing urination and close to allow urination to cease.  The contraction of the pelvic floor muscles closes the lower urethra which squeezes any remaining urine back into the bladder. 

Pelvic floor exercises more often than not restore muscle function as well as lessening symptoms of incontinence.  

Which of us should be doing Kegels?

First things first, Kegels are not for everyone, and for some people they may even do more harm than they do good! Kegel exercises are good for many people, increasing the strength of the pelvic floor this can relieve symptoms of bladder leakage and prolapse and can even improve sex.

Some people can have pelvic floor disorders, resulting in the pelvic floor being too tight.  This leads to the pelvic floor often being in a state of continuous overaction, this can make it harder to react when one needs it to contract, either because there is very little range for it to contract further, as well as the muscle being fatigued.  Therefore, trying to prevent an accident when you really need to go, or clenching when one sneezes can result in leakage.

In these cases doing Kegel exercises is not recommended, we recommend seeing a women’s health physical therapist prior to beginning any Kegel exercise routine, as it can be difficult to know if you have a weak pelvic floor, or an overactive one without a consultation,  PTs can often help diagnose your problem assisting in exercising properly and methods in relaxation of the pelvic floor. 

How to do Kegels – step by step guide

Like any exercise, it can be difficulty to know if you are performing it correctly, but with daily commitment it can come instinctive, so we have compiled a few tips to assist you with this.

Firstly to identify your pelvic muscles, if you are able to stop the flow of urine mid-urination, you have identified your pelvic floor, this is the most difficult part of this particular exercise as it is often not a muscle one is accustomed to identifying and actively using.

Building up a routine is key to seeing improvements.  Performing exercises with an empty bladder, your first goal should be tightening your pelvic floor muscles for a minimum of five seconds, relaxing for another five seconds on your first day.  As you improve you will be able to do this for a greater amount of time with the same time of relaxation in-between each repetition, this can be done at your own pace incrementally.

First things first, when you have perfected your Kegels, it is recommended to aim for at least three sets of ten exercises at least three times per day.

The not to do’s. Try not to flex the muscles in your abdomen, thighs or buttocks.  Avoid holding your breath and try to breath freely, this prevents putting stress on the body.

Encourage yourself! These exercises do feel strange to most of us, and that is ok, the longer you stay with it, the better your bladders health will become. And importantly this will likely improve sexual pleasure!

The twitch muscles

To enable a full workout of your pelvic floor you will need to work both your slow twitch and fast twitch muscles.  These two types of exercise are essential for overall improvement.

Slow twitch exercises. These are referred to as long contraction exercises, these work on supportive strength of the muscles.  These are gradually tightened, lifted up, and held for several seconds.  At first it holding this contraction for more than one or two seconds can be very difficult, but your ultimate goal should be to hold the contraction for ten seconds, rest and repeat up to three times across three repetitions, the rest is important as this will allow you to avoid taxation of the muscle.

Fast twitch exercises. These are referred to as a short contraction exercise, this exercise works to cut off the flow or urine, preventing leakage. This muscle is rapidly tightened, lifted up and released.  It is recommended to exhale as you contract, then continue to breathe normally as you do the exercise.

This should be part of your overall exercise plan, to perform three sets of ten long and ten short contractions at least twice per day.  As with all exercises the quality of the exercise is of the highest importance over quantity, and doing a smaller number of higher quality exercises will be far more effective than doing many incorrectly.  Correct application of a routine like this one should see improvements within three to six months.

Kegel balls or Kegel weights like ‘The Rumbly ones’, or the ‘The Vibrating ones’ or other similar devices can provide resistance against muscle contractions, similar aids can also be prescribed by a health professional and used under professional supervision if required.

Spotting your improvement

Don’t be discouraged if you are not able to control your bladder as soon as you would like, but instead look out for the signs of improvement, these may be small at first but remember gradual improvement is the overall goal that your pelvic floor muscle exercises are working, and you are on the way to better bladder improvements and a better sex life!

- Drier underwear, without or with a lessening of the feeling of consistent dampness

- Fewer ‘accidents’

- An ability to hold the contractions for longer or to do more repetitions

- Longer time between bathroom visits.

Often when certain women find performing these exercises with difficulty, these can be assisted with biofeedback therapy.  With professional instruction from a nurse specialist or physical therapist. This can additionally lead to improvements in the strength of the pelvic floor.

Its crucial to remember that incontinence and the pelvic floor symptoms almost always have solutions and should not be shrugged off as normal, and finding time to include these exercises into your daily routine will help in long term pelvic floor strengthening.

P.S. Trans we love you

So a little unspoken and often unknown element of going through transition as well as starting testosterone therapy, this causes the widening of the vaginal canal, which can contribute in part to a loss of strength in this region.

This can often be a difficult and very painful topic, but due to this process retention in part can be weakened, and we would encourage any F2M transmen out there to try and if you can keep working on Kegel exercises to keep up both your strength as well as bladder retention in the long term as this can also be impacted.

We have found it difficult to find a great deal of information on this topic, so if you or your friends have any insights into Kegels for F2M Transmen we would very much like to hear about it, so we implore you to please get in touch and assist us in writing a full article about this topic!