What to do if Kegel Exercises Don't Work

Kegel (pelvic floor) exercises are clinically proven to strengthen your pelvic floor muscles. Depending on your overall health and your commitment to Kegel exercises, you will see results anywhere from 4-12 weeks. However progress is not always easy to identify. What if you’ve given Kegels a go and have not had any noticeable benefit? Take a look at our advice below to make sure you are not making any common mistakes.


How Do You Know They Aren't Working?

Use a biofeedback pelvic trainer to measure the squeeze of your pelvic floor, insert the vaginal probe and contract your pelvic floor muscles. The tool can confirm you are contracting the correct muscles and how effective you are doing it. It teaches you how to make each squeeze more valuable, and as a result it can improve the effectiveness of your pelvic floor exercises by almost 25%!




Make Kegels Part of Your Routine

Kegel exercises are essential to your health, just like brushing your teeth. So why not do them at the same time, morning and night.

If you do not routinely complete your Kegel exercises, you are unlikely to see an improvement. Manual exercises need to be completed daily, or you can use an electronic toner just once a week to maintain your pelvic floor after following our 12 week pelvic floor exercise plan. Here are some good times of day to introduce Kegels:

  1. When you brush your teeth - Kegel exercises are essential to your health, just like brushing your teeth. So why not do them at the same time, morning and night.
  2. When you're at a red light - We travel almost every day. Use this time wisely; every time you hit a red light – Kegel, every time you’re bus or train comes to stop – Kegel!
  3. When you cough, laugh or sneeze - Make it a habit to squeeze your pelvic floor muscles when you cough, laugh or sneeze. These are the times your bladder and bowel are put under pressure and you will be more vulnerable to little embarrassing accidents.
  4. When you're doing your chores - ‘Whistle while you work’, how about Kegel while you work? Pick a chore: vacuuming, ironing, pot washing; and Kegel while you do it!
  5. During the TV adverts - Kegel during the opening credits, again during the ad breaks and then during the closing credits. If you are using an electronic toner, you may feel a tingling or 'knocking' sensation in your pelvis, but it wont be enough to distract you from your favourite show.
  6. Before or after sex or masturbation - Use your electronic toner before sex to invigorate and awaken your tissues making orgasms more frequent and powerful. Use afterwards to give your pelvic floor a cool down after its cardio workout!
  7. While browsing the internet or reading a book - Many of us bring our tablet or laptop into bed with us, why not bring your electronic toner too. Whilst you read the latest news, watch funny cat videos and answer emails, its a great time to start a programme.

5 Common Pelvic Floor Exercise Mistakes

The pelvic floor is complicated and it’s easy to make a mistake without realising – we’ve put together a list of the 5 most common mistakes we’ve come across and how to fix them:

  1. Bearing down instead of lifting - If you push downwards when you do a Kegel then you could be straining the muscles, so that they overstretch and weaken further. If you notice your symptoms are getting worse then this may be the cause. A proper Kegel should feel as if you are lifting your muscles upwards towards your belly button, as if you are trying to stop peeing mid-flow. Sit down and try to lift your vagina and anus away from the surface you’re sitting on without moving your pelvis, this is the right kind of movement.
  2. Not activating every muscle - Your pelvic floor includes your urethra, vagina and anus, which poke through the pelvic floor to the outside. Tense as if trying to stop passing wind and urine at the same time, contracting the muscles around all three of these openings at once. Avoid squeezing your buttock or abdominal's though - put your hand on your buttocks to check they are not tensing, if they start to contract, release your muscles and try again. Read our guidance on How to Find Your Pelvic Floor Muscles for more advice. If you continue to have trouble then you would benefit from using an electronic pelvic toner, which exercises only the pelvic floor muscles for you.
  3. Contracting but not relaxing - A single Kegel includes the total relaxation of the muscles as well as the contraction. This allows the blood to flow back into the muscles, feeding and strengthening them. If you don’t do this properly then you risk muscle spasms and fatigue as the muscles become tight, leading to unpleasant conditions like pelvic pain and constipation. To make sure you are fully releasing your muscles, breath deeply while you exercise. Breath in and contract while counting slowly to 5, then breathe out to a count of 5 while you relax. You should be able to hold a conversation whilst you do your Kegels, providing you can talk and count at the same time! Most importantly, don't forget to stop when your muscles are tired, don't overdo it.
  4. Bracing too much - If you are intentionally contracting your abdominal muscles while you Kegel then you’re probably not feeling much benefit. You may think that you can get two exercises done at once, however activating your core muscles too much can strain your pelvic floor. This can make your pelvic floor muscles spasm, causing pelvic pain. Try to focus on just contracting your pelvic floor muscles when you Kegel. You will probably feel the very bottom of your abdomen tense while you do this, this is fine and will help keep your muscles strong, but it shouldn’t be an intentional movement. If you’re having trouble avoiding this, then you would benefit from using an electronic pelvic toner, which exercises only the pelvic floor muscles.
  5. Bad posture - As well as causing back pain, slouching has a negative effect on your pelvic floor. Exercising with poor posture will strain your pelvic floor rather than exercise it. Sitting up straight while you do Kegels makes them 24% more effective. When your torso is properly aligned, everything is much more supported and your pelvic floor can contract more efficiently. Make sure your bum is at the back of your chair and your spine is lengthened. A posture cushion in a sturdy chair can help you to do this, or a yoga ball; sit up straight with your feet on the floor hip width apart. Balance evenly on your pelvis, look forwards and concentrate on lengthening your spine as you contract.


The Exercises Still Don't Work

There is a possibility that your muscles are too weak for manual Kegel exercises to be effective. Or you may have some nerve damage as a result of a pelvic surgery or childbirth, which can prevent you from voluntarily contracting and relaxing these muscles. 64% of GP's, Consultants and Healthcare Professionals recommend using an electronic pelvic toner as a first course of action. The NMES used by electronic pelvic toners are more than twice as effective as manual pelvic exercises, and can bring back the sensation which allows you to voluntarily contract and relax these muscles.

If you believe there is a medical reason why you are unable to improve the strength of your pelvic floor, please speak to your GP or Gynecologist.


Sources

Chmielewska, D. Stania, M. Smykla, A. Kwaśna, K. Błaszczak. E. Sobota, G. Skrzypulec-Plinta, V. (2016). Acta of Bioengineering and Biomechanics. Bioelectrical activity of the pelvic floor muscles after 6-week biofeedback training in nulliparous continent women. [online] 18(3), p105-113. [viewed 17/04/18]. Available from: https://www.semanticscholar.org/paper/Bioelectrical-activity-of-the-pelvic-floor-muscles-Chmielewska-Stania/d54d8b4ca52334ae9aa075a1884b0ffb95062dd0

Hay-Smith, E. J. C. Herderschee, R. Dumoulin, C. Herbison, G. P. (2011). Cochrane Database of Systematic Reviews. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. [online] 7(12). [viewed 16/04/18]. Available from: http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD009508/full

Mayo Clinic. (2017). Pelvic organ prolapse. [online]. Mayo Clinic, 2017. [viewed 16/04/18]. Available from: https://www.mayoclinic.org/diseases-conditions/pelvic-organ-prolapse/care-at-mayo-clinic/mac-20360560

National Childbirth Trust, NCT. (2014) Pelvic floor exercises how-to guide: Pregnancy & beyond [online] National Childbirth Trust, 2014 [viewed 05/04/2018]. Available from: https://www.nct.org.uk/pregnancy/pelvic-floor-exercises-during-and-after-pregnancy

NICE. (2005). Intramural urethral bulking procedures for stress urinary incontinence in women. [online] National Institute for Health and Care Excellence (NICE), 2005. [viewed 16/04/18]. Available from: https://www.nice.org.uk/guidance/ipg138/resources/intramural-urethral-bulking-procedures-for-stress-urinary-incontinence-in-women-pdf-1899863165915845

NICE. (2006). Insertion of biological slings for stress urinary incontinence in women. [online] National Institute for Health and Care Excellence (NICE), 2006. [viewed 16/04/18]. Available from: https://www.nice.org.uk/guidance/ipg154/resources/insertion-of-biological-slings-for-stress-urinary-incontinence-in-women-pdf-1899863280129733

NICE. (2007). Faecal incontinence in adults: management. [online] National Institute for Health and Care Excellence (NICE), 2007. [viewed 16/04/18]. Available from: https://www.nice.org.uk/guidance/cg49/resources/faecal-incontinence-in-adults-management-pdf-975455422405

Price, N. Dawood, R. Jackson, S. R. (2010). Maturitas. Pelvic floor exercise for urinary incontinence: A systematic literature review. [online] 67(4), p309-315. [viewed 16/04/18]. Available from: http://www.maturitas.org/article/S0378-5122(10)00317-8/pdf