I was asked a great question the other day regarding Kegel exercises and the confusion caused from some recommendations to complete 80+ repetitions per day vs. my recommendation to complete only 8-10 repetitions per day.
This is a fantastic question and it highlights the difference between the complete 2-step Kegel that is the key to resolving your incontinence and the “quick flick” Kegel that only works one action of our pelvic floor muscles. Knowing the difference between these two approaches is very important in rehabilitating pelvic floor muscles.
First, let me describe the quick flick Kegel. It is simply tightening the sphincter muscles to stop the flow of urine. These can be done in quick succession to a rhythm of “tighten, relax, tighten, relax”, and so on. This sphincter muscle is important to work since it contracts very quickly every time we cough, sneeze, laugh, etc. It is a fast twitch muscle that can contract quickly and with good strength, but it lacks endurance. So what happens when you go for a longer walk, run, or, heaven forbid, someone tells you a really, really, funny joke? Those fast twitch sphincter muscles lack the endurance to hold on for these activities.
Lucky for us, we also have slow twitch endurance muscles within our pelvic floor that CAN keep us continent during prolonged activity. We can strengthen these muscles and maximize their endurance by elevating our pelvic floor. That is why a 2-step approach to a Kegel exercise is so important. The best way to maximize the endurance of our pelvic floor elevation is to draw your pelvic floor up into your pelvic outlet, as if there were a string attached from your belly button to your pelvic floor, and you are attempting to pull it up as high as you can. The challenge is to hold this pelvic floor elevation for at least an 8-count as you continue with a regular breathing pattern.
It is the elevation and endurance hold that is often lost in Kegel instruction. You will find that if you go through the 2-step process, your pelvic floor will actually fatigue throughout your reps, giving you the feeling like you just can’t keep it elevated for the full 8-count. Patients/clients will tell me they are more symptomatic that day or even the next day if they over-do the reps (20+) on the 2-step Kegel.
This is why I include only 4 repetitions of a complete 2-step Kegel before each workout and after each workout on our Hab It: Pelvic Floor DVD. Eight quality repetitions of a 2-step Kegel including both quick flicks and endurance holds is far more beneficial than 80+ repetitions without a direct purpose.