5 ways to make Kegel exercises more effective

As a pelvic floor physical therapist, one of my pet peeves is the advice that Kegel exercises are for everyone. That’s just not true. I have nothing against Kegels, because they do work—for some. They’re just simply not the end-all-be-all or Holy Grail of the pelvic floor, because there’s a lot that goes into finding out if Kegels are the right pelvic floor exercise for you.

I’ve helped thousands of women recover pelvic floor function without medication or surgery. But most importantly, I’m not prescribing any “cure all” solution to all your pelvic floor issues. There’s a lot of bad advice out there—especially when it comes to your pelvic health.

Here are 5 reasons why Kegels might not currently work for you, how to make Kegels more effective if they do—and actionable steps to finally get you the results you’re looking for.

Related: You can (and should) start pelvic floor exercises right after birth. Here’s why

5 reasons why Kegels might not work for you

1. The pelvic floor is just one part of the system

It’s important to understand that your pelvic floor is just one part of a larger system of core muscles, and you need a complete, robust approach when it comes to healing pelvic floor issues. Look at it like a system, everything is interconnected and corresponds together.

Breathing three dimensionally, with your diaphragm, is the first step.

Action step: Check in with your breathing by putting one hand on your chest and one hand on your waist. Take a deep breath in. Where are you feeling the breath move? Are you a chest or waist breather? This is a great way of connecting the two parts (the diaphragm and the pelvic floor) of the system back “online” with one another. Ideally, you should feel your waist moving in all directions—forward, back and both sides expanding.

You can throw a Theraband or even a tie around your waist and while you are washing your face, feeding your kiddo or reading this article (!) to practice feeling your waist expanding in all of these directions. This will help you wake up your diaphragm, a key member of the pelvic floor system.

2. Your posture could be suffering

Kegel exercises are a very isolated approach to improving pelvic floor health. It’s kind of like when we try to do arm exercises because we want toned arms—only to skip “leg day” or ignore exercising the rest of our bodies.

The way you sit affects the tone of your pelvic floor muscles. Many of us are sitting with poor posture all day: on the tailbone, with your body in a C-shape. The good news is this is fixable. Good posture keeps your pelvic floor muscles in alignment without putting excess strain on them, which will lead to better function overall.

Action step: Check your posture a few times throughout the day. Take a picture of yourself sitting—or have a partner do it for you. What do you notice about your body’s alignment? For proper posture, think ears over shoulders over hips.

Related: 9 safe and simple pregnancy exercises for each trimester

3. You’re under-thinking it

A lot of people think about doing Kegels at the traffic light or while they’re waiting in line at the grocery store. It’s this mentality of, “I can squeeze in 10 Kegels right now and I’m good.”

But, in reality, your pelvic floor is a part of the body that can benefit from being present and mindful.

Action step: Instead of doing Kegels absentmindedly or slamming them out like a bicep curl, try a thoughtful, mindful approach to doing your pelvic floor exercises. You can improve the brain-to-muscle connection by paying attention during the exercise, activating the pelvic floor muscles that are not as involved so that their support becomes more automatic down the road.

Related: What if we saw sex as self-care?

4. You’re overthinking it

Sometimes we can be so lost in our heads that we overthink Kegels. Really, the exercise is very simple! But it works best when we’re relaxed mentally and physically.

Action step: As you Kegel, take a minute to walk your mind through some visualization techniques. Imagine an elevator door closing and lifting, closing and lifting. Or, one of my favorites, cold butter melting in a hot pan, which is great for visualizing the relaxation portion of the exercise—and just as important for full range of motion.

5. Your pelvic floor muscles are too tight

Around 85% of my clients in my private practice have pelvic floors that are actually too tight; this comes as a great surprise to them when they come to see me due to urinary incontinence after birth, and they think all they need to do is strengthen down there.

Too-tight pelvic floor muscles means that the muscles are not coordinated and flexible, so they can’t move through a full range of motion.

Imagine doing more tension and flexing on top of that! That’s exactly what Kegels do; they tighten and lift. So if you’re already tense in your pelvic floor, your Kegel exercises could actually make the issues you’re experiencing worse.

Action step: Try to do a quick Kegel. What do you feel? If you feel like it’s very easy to squeeze but you don’t feel the relaxation very easily, you might be too tight. For a professional opinion, reach out to a pelvic floor physical therapist near you, who can best help you come up with a care plan that works.

A note on making Kegels more effective

It’s time to make these secrets about pelvic floor health not so secret anymore. And as always, check in with your care provider if you have any concerns about your pelvic floor health, or if you are experiencing pain.

A version of this story was originally published on Oct. 9, 2020. It has been updated.