What is a true Kegel exercise?

What is a True Kegel Exercise

A true Kegel exercise is an isolated, voluntary contraction of the pelvic floor muscles held for 6-8 seconds with 6-second rest periods between contractions, performed without breath-holding, straining, or engaging abdominal, buttock, or thigh muscles. 1

Essential Components of Proper Technique

The Correct Muscle Contraction

• The exercise involves isolated pelvic floor muscle contractions only, without activating surrounding muscle groups 1
• Each contraction should be held for 6-8 seconds, followed by a 6-second rest period between contractions 1, 2
• The term "Kegel" refers specifically to voluntary contraction of the pelvic floor muscles 3

Critical Breathing Pattern

• Normal breathing must be maintained throughout the exercise—never hold your breath or strain 1
• Avoiding breath-holding prevents the Valsalva maneuver, which can actually worsen pelvic floor dysfunction 1

Recommended Exercise Protocol

• Perform exercises twice daily for 15 minutes per session 1, 2
• Each session should include multiple sets of contractions 1
• Continue the program for a minimum duration of 3 months to achieve optimal benefits 1

Why Professional Instruction is Critical

The Problem with Self-Instruction

• Simple verbal or written instruction alone does not adequately prepare patients for a Kegel exercise program 4
• In one study, 25% of women who received only brief verbal instruction performed the exercise in a way that could potentially promote incontinence 4
• Only 49% of women demonstrated an ideal Kegel effort after brief standardized verbal instruction 4

The Solution

• Instruction on proper technique by trained healthcare personnel is essential to obtain optimal benefits 1
• Professional instruction maximizes effectiveness and prevents incorrect muscle activation 1
• Biofeedback using perineal EMG surface electrode feedback can teach proper muscle isolation 1

Expected Outcomes with Proper Technique

Effectiveness for Stress Urinary Incontinence

• Pelvic floor muscle training achieves up to 70% improvement in symptoms when performed correctly 1
• The exercises increase continence rates and improve quality of life 1
• Women with mild stress incontinence respond more favorably than those with severe incontinence 5

Timeline for Results

• Significant improvements in urinary leakage can be seen after 4-6 weeks of consistent training 6
• Long-term adherence maintains benefits over time 1

Common Pitfalls to Avoid

Incorrect Muscle Activation

• Do not bear down or push out during the exercise—this is the opposite of what should happen 4
• Avoid engaging abdominal muscles, buttocks, or inner thighs during the contraction 1
• Some women inadvertently perform a Valsalva maneuver (straining) instead of a proper contraction, which can worsen symptoms 4

Inadequate Training Duration

• Stopping the program before 3 months may result in suboptimal outcomes 1
• Benefits are maintained only with continued adherence to the exercise program 1

Lack of Professional Guidance

• Attempting to learn the technique from written materials alone frequently results in improper execution 4
• Without proper instruction, patients may unknowingly perform the exercise incorrectly for months 4