We’re often told that by religiously practising kegel exercises, our pelvic floors will thank us, but this might not be the whole story. Kegel exercises are thought to help strengthen your pelvic floor muscles, but as Dr Molly Scheumann, DPT and PT from @thedowntheredoc and marcycrouch.com tells us, this isn’t quite true. “After 13 years as a pelvic floor PT, I can confirm that most people do not know how to perform kegels correctly. Kegels are a complex exercise that should also involve some of your abdominal muscles as well as breathing. Kegels can help strengthen the pelvic floor muscles, however they are not the answer to all pelvic floor issues.
“If a person is experiencing leaking, pain, or pelvic pressure they should go to a pelvic floor therapist so that they can learn which types of exercises are appropriate for them and how to perform them correctly.”
But how else can you strengthen the pelvic floor muscles, and which exercises should be avoided if you have a weak pelvic floor?
How to do a kegel exercise
Let’s start with kegel exercises, and how to perform them correctly. According to The American College of Obstetricians and Gynecologists, you should:
- Squeeze the muscles that you use to stop the flow of urine. This contraction pulls the vagina and rectum up and back.
- Hold for 3 seconds, then relax for 3 seconds.
- Do 10 contractions three times a day.
- Increase your hold by 1 second each week. Work your way up to 10-second holds.
- Make sure you are not squeezing your stomach, thigh, or buttock muscles. You also should breathe normally. Do not hold your breath as you do these exercises.
How often should you practise pelvic floor exercises?
Everyday, Dr Molly tells us, “Once someone learns the proper way to do a kegel, it is important to incorporate those into daily activities and workouts.” Even walking down the street or lifting bags of groceries can engage your pelvic floor and once you have introduced this into your daily routine you can move on up. As Dr Molly says, “Our pelvic floor muscles are just like any other muscle in our body where they need to be trained to do easy exercises and then progress to harder exercises. Think about training for a marathon: You shouldn’t run a whole marathon when you start training. You start small and build up.”
What other exercises are good for the pelvic floor?
Of course, it’s not just kegals that strengthen the pelvic floor muscles. Here are other exercises to add to your routine:
Strengthening your pelvic floor muscles doesn’t have to mean returning to the gym. Here’s some bodyweight exercises you can add to your routine to strengthen your pelvic floor:
- Squats: To do a squat, stand with your feet slightly wider than shoulder-width apart. Engage your core and your pelvic floor muscles as you bend your knees, pushing your hips outwards as you lower down.
- Bridges: To do a bridge, start by lying on your back, with your feet pressed into the floor and your arms next to your body. Engage your core and squeeze your pelvic floor muscles as you raise your hips up to the ceiling. Your back should be straight. Hold this position for a few seconds, before lowering your hips back down to the mat.
- Bird dog: To do a bird dog, start on all fours. Squeezing your core, extend your left leg out behind you, and raise your right arm out in front of your body as you do so. Pause here for a few seconds, before lowering back to your starting position and repeating on the opposite side.
- Split table top: To do a split table top, start by lying on your back in table top position. Engage your core and your pelvic floor muscles and, keeping your upper body still, slowly lower your knees outwards towards the ground. Go as far as is comfortable, before slowly bringing your legs back together.
Often we can be left thinking that a weaker pelvic floor means the end of a running career. So, it’s good news for runners as Dr Molly is a firm believer in safely getting people back to the hobbies they love. “Hobbies like running are linked to people’s identities, can be a great stress reliever, and great for overall strength and cardio. If you run and experience leakage, a pelvic therapist can help you adjust your running gait, strengthen your abdominals, look at your posture and breathing, and improve your pelvic floor muscles in order to decrease or eliminate leaking. This can be done for any sport.”
It might not be the workout you think of immediately but Dr Molly disagrees: “Every time your body moves as you swim horizontally your pelvic floor muscles turn on and are working to keep you stable. In fact, when done correctly, any movement is good for the pelvic floor.” See you in the pool.
You might assume cycling would aggravate your pelvic floor but variety of movement brings plenty of benefits. Dr Molly explains, “Pelvic floor muscles are just like the other muscles in our body: they benefit from relaxation, stretching, strength training and endurance training.” Sitting on a bike encourages you to engage muscles for stability and a low impact cycle ride promotes endurance. Remember to stretch after a ride and invest in the right shaped saddle.
What exercises should be avoided?
If you do suffer from a weak pelvic floor, either from pregnancy or childbirth, it’s a good idea to swap high-impact moves out of your workouts until you’ve worked on strengthening the muscles. While the pelvic floor is involved in any exercises we perform, Dr Molly recommends that we take it slowly when it comes to upgrading our workouts: “Instead of jumping right into the hardest exercises like planks, jumping jacks, and jump squats we need to work our way up to them. Otherwise, the exercise is too hard for the pelvic floor, and it will just give up, not gaining any strength from the super hard workout.”
Instead of jumping, try stepping to the side and a squat can be modified with gentler step-ups instead. Replace a plank with a kneeling plank for a move that will still engage the abdominals but not put the pelvic floor under too much pressure.
Looking for more workout inspiration? Here are 8 of the best Pilates exercises to strengthen your core, and 7 of the best exercises to try if you have lower back pain.