The more you know … you know. Recently, Dr. Helene Darmanin, PT, DPT, CSCS, orthopedic and pelvic health physical therapist, Pilates instructor, author, and founder of Mama Bear Physical Therapy, shared the myths and truths about the pelvic floor. Today she’s providing more educational insight and walking us through the right way to Kegel.
We’ll let her take it from here.
“The way to strengthen our pelvic floor is, yes, by doing daily Kegels. Before starting, you first need to establish a good pelvic floor range of motion—diaphragmatic breathing is the best way to do this. Then you can try pelvic floor muscle contractions, aka Kegels.”
The correct way to Kegel, Dr. Helene’s step-by-step guide:
“First, let’s start with a quick anatomy lesson:
1. Perineum: Between the vaginal opening and the anus (feels a little tough or knobby because many pelvic floor muscles intersect there)
2. Pelvic floor: a diamond-shaped group of muscles that sits in the bowl of the pelvis
3. Bony corners of the pelvic floor (where the muscles attach): pubic bone (in front), tailbone (in back), sit bones (on either side)
1. Start by lying down to ease the work of the muscles (not having to hold your organs up against gravity in a supine position).
2. Find your Kegel, using one or all of these methods:
• Deep breathing: the four bony corners of the pelvic floor will pull together naturally as you exhale, and your perineum will lift up toward your ribs.
• Use a hand or a mirror for feedback (should feel/see perineum pull up and in, and the anus close).
• If you are having difficulty finding a Kegel, you can stop the flow of urine while peeing on the toilet ONCE (never again).
• Common cues: imagine lifting a blueberry with your vagina; feel like the perineum is an elevator going up into the body; close the flower of your vagina; squeeze a tampon; stop the flow of urine; feel like you have to pass gas and you’re holding it in.
If you’re doing it right, you will feel tightness around the vagina and anus, four bony corners coming closer together, and the perineum or middle of the pelvic floor lifting and narrowing.
You found how to Kegel, now what?
1. Slow holds: Try to hold a Kegel at about 60% of your maximum effort level for up to 10 seconds. Repeat as many times as you can (up to 10) with a rest in between, holding for the same amount of time with the same effort level as the first one. Once you can’t keep the contraction the same intensity or for as long, you’re done with that set. Ideally, do two sets.
2. Quick flicks: Quickly perform a Kegel and then relax fully before performing another one in quick succession. Try to do 10.
Now that you understand how to do a Kegel correctly, aim to achieve these goals:
1. To be able to sustain a slow hold contraction for 10 seconds without losing any intensity, and to be able to do this 10 times in a row (with rests in between contractions).
2. To not use any “accessory muscles”—inner thighs, glutes, and abs should stay relaxed and the effort/movement should be isolated in the pelvic floor.
3. No breath holding: you should be able to breathe normally whether or not you are performing a Kegel (though you may use breath initially to help facilitate finding the coordination).
4. Once you feel confident in your Kegels, and can perform ten 10-second slow holds in supine, then you can progress to sitting, then standing, then moving while performing a Kegel.”
New workout routine starting in 3, 2 … we’re doing it right now. Can you tell?