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How To Do Kegels

Pelvic floor exercises, which include kegel exercises, are extremely useful in decreasing pain and improving lumbar spine function – especially to women post-partum.  After 9 months of carrying a baby in utero, women’s abdominals stretch and are rendered less effective in keeping the lumbar spine stable. Additionally, the extra weight carried in the front of their bodies increase strain on the lumbar spine and pelvis. During birth, episiotomies may happen, tearing and stretching and ligaments of the pelvic floor may happen, and C-sections (a complete surgical rupture of the abdominal fascia) can also happen, further jeopardizing the mother’s post-partum spine and pelvic function.

Some common symptoms we see in the clinic is dyspareunia (pain with intercourse), incontinence (leaking when laughing or exercising), and pelvic prolapse.  One of the ways we can treat for these issues is from introducing Kegel exercises.  Not all women are clear what they are or how to do them, so here is a Q&A about Kegels:

What are Kegel exercises?

Simply put, they are exercises that contract and strengthen the pelvic floor muscles. This is similar to how bicep curls may strengthen bicep muscles. While most women have heard about Kegel exercises, research indicates only 30-50% of people perform them correctly.

Why does correctly contracting the pelvic floor muscles matter?

Correct activation strengthens the desired muscles. This can help with decreasing leaks/incontinence, healing after giving birth, stabilizing pelvic prolapse symptoms, healing after
trauma including falls on the buttocks, and enhance pleasure for both partners during intercourse.

What’s the harm in doing this incorrectly?

If done incorrectly, they can increase leaks, prolapse symptoms, and further weaken already compromised muscles.

It is important to “draw the pelvic floor up and in” and avoid forceful bearing down, as well as avoid breath-holding.

How do I do Kegels on my own?

1. Lie on your back to start, knees bent and opened. Check that your stomach and bottom muscles are relaxed – make sure you’re not holding your breath. Use a hand mirror to observe your pelvic floor muscle (“PFM”) area = the muscles around your vagina. When you perform a Kegel, you should see the perineum (area between vagina and rectum) draw up and into into your body.

2. Squeeze and lift your pelvic floor muscles as strongly as you can. (You may only feel a subtle movement to begin with). Tighten your pelvic floor muscles, and not the muscles of your thigh or buttocks. Feel your pelvic muscles pulling up and inward into your abdominal cavity with each contraction.  You can feel the contractions with your fingers – make sure you are not pushing down and out (this is the opposite of a Kegel!)

3. Try and hold the squeeze for 3 – 5 seconds (you may like to begin with just 3 seconds).

4. Rest for 5 – 10 seconds and then repeat the ‘squeeze and lift’ 5 – 10 times. This is one set.

5. The most important part of doing a Kegel is the relaxing after the contracting. Full relaxation is key!! Fully letting go your pelvic floor is critical for getting a great contraction. If you hold a low level of contraction all the time, you get weaker and can never fully contract your pelvic floor. This is what causes leaks. Focus on both the contraction phase and the releasing phase.When you first start out your muscles might be weak, however it’s important that you don’t ‘cheat’ by holding your breath or squeezing your inner thighs/ bottom. Try to work up to three sets each day.

6. Once you’ve got the hang of the exercises you might like to link your exercises to other regular daily activities as a reminder. Try them out when brushing your teeth, having a shower or after toileting. The most important part of doing a Kegel is the relaxing after the contracting.  A pelvic floor physical therapist can help guide you on how to properly perform Kegels if you are unsure or cannot fully feel muscle activation. For better guidance, Stride Strong Physical Therapy’s women’s health physical therapists can help guide you through this process, especially if you have concurrent pain or you feel you’re not sure about this exercise.

If you would like to come and visit a womens health physical therapist, we have private treatment rooms at our Hillsboro clinic for patients who want to discuss their concerns with a specialized pelvic floor physical therapist in a private and quiet setting. To read more about our Pelvic Floor Physical Therapist, click here.

Sources:

Eldeeb et al. Effect of segmental stavilizaing exercises augmented by pelvic floor muscles training on women with postpartum pelvic girdle pain: A randomized controlled trial. 2019 Jan 4. doi: 10.3233/BMR-181258. 

Nilsen et al. Mechanical oscillations superimposed on the pelvic floor muscles during Kegel exercises reduce leakage in women suffering from stress urinary incontinence: A prospective cohort study with a 2-year follow up.  2018 Oct;97(10):1185-1191. doi: 10.1111/aogs.13412.

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Alice Holland, DPT

Doctor of Physical Therapy, Director at Stride Strong Physical Therapy
Alice earned her Doctorate of Physical Therapy from USC in 2007, and have practiced Physical Therapy for 12+ years in the Outpatient Orthopedic Setting. Certified in ASTYM, she also has been a featured expert on Physical Therapy on numerous publications including health.com, healthline.com and yahoo.com.
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Ana Lucia Pinheiro
Ana Lucia Pinheiro
02:18 20 Oct 17
This place is amazing. I am so happy I found Stride Strong PT. Alice pays attention to all of the details, she watches every single move I make, my posture, and the way I move through every exercise. She is very knowledgeable, she was able to pin-point the problems in my back and she has a plan to help me become stronger where I need. The place is brand new, huge, and has nice exercise machines. I tried a few physical therapists in the area, and Alice is TOP, second to none, and I feel super lucky to have found her. Highly recommended!!
Prashant Gupta
Prashant Gupta
01:00 02 Oct 17
Dr. Alice at Stride Strong is one of the best PTs I have come across. Her attention to detail and assessment of the root cause of injury is very good. She is excellent in evaluating pain patterns and giving a training schedule for a rehab & injury prevention, she is extremely knowledgeable. I would strongly recommend Stride Strong to anyone looking for PT. It is easily the best PT clinics in Hillsboro area.
steven zollin
steven zollin
20:57 14 Sep 17
Highly recommend Stride Strong Physical Therapy , Alice showed me proper form to assist in recovery with my shoulder and is very knowledgeable.
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I recently had a massage from Joel at the Hillsboro location. He was able to work on an ongoing issue I have been experiencing with my back after a sports injury, and I left feeling so much better. The whole facility looked incredible, and everyone I met was friendly and welcoming. I would highly recommend Stride Strong for massage and physical therapy.
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08:20 08 Nov 17
Dr. Sydney is by far the absolute best physical therapist I've worked with ever! Her expertise in designing highly effective and efficient exercise plans is beyond compare. I feel so much better as my strength and function increases. She comes up with the most brilliant and fun ideas to motivate. To my delight she even offered to come to my home in Vancouver and work with me on my own equipment including a Stott Pilates Reformer. Talk about going above and beyond! Couldn't be more grateful I found her!!!
Clare Perry
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21:58 23 Oct 17
A full hour of a dedicated PT professional's time without aides or techs? That's just one of the things that sets this clinic apart from others. Competent, professional, and amiable, Dr. Alice Holland and her team are the best in the area. While I generally see them at the Cedar Mill Clinic on Cornell, situational constraints took me to their new Hillsboro clinic today near Intel Jones Farm. Beautifully furnished, spacious with easy parking and access. May you continue to grow and thrive, Stride Strong!
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After foot surgery I went to Stride Strong for therapy with Alice Holland. She helped me reach my full mobility again by continuously introducing new and challenging exercises. The entire staff is friendly and professional. They are always on time and do not rush. I look forward to doing 1/2 marathons again and riding my recumbent trike. Thank you Stride Strong for your care and high level of expertise.
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The best physical therapy ever. Both JP and Sydney were a great PT, they helped me understand how I can help treat my injury and how it may have caused. And also they informed about so many techniques that I can use to help my injuries or any other injuries I get in the near future. They are both friendly and nice to talk too, and verbunformative. And there is also Krystal, she is the best front desk receptionist ever, she is nice and friendly and can easily manage your schedule based on the patients comfort if they want to schedule or not. She can help and she replies fast to any patients email. And she is easy to talk to. Thank you Stride Strong Physical Therapy.
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In just a month I've seen great progress! I've been incorporating the exercises taught to me into my daily workout routine. Im very happy with my continued results.
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23:43 10 Jun 18
Mary Szal here: I've had three sessions with Brittany at the Hillsboro location. I can say that she has been the most effective and instructive physical therapist I've ever experienced. Her personality, energy, knowledge and results are top notch.
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00:05 22 Mar 18
Awesome place for PT. Hillsboro location has plenty of parking and very spacious. I had the pleasure to work mostly with Dr. Alice Holland and JP. I came in with a shoulder injury and thank goodness they understood what I was going through. They are the best of what they do, I would recommend Stride Strong to anyone who needs PT.
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