Effective Kegel exercises

Kegel exercises strengthen the muscles of the pelvic floor, which support the bladder and other pelvic organs. Kegels can help treat stress urinary incontinence and help prevent it from getting worse, and can also help with urge suppression.

“Used in combination with other conservative managements, they can be very effective,” says Frances Stewart, advanced practice nurse and nurse continence advisor at Women’s College Hospital. “But in order to be effective, Kegels must be done correctly.”

Identifying the right muscles

A Kegel exercise contracts the muscles of the pelvic floor, squeezing and then releasing.

“The best way to tell if you’re contracting the right muscles and doing an effective Kegel is to insert a finger into your vagina,” Stewart says. “If you can feel the vaginal walls tighten around your finger when you contract your pelvic floor muscles, you’re using the right muscles.”

Cones can also help women learn to do Kegels. A weighted cone is placed in the vagina, and held there using the pelvic floor muscles.

“You start with a very light cone, and work up to progressively heavier cones, and hold them for a certain period of time,” Stewart says. Cones can be helpful for some women, but they have the disadvantage of adding a cost to an exercise that in most cases requires no equipment.

It’s important to use the right muscles, or Kegels won’t be effective.

Kegel exercises use the same muscles that are used to stop the urine stream while urinating. However, avoid trying to identify the right muscle group by stopping and starting the urine stream. This is not recommended because stopping and starting while urinating can prevent the bladder from emptying properly.

“If you think you’re not doing Kegels correctly, a nurse continence advisor or a physiotherapist can help,” Stewart says.

Regular exercise

Like any other muscle group, the pelvic floor muscles need regular exercise to become stronger.

“Different people teach different Kegel regimens, but I recommend squeezing for a count of five, and slowly releasing the muscles for a count of five. Start by doing 10 of those, four times a day,” Stewart says, adding that it’s important not to over-do it at first. “Then work your way up to sets of 15 repetitions, and then 20 repetitions four times a day, with the goal of 80 Kegels per day.”

Stewart recommends doing a set of Kegels at breakfast, lunch, dinner and bedtime as a simple way to incorporate Kegels into a daily routine.

“Once you’ve learned to do Kegels, you can do them almost anywhere,” she says. “You don’t have to be sitting down, you don’t have to be lying down. You can do them on the subway or at stop signs or anywhere. But it has to be regimented, so make yourself a program.”

Like building any muscle group, it takes time to strengthen the pelvic floor.

“It takes six weeks to three months to see results,” Stewart says. “A lot of people give up doing Kegels because they don’t see a great result in a short period of time. The important thing is to do them correctly and to continue to do them on a regular basis.”