How Do I Contract My Pelvic Floor Muscles?
Hello friends! Do you know what a Kegel is? Do you know when you should do Kegels? Did you know Kegels can actually make some pelvic floor symptoms worse? Individuals with pelvic floor conditions (like incontinence and pelvic organ prolapse) are often told to “do some Kegels,” but they are given very little education on how to properly perform them. Today we are going to discuss the details of Kegels (pelvic floor muscle contractions) and we will give you some of our favorite cues to help you perform them properly.
So let’s start by talking about the difference between contracting and relaxing your pelvic floor muscles (PFM). Your PFM act like a hammock, connecting to the pubic bone in the front and the tailbone in the back. They support the pelvic organs. As you contract your PFM (do a Kegel), the pelvic floor muscles squeeze and lift, providing support to those organs. As your PFM relax, they open and lower, allowing for functions like peeing and pooping to happen. While Kegels often get the attention, know how to relax your PFM is just as important!
When done properly, PFM training has many health benefits. It strengthens the pelvic floor muscles so that they can provide support to the core and the pelvic organs. Strengthening the pelvic floor muscles can help to improve circulation to the region. Plus, if you are dealing with urge incontinence or overactive bladder (OAB), pelvic floor muscle contractions can be used as an urge suppression technique to help manage your symptoms.
Before we talk about cues on how to perform PFM contractions properly, it’s important to note that you should not perform Kegels if you are having pelvic pain—this can make your symptoms worse! If you have pelvic pain, see a pelvic health provider who can help you to manage your symptoms.
Kegels don’t always come naturally, but there are many different cues to help your brain connect to your PFM. Here are some of our favorites.
For individuals with vaginas:
For individuals with penises:
Regardless of whether you have a penis or a vagina, cues like trying to hold back gas or stopping the flow of urine can be helpful. Keep in mind that not all cues work the same for each person. Try different cues until you find the one that works best for you.
For females, you can use a mirror to look at the outside of your pelvic floor. The area between the vagina and the anus is called the perineal body. As the pelvic floor muscles contract, the perineal body should draw up towards your head slightly. As the pelvic floor muscles relax, the perineal body should lower towards your feet.
If you are using these cues but still having difficulty, or if you are still unsure about whether or not you are contracting or relaxing your PFM, products like Joy ON and Elvie can help. These are a type of biofeedback unit. Each one is inserted vaginally and measures the amount of pressure given by your PFM. As you contract the PFM, the pressure goes up; and as you relax the PFM, the pressure goes down. Each device connects with an app on your phone so you can see in real time what your pelvic floor muscles are doing.
When training your PFM, avoid these common mistakes:
Squeezing other muscles (belly, butt, inner thighs, toes, or everything!)
Holding your breath
In addition to the strength of your PFM, there can be other things impacting your pelvic floor. If you are having trouble, a pelvic floor physical therapist is an excellent resource. Not only can they help you learn to contract and relax your pelvic floor muscles, but they can look at other areas of your body (like your back and your hips) and screening for neurological signs to see if there are any underlying issues affecting your pelvic floor.
To learn more about the pelvic floor check out these resources below:
Ask your healthcare provider for a referral to a pelvic therapist.
Find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.
Watch our Pelvic Floor Muscle Training Playlist on YouTube
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics
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An Innovative Way to Use Internal Electrical Stimulation For Severe Pelvic Floor Dysfunctionwith Elizabeth Makous MSPT, CLT, PRPC, CES
Vaginal Weights: Evidence-Based Research Review with Amanda Olson PT, DPT, PRPC
What experiences or tips do you have that can help others? We’d love to hear them. Please join the conversation in the comments section below.
Written by Emily Reul, PT, DPT