Yes, these pelvic floor exercises really work! Here's how to get started.

By Amanda First, Published September 2012, Prevention 

 

You may have heard of Kegel exercises—the squeezing and releasing of the pelvic floor muscles—as a way to strengthen your sex life. But, since they target the muscles that wrap around your urethra, they can also work wonders for bladder control: Research shows that up to 70% of women with stress incontinence who regularly exercised their pelvic floor experienced improvement.

That said, the exercises—named for gynecologist Arnold Kegel, MD, who first wrote about them in 1948—are not as easy as they seem. At least half of women with urinary incontinence have difficulty isolating their pelvic floor muscles, says Benjamin Brucker, MD, a urologist at NYU medical center. If doing Kegels on your own hasn't been working for you, you might be using the wrong muscles or an improper technique. Try these tips to make sure your pelvic floor gets the best workout possible:

 

What's the right way to do Kegels?

• To get a sense of which muscles you're working, try to stop urinating mid-stream. That's the area you want to target during Kegel exercises.
• Imagine squeezing a pebble with your vagina.
• Try your Kegels in front of a hand mirror. If you’re doing them properly, your perineum, or the skin-covered area between your vagina and anus, should contract with each rep.

Ideally, each rep should last 10 seconds, but that's no easy feat. Start with at least 4 or 5 reps of 2-second holds, 2 or 3 times a day, and increase your hold time week by week.

 

What if I need more help?
If you're not sure Kegels have been working for you, consider booking an appointment with a pelvic floor physical therapist—for women who have trouble isolating their pelvic floor muscles, physical therapy can make an enormous difference, Dr. Brucker says. Your physical therapist will prescribe a personalized exercise program to strengthen your pelvic floor over time.

"Just like the way a physical trainer works with you on reps at the gym, we increase the length of each Kegel from two seconds to five or ten seconds as you get stronger," says Amy Stein, MPT, the founder of Beyond Basics Physical Therapy in New York City and a practicing pelvic floor physical therapist. The muscles in your pelvis affect your legs and abs as well, and vice versa, so after helping you isolate and exercise your pelvic floor, a physical therapist will introduce core-strengthening exercises. "If your abdominal or leg muscles are weak, your pelvic muscles may be working overtime," Stein says. Try Pilates for a core workout that extends to your pelvic floor.

 

How do I know if my Kegels are working?
Your gynecologist/urologist or pelvic floor physical therapist may also suggest biofeedback, an electronic sensor system that maximizes the effectiveness of each Kegel session. The sensors detect the strength of each contraction and where it's coming from, so you and your doctor can see whether or not you're using the correct muscles. Of course, you should practice every day at home—or at work, or in the car, or at the supermarket... You can do "the invisible workout" anywhere, but Dr. Brucker suggests making them a part of your daily routine. "Do your Kegel exercises right after you put on your clothing, or when you're sitting and reading the newspaper, so you remember to do them every day," he says.