Practice Makes Perfect: An Introduction to Kegel Exercises

Performing kegels each day may help keep incontinence away


This is Karlotta Davis. I am a professor of Obstetrics and Gynecology at University of Colorado Health Sciences Center.

I am here to talk to you today about Kegel contractions. Arnold Kegel was an Obstetrician/Gynecologist who learned in the 1940s the importance of the levator ani muscle, which has commonly become known as the Kegel muscle. He did a study and actually had patients perform 600 Kegel contractions on a daily basis. He had them keep diaries that would allow them to remember doing Kegel contractions.

What he discovered was that women who did regular contractions of this pelvic floor muscle did much better in terms of incontinence.

How he made this discovery is not really clear, but we know today that women who do regular Kegel contractions make a huge difference in their incontinence – both stress incontinence and urge incontinence. Stress incontinence occurs with a cough, laugh or sneeze. Urge incontinence is that little surprise that one may have when they have to reach the bathroom frequently and urgently.

The levator ani muscle, which is also known as the Kegel muscle, is the pelvic floor muscle, which has three openings in it. It is a funnel-shaped muscle that has an opening in the urethra, the vagina and the rectum. If you contract any part of that muscle, you will contract each of the muscles.

I usually ask patients to contract the part surrounding the rectum because it is the easiest to visualize. I ask patients to do a squeeze as though they were trying to hold back gas or trying to pinch off a bowel movement. And while that is very graphic, it actually helps patients to understand the muscle they are supposed to contract.

So to visualize this, I ask patients to contract their slow twitch fiber muscles and their fast twitch fiber muscles. The way you discern the different types of contractions is by the length that you hold the contractions. For slow twitch, you are going to hold the contraction for a longer period of time. I would ask patients to do a squeeze, 2, 3, 4, relax. Do that again. Squeeze hard, 2, 3, 4, relax. Now you should see no movement on the outside. You should not contract your abdominal muscles or your buttocks muscles. And then for the fast squeezes you would squeeze hard and relax, squeeze hard and relax.

Now that you have a stronger Kegel muscle, and in fact you can get this stronger muscle if you do these exercises every day for six weeks, you can put them to work. And our next video blog will tell you how to put them to work.

Thank you very much and remember: practice makes perfect. As a flutist I have learned that you have to do scales before you can do long flourishes and it’s the practice that really makes the difference. So, if it seems hard going at the initial time that you practice I would suggest keeping up with it, keep working and, as always, continue doing your Kegels. Thank you.

University of Colorado Urogynecology is a specialty women’s health practice focused on female pelvic health and surgery. Our physicians are also professors & researchers for the CU School of Medicine, one of the top-ranked medical schools in the nation.

Learn more about us