Kegel Exercise: How To

• Are you like millions of women who leak urine?
• Do you know where every bathroom is in a 5-mile radius of your house?  
• Dou wear a pantyliner to catch the little leaks that might occur if you cough, sneeze or laugh?  
• Are you like millions of women who leak as soon as they put the key into the front door lock. What’s up with that?

You Are Not Alone

If any of this sounds familiar, it’s because millions of women will experience some leaking, what we call urinary incontinence, at some point during their lives. This isn’t a topic that most women feel comfortable bringing up, even with their healthcare providers.

Most of my patients are surprised to learn that they’re not the only ones dealing with this. One patient told me she didn’t want to mention it because she was sure she’d be scolded for not doing Kegel exercises 10,000 times/day. As she said, “I don’t even know if I’m doing them right.”

Normal Anatomy

Women who are dry and don’t leak urine are usually younger and have not had any pregnancies. Although, many women who have never been pregnant start to leak after 45.

As you can see in this illustration, prior to any pregnancies, our bladders sit up on the pelvic floor muscles, much higher than the vagina. There are little valves at the bottom of the bladder that prevent any leaking. These are surrounded by muscles and they keep us dry if we exercise them.

However, after a pregnancy or after 45, everything tends to move down. I’m sorry, ladies, but Gravity is NOT our friend here! Those lovely valves that kept everything dry, well, now they’re lower, and if the muscles are weakened, then leaking can occur.

And this can also occur as we age and by one or more of the following factors:

• Added weight
• Pregnancies
• Loss of estrogen
• Menopause
• Nerve damage from diabetes
• Hereditary factors
• Repeated straining  or pushing, such as what many people do when constipated

Eventually, over time, as gravity works it’s not-so-nice magic on the pelvic floor muscles, the bladder can slip down into a curved position where some of the urine will rest in a pool that never quite empties, which can lead to leaking.

Should You Exercise Your Pelvic Floor Muscles?

The pelvic floor is like a small trampoline, it has a little bit of bounce and keeps all the organs in their places with bright shiny faces. Exercising your pelvic floor muscles helps strengthen those muscles and as they get stronger, it can help women regain control, which leads to less leaking.

Take this Quick Yes or No Quiz

• Even if I squeeze hard, I can’t stop my urine flow
• I leak urine 1 or more times a week                                         
• I wear a pad every day because I leak every day                   
• I sometimes avoid going out because I’m afraid I’ll leak     
• I sometimes leak as I’m walking to the bathroom.                   

If you answered Yes to any of these questions, practicing pelvic floor exercises can help you regain more control over your bladder.

How to Exercise Your Pelvic Floor

It may be difficult to isolate the muscles of your pelvic floor and to learn how not to use your abdominal muscles to squeeze, hold and then relax. Here’s how you might practice in the privacy of your bathroom. I recommend trying this while seated on the toilet.

• Sit as comfortably as possible on the toilet
• Take a few deep breaths
• Now try squeezing or tightening your vagina, without squeezing or tightening the muscles in your abdomen or buttocks
• Hold the squeeze for 3 seconds, while you breathe in and out
• Practice this the next time you urinate to see if you can slow or stop your urine flow
• If you have a partner, you can also practice these squeezing exercises during sex

I hope this helps. If you need to find a pelvic floor physical therapist, click here for a PT locator for certified pelvic floor physical therapists.

If you have any tips on how you remind yourself to exercise your pelvic floor, leave a comment. Stay Dry!