The terms used to describe exercises for the deep muscles at the base of the torso can be confusing, with “pelvic floor exercises” and “Kegels” often used interchangeably. These muscles, collectively known as the pelvic floor muscles (PFM), form a sling structure extending from the pubic bone to the tailbone. This muscle group supports the bladder, bowel, and, in women, the uterus, playing a significant role in continence and core stability. Understanding the difference between the broad category of exercises and the specific technique is the first step toward effective training.
Clarifying the Terminology: Pelvic Floor Exercises vs. Kegels
Pelvic Floor Exercises (PFE) is the comprehensive term for any movement or strategy intended to improve the function, strength, and coordination of the pelvic floor muscles. This category includes a range of techniques, from isolated contractions to integrated movements with the core and breath.
The term “Kegels” refers to a specific, standardized type of PFE, named after Dr. Arnold Kegel, an American gynecologist who first described the exercises in the late 1940s. Dr. Kegel focused on the repeated contraction and relaxation of the PFM primarily to address issues like urinary incontinence. Therefore, while all Kegels are a form of PFE, not all PFE are traditional Kegels.
Locating and Engaging the Pelvic Floor Muscles
Correctly identifying the pelvic floor muscles is a common initial challenge, as many people mistakenly contract their glutes, inner thighs, or abdominal muscles instead. The correct sensation is an internal “squeeze and lift,” as if you are trying to pull the base of your pelvis upward toward your navel. The muscle contraction should be internal, creating a sensation of drawing in and up rather than bearing down.
A reliable method for both men and women is to imagine trying to stop the passage of gas. The muscles used to squeeze the anus shut are the PFM, and feeling a distinct pulling sensation at the rectum confirms correct engagement. For women, a more specific test involves inserting one or two fingers into the vagina and attempting to squeeze the muscles around the finger. Men can also identify the muscles by trying to lift the base of the penis without moving the rest of the body. While stopping the flow of urine midstream can help identify the muscles initially, this should not be a regular practice, as it can interfere with proper bladder emptying and potentially lead to infection.
Step-by-Step Guide to Performing Kegels
The standard Kegel exercise focuses on two types of contractions: slow-twitch for endurance and fast-twitch for quick response. Begin in a comfortable position, such as lying down, which reduces the influence of gravity and the core muscles. The starting technique involves a smooth, controlled contraction of the PFM, mimicking the “squeeze and lift” sensation.
For slow-twitch fibers, contract the muscles and hold the squeeze for three to five seconds, then fully relax for the same duration. Maintaining normal breathing throughout the hold is important, avoiding the tendency to hold the breath or strain. The relaxation phase is equally important, allowing the muscle to recover and preventing chronic tension.
Once the slow-twitch holds are mastered, incorporate fast-twitch contractions, which are quick, strong squeezes followed immediately by a full release. These quick contractions are essential for the rapid muscle response needed when coughing, sneezing, or lifting. A common routine involves performing three sets of 10 to 15 repetitions daily, mixing both slow holds and quick flicks. Consistency is key to achieving noticeable strength improvements, which may take between three to six weeks of regular practice.
Functional Integration: Beyond Basic Contraction
Moving beyond the isolated contractions of a traditional Kegel involves integrating the PFM into everyday movements, which is a broader form of Pelvic Floor Exercise. The pelvic floor is part of a deep central stability system, working in coordination with the diaphragm, deep abdominal muscles (transverse abdominus), and small back muscles (multifidus). This coordination is often referred to as the inner core unit, which functions dynamically during movement.
A key technique for functional integration is coordinating the PFM with your breath, known as the “connection breath.” As you inhale, the diaphragm descends, and the pelvic floor should naturally lengthen and relax. Conversely, as you exhale, the diaphragm rises, and the PFM should gently contract and lift.
Applying this coordination to daily life means timing the PFM contraction with exertion, often called “exhale on exertion.” For example, before lifting a heavy object, coughing, or standing up, exhale and gently contract the pelvic floor and deep abdominals. This preemptive tightening offers a protective brace, ensuring the strength developed during isolated Kegels translates into real-world stability and continence.