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Pelvic Floor Muscle Exercises
  The first step in strengthening your pelvic floor with Kegels is learning how to isolate the muscles. It is harder than you think, mostly because they are not really in our conscious control. You don’t think much about emptying your bladder or bowels, if everything is working right at a social appropriate time and place it just seems to happen. However, you can learn to identify the right muscles with one of these techniques: Try to stop the flow of urine while you are on the toilet. If you slow or stop your stream you are using the right muscles. Remember how it feels, but only do this once or twice as this is for show not practice. This is because urinating is a complex reflex and if you mess around with it too much it could stop working the way you want it to! Pretend you are in a crowded elevator and squeeze the muscles you would to stop a fart. You should feel a pulling sensation into your body if you are doing it correctly. Put a lubricated tampon (the 10 cent cost I referred to earlier) in your vagina and tighten the pelvic floor muscles as you gently pull on the string. This is a form of simple and effective biofeedback. If you feel resistance when you tug you are using your pelvic floor muscles correctly. Place 1 or 2 fingers in your vagina and tighten your pelvic floor muscles. Do you feel a squeeze? If so, you are doing it correctly. Once you feel comfortable identifying the muscles move on to the exercises. The act of contracting the pelvic floor is called a Kegal and there are 2 routines to choose from, quick flicks and sustained contractions. A quick flick is a contraction and release and a sustained contraction is a contraction of the pelvic floor muscles for 5-10 seconds. That is why no one needs to walk around all day with a jade egg as sustained contractions for hours is not recommended (meaning the advice form GOOP on this is terrible). Exercising a muscle involves putting it through its range of motion. When you are first starting do your exercises lay down with your knees bent and take deep, relaxing breaths. You want to make sure your belly (abdominal wall), buttocks and inner thighs are always relaxed. If they aren’t it is harder to isolate your pelvic floor correctly and you could end up contracting these muscles instead. For sustained contractions do a Kegel for 5 seconds then relax completely for 10 seconds (or two breaths if that is easier). Each contraction and relaxation is one repetition. Do 10 repetitions three times a day. For quick flicks do 5 Kegels quickly in a row, taking 1-2 seconds for each contraction and release. These 5 quick Kegels is one cycle of quick flicks. Do 5 cycles of quick flicks with a 5-10 second rest afterwards (so 25 quick flicks) for one set. Do one set of quick flicks three times a day. To recap for beginners it is 10 sustained contractions three times a day or 25 quick flicks three times a day. It is good to do both sustained contractions and quick flicks. Consider doing one exercise on odd days and the other on even or alternate in other ways. One you have the hang of it you can progress to doing your Kegels (sustained contractions or quick flicks) while walking or sitting or standing. Build up the length of time of sustained contractions to 10 seconds and work up to doing 6 sets of 10 repetitions throughout the day, so 60 sustained contractions a day. If you know you are going to cough or sneeze try to do a sustained contraction right before as it will help prevent leakage of urine. If you really have to pee and are worried about leaking do a set of quick flicks. It will temporarily relax the bladder muscle and then calmly move to the toilet. It will take 6-12 weeks to see improvement. Like all exercises consistency is the key. If an app helps you with this, that’s great but you can always just set reminders on your phone. By 4-5 months of daily practice you will have achieved the most benefit. At this point you can back off to 3 days a week. No one has studied whether expensive trainers or vaginal video games make a difference. If those motivate you, then great. If you are the type of person who has an unused bathroom scale, ask your self how will this be any different before you shell out your cash. If you are having difficulty mastering the technique or after a few months are not seeing any change, I’d consult a pelvic floor physical therapist. They are experts in this and often just a few visits will get you on your path to pelvic floor greatness.