Kegel exercises and the pelvic floor
How do you train the pelvic floor?
If you’ve recently discovered the concept of Kegel exercises, and their purported effectiveness in addressing all sorts of sexual issues, but you’re feeling a bit confused about whether you’re ‘doing them right’ then continue reading! I get asked very often about the ‘correct’ way to do Kegels and train the pelvic floor and unfortunately there isn’t a straightforward answer. It depends on the reason why you want to train your pelvic floor, and a lot of other individual factors. I’ll try to cover this as broadly as I can, whilst also focussing in on some of the most common scenarios I’ve seen in the 5000+ hours of intimate bodywork sessions I’ve given. As always though, please remember that I’m not a medical practitioner, this article is not a substitute for professional medical investigation and diagnosis and you should always speak to your healthcare provider if you have concerns about your pelvic health.
What is the pelvic floor?
The pelvic floor is a collection of muscles and connective tissue that form a hammock shape at the bottom of your pelvis. The muscles connect to your tailbone at the back, your pubic bone at the front and the internal edges of your pelvis (your groin, the top of your thighs). The ‘hammock’ supports your bladder, bowel, and, for women, the uterus. The muscles control the action of peeing and pooping, they support your organs, and they play a role in posture and of course sexual function – relaxing and contracting the vaginal and anal openings, providing structural support for erections and controlling blood flow into the erectile tissue.
What are Kegel exercises?
Kegel exercises are simple movements designed to strengthen the pelvic floor muscles. They’re named after Dr. Arnold Kegel, who first described them as a way to help with urinary incontinence, but they’re useful in many other ways. They involve intentional contractions of the pelvic floor muscles, usually combined with mindful breathing, to strengthen the muscles just as you would your biceps in the gym. Imagine stopping a pee half way through: the muscles that engage are your pelvic floor muscles. To do a Kegel exhale and engage those muscles, then inhale and relax. You can do this with slow breaths or faster breaths – this works the muscles in different ways, much like walking versus running.
Things to consider when doing Kegel exercises
Asking ‘what’s the correct way to train the pelvic floor’ is like asking athletes ‘what’s the proper way to work out?’ – a powerlifter will follow a really different program to a golfer, for example. There’s no one ‘correct’ way, you have to take into consideration the following things…
- what outcome are you trying to achieve? e.g. targeting bladder issues, healing from a hernia, trying to access more relaxation to deal with vaginismus, strengthening muscles to support erections, repairing after childbirth, improving muscle recruitment for better posture etc.
- what’s the current state of your pelvic floor awareness, tone and muscle recruitment/deactivation? e.g. if you already have a chronically tight pelvic floor then hammering away with strongly contracting Kegel exercises will make things worse.
- gender considerations: women are obviously more likely to be affected by childbirth than men, so the ‘correct’ training for a woman will be different to a man.
Whatever you do has to have an informed starting point relevant to you the individual. In my experience, any good program will include a balance of:
- strengthening: e.g. kegels, Pilates and other somatic exercises, and good postural awareness
- relaxation: e.g. stretches, breath work, postural awareness again
- touch: e.g self-massage, pelvic physiotherapy, dearmouring
How to do Kegel exercises
In my work I see two common scenarios:
- Tight and painful: this manifests as pain during sex (vaginismus), or premature ejaculation.
- Weak and numb: this often shows up in difficulties reaching orgasm, or erectile dysfunction.
Tension and tightness causes painful penetration, which then creates a muscle memory and an anticipation of pain, which causes more contraction. It’s a frustrating negative feedback loop. An overly tight pelvic floor makes it harder to control the muscular contractions, which can lead to the involuntary contractions of PE. Chronic tension also places pressure on the pudendal nerve causing hypersensitivity in the penis – making it difficult to last as long as you’d like.
So, to work with this first scenario, tight and painful, it’s important to focus less on the contraction aspect of the Kegel exercises and allow your nervous system and your muscles to learn how to disengage.
I recommend beginning with deep breathing to calm bring the nervous system into a more relaxed state. Bring in some pelvic stretches – you’ll find a follow along class for this in my online course in mindful masturbation, but any simple yoga stretches for the hips and pelvis are great.
Then add in your kegels; think about only using about 30% effort for the contraction phase – it’s not about squeezing as hard as you can – and then inhaling as slowly and smoothly as you can (ideally through the nose) to maximise the time spent on the relaxation phase.
Self-massage for the pelvic floor is a vital part of the program if your pelvic floor is tight. Again, you’ll find lots of techniques in the follow-along videos in my online mindful masturbation course to support you with this. Receiving regular massage from a partner, or a professional can also be really helpful.
When the pelvic floor is weak, which goes hand in hand with numbness or ‘disconnection’, the engagement of the muscles is sort of uncoordinated or inefficient. They’re not working together in the way they need to in order to create strong and long-lasting erections, or for many women it feels like you’re on the edge of orgasm, but not able to get there. Weak muscles can also affect blood flow to the vaginal tissues, which can mean a lack of natural lubrication.
To work with this it makes more sense that you need to strategically train the contraction strength and coordination of your pelvic floor.
In this scenario I recommend working with a body scan meditation to increase the internal awareness and neurological connections to the muscles. Conscious movement practices like Pilates, Somatics, or even things like Qi Gong, Tai Chi or dancing are great in helping you to strengthen the body-mind connection.
Any Kegels you do can focus more on the contraction phase, but should also not be an over-exertion with each squeeze. Start small – don’t try and bash out 500 on your first day. Try 3 sets of 10, spread across the day. You can gradually increase the volume. It’s also more appropriate to try the faster ‘flutter’ Kegels – not just long slow breaths – when you want to improve strength, so mix in some of those to your ‘training’. I sometimes use a ‘Tabata’ approach: 20 seconds of squeezes at a fast pace, 10 seconds rest, repeat for 4 minutes 🙂
Ready to give Kegel exercises a try?
As you can see, there’s a lot more to it than just doing a generic set of exercises. In this article we haven’t covered any of the considerations of post-surgery, post-natal, specific injuries or complex postural and mechanical issues. If you want to know the ‘correct’ way to work with these I advise finding a qualified pelvic physiotherapist or bodyworker so that you can really tailor the program to your needs. But hopefully the points we’ve covered today will help you get going with your pelvic fitness program – I’d love to hear from you in the comments with how you’re getting on!
If you’d like to join a follow-along class I’ll be doing one of these as part of my Members-only livestream events on YouTube in the coming months. Check out this video for details on how to access the channel membership and I’ll see you there!
Libby
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