K is for Kegels!

You might live your whole life without hearing about, thinking about or reading about Kegel exercises; and then — you get pregnant. Suddenly they’re a part of your doctor’s recommendations, woven into your yoga class, insisted upon with grave intensity and warnings of reproductive organs spilling out onto the floor from a severely weakened pelvic floor.

For those new to this very personal, yet popular, pregnancy and postpartum discussion topic, let’s start with the basics: What is a Kegel exercise? And what’s all the fuss about?

What are they?

Kegels are named after Dr. Arnold Kegel, the 1950s gynecologist responsible for developing a tool for measuring the strength of the pelvic floor muscles (the perineometer). He was also the guy who came up with specific exercises to strengthen this group of muscles. 

Though there are different ways to do Kegels — which the good doctor also associated with more frequent and intense orgasms for women — they’re often described as the muscle contraction needed to stop the flow of urine. 

This is a good starting point in figuring out what the heck you’re supposed to do while working your pelvic floor. Variations include 1) a slow pulling in of this muscle, holding it for a certain amount of time and slowly releasing it and 2) the elevator method, in which the woman contracts the vaginal canal in a series of stops or pauses as if on an up-going elevator. (A comprehensive list of exercises can be found at the Dr. Sears website.)

Wait: Weights?  

There are even weights for doing Kegels! You heard me! I spoke with Amanda Olson, the pelvic physical therapist at Intimate Rose, one of the leading Kegel weights companies. 

“Kegel weights are beneficial for several reasons,” she said. “First and foremost, many women are doing Kegels wrong. To contract the muscles, you must squeeze and pull them up and inward — like one of those token games where a claw grabs a toy and pulls it up. Many women are pushing down on the muscles instead of pulling up.” 

Olson went on to say that not only are the weights educational, in that they teach a woman which muscles to use, they’re also progressive. 

Intimate Rose weights come in increasingly heavier weights. You work up to a certain weight-lifting capability, just as you would with any exercise program. (There’s even a private Facebook group for users.)

Many birth professionals (myself included) appreciate the benefits of Kegels, but usually recommend a more varied path to pelvic floor health that includes other exercises, adequate sleep and good nutrition and hydration. 

Don’t overdo it

Kate Andrew, a Northfield-based certified professional midwife and founder of Southern Minnesota Midwifery, said Kegels are just one small aspect of good pelvic floor health and can actually be overdone.

“If they are the only thing you are doing for your pelvic floor or you are doing them in excess, you will be working your muscles in one specific way, over and over again, which actually results in a weakening of the pelvic floor,” she said. “We need variety — such as also adding squats and stretching.”

Indeed, biomechanics expert Katy Bowman argues that alignment and adjacent muscle strength — not Kegels — are what make a strong pelvic floor. Her video, Down There: For Women, offers an “easy-to-follow protocol for stretching and strengthening the muscles that keep the pelvis aligned, allowing the pelvic floor to operate less like a hammock and more like a trampoline.”

(Read a fascinating anti-Kegel interview with Bowman.)

Where does this leave us? 

I think it’s important to have an awareness of Kegels, especially if you’re actually experiencing issues with leakage. 

I also agree with Andrew, however, that a great many things can help with our pelvic health — yoga, Pilates, breathing, water, warm tea, salt baths and a healthy sexual relationship, too.

Jen Wittes is a certified postpartum doula and writer who now works in marketing and communications. She lives in St. Paul with her husband, two kids and two cats. Send questions or comments to jwittes@mnparent.com.