Q. How many kegels should I do every day?
A. Start out doing 2 sets of 5 twice a day, holding each contraction for 5 seconds. Gradually increase the length of the hold until you can hold it for 10 seconds. Next, increase the number you do each time until you can do 2 sets of 10, holding each for 10 seconds. It would go like this: contract and hold for 10 seconds (breathing normally), and then relax for 10 seconds (taking a deep belly breath). Repeat the sequence until you’ve completed 10 exercises. Rest for a few minutes and then do another set of 10 in the same way. Repeat this sequence again later in the day.
Q. But I read I should do 100 kegels really fast. Why do you recommend only 5-10?
A. The pelvic floor is made up of two kinds of muscle fibers: slow-twitch (70%) and fast-twitch (30%). Slow-twitch fibers respond best to slow, step-by-step engagement like the holds we have described. If you only do fast Kegels, you’re not strengthening the majority of the muscle fibers. That’s why it’s important to learn to do the Kegel “hold” as described above. The other 30% of muscle fibers are important too, so we recommend that once you’re comfortable with the Kegel “hold,” you learn Kegel “flicks.”
To do these, tighten your pelvic floor muscles the same way as before but more quickly, then relax. The entire cycle should take about 3 seconds; you should breathe normally and keep the rest of your body relaxed throughout. Do about 20 twice a day, and finish the set with a deep belly-breath.
Doing too many too fast will overwork the muscles and lead to poor technique that could compromise your progress or lead to other problems.
Q. Once I have my routine of two sets of 10 kegel “holds” and 20 “flicks,” how should I progress from there?
A. If you began by using a tool, now is the time to learn to contract your pelvic floor muscles without the tool. It’s important to learn to exercise without it; you’ll want to do your exercises in different positions and during various activities to progress further. Once you’ve mastered holding for 10 seconds without the tool and without involving your buttock or abdominal muscles while lying down, the next step is to do your exercises sitting up. Once you can hold for 10 seconds sitting up, still using good technique (not involving other muscles, remaining relaxed, breathing normally) you may do them while standing. After that, you can do your exercises while you do functional tasks like lifting, walking up stairs, jumping, etc. It’s important to make sure you are able to contract and relax your pelvic floor muscles without involving other muscles in your body, and while breathing normally, so don’t rush the process! Guidance from a professional can help you be sure you’re doing Kegels correctly before moving to the next level.
If you want to try some advanced exercises, you can use a tool to add weight or resistance while you do your exercises. Once you have mastered lying down, holding for 10 seconds with the tool inserted, and without involving other muscles, the next step is to hold the outside end of the Kegel tool with your hand and pull gently outward on it, using your pelvic floor muscles to hold the tool in. Once you can hold for 10 seconds, still using good technique (not involving other muscles, remaining relaxed, breathing normally), you can do this while standing. If you’re using the Exercise Egg, the weight of the egg itself will offer resistance.
If you wish to go further, you can put coins in the egg’s storage pouch, and hang it from the string attached to the egg. Add more coins to increase the weight.
Q. I heard that to learn kegels, I should try to stop the flow while I’m urinating. Is that true?
A. Purposely stopping the flow of urine can be uncomfortable, lead to urethral irritation, and “confuse” the bladder, making it harder to completely empty when you urinate. It is not recommended.