When Kegels are done properly, consistently, and in adequate volume, improvement in pelvic floor strength and symptoms of incontinence (weak bladder control) or pelvic organ prolapse should be noted around 6-8 weeks.
The amount of time it takes to completely resolve issues such as incontinence or pelvic organ prolapse can take anywhere from three months to a year, depending on other health and lifestyle factors.
What Are Kegel Exercises?
Kegels are a method of contracting and strengthening the pelvic floor muscles, and therefor it is important to remember that as with any muscle strengthening program, results take time and require consistency.
The number of Kegels done daily and throughout the week are vital in ensuring that steady progress is made in a timely fashion.
Research shows that Kegels should be performed with a contraction hold time from 5-10 seconds for 10 repetitions, and these should be done 3-8 times per day, with 1-2 days off per week to allow for rest.
Kegels With Weights
Vaginal weights, also referred to as Kegel balls or Kegel weights can also be used to help strengthen the muscles and improve endurance to prevent incontinence or pelvic organ prolapse.
An added benefit of using Kegel weights is that the muscles must activate properly in order to keep the weight in the vaginal canal. Thus, the weight acts as a trainer and helps to ensure that Kegels are done properly due to their ability to help people properly locate and contract the pelvic floor muscles.
There is a wide variance of volume required to achieve individual goals. For this reason, it is recommended to seek an evaluation and treatment from a qualified pelvic floor physical therapist.
Various factors determine how long a Kegel exercise program takes to be completely free of leaks or pressure in the pelvis. This includes how long symptoms have present (months will require less work than an issue that has been ongoing for years).
Other factors that will require more time include:
- History of childbirth and of multiple childbirths
- Post-surgery status
- History of cancer treatment in pelvis or abdomen
- Presence of soft tissue disorder such as Ehler-Danlos Syndrome
- Nerve damage in the pelvis or abdomen
- History of chronic constipation
- Presence of pelvic pain
- The Kegel program you choose and adherence to it
What if Kegels Aren’t Working?
Research shows that many women are doing Kegels the wrong way. Many women are not properly contracting the pelvic floor muscles and are in fact exercising the wrong muscles.
This can lead to frustration and a lack of results. The most common way that women do Kegels wrong is by squeezing their glutes (buttocks) instead of their pelvic floor. Another common mistake is squeezing the inner thigh muscles or clenching the abdominal muscles.
If Kegel exercises aren’t working for you, it is helpful to verify that you are doing them properly.
Here are some methods of testing yourself:
The Stop Test: The stop test involves testing yourself while you urinate on the toilet. Mid-stream, contract the pelvic floor muscles to shut off the flow of urine. If you are able to shut off the flow of urine, you have successfully done a Kegel.
Make a mental note of these muscles to help your Kegel exercise practice. This test is meant to be performed once or twice to verify that you contract the correct muscles, however a repetitive kegel exercise practice and program should never be done on the toilet.
Repeatedly contracting the muscles in a Kegel while urinating can be damaging to the pelvic floor muscles and urethra tissue. If you find that you were not able to shut off the flow of urine it is advisable that you contact a pelvic floor physical therapist.
A complete evaluation and one on one education will help to build up pelvic floor muscle strength.
Use a mirror: Visual feedback is a powerful teacher. Grab a small handheld mirror and remove your clothing from the waist down. Sit in a reclined position or lay down and prop your head up with the mirror held so that you can see your vulvar and pelvic anatomy.
This will include the clitoris, urethra, vaginal opening, and anus surrounded by the vulva in women. When a Kegel is done correctly, the anus will close in a “wink”, as will the vaginal opening, and the skin on the clitoris will nod downward and inward.
You will also see a slight “lift” of the pelvic floor muscles as they move inward and upward.
Other factors such as the presence of scar tissue, difficulty with co-ordination, and nerve damage to the pelvic floor or abdominal muscles can result in Kegels are not working for you.
It is advisable to seek evaluation by a pelvic physical therapist who is specially trained in evaluating the pelvic floor muscles to assist in determining the cause and creating a plan to help you reach your goals.