Simplify the Kegel

The kegel is backed by solid evidence. Unfortunately, like all forms of exercise, kegels can’t help if we don’t actually do them. I’d wager most women who would benefit from kegels fall into the “I did them for a bit, but then stopped” category.

That includes me. Although a daily kegel session takes maybe 2-5 minutes a day to maintain, until last year, I found myself falling off the wagon for weeks at a time. Implementing a new habit, even a teeny tiny micro-habit, is hard. Usually after taking a few weeks off, I’d chastise myself for abandoning my kegels, so I’d recommit to starting a routine again…and would promptly continue to not start a routine.

Then, one day I made a groundbreaking discovery that changed everything. Okay, that’s not true. I came to an obvious and commonplace realization: I’m kinda lazy. This means simple is better. The more I simplify my kegel routine, the more consistent it becomes. And with the kegel, consistency is king.

Why Kegel?

I’ve talked about the why in past posts, so if you still aren’t convinced, read those first. The kegel won’t help everyone, but it’s evidence based and personally has been very helpful. Plus, a recent study showed that educating women about the pelvic floor does not ease symptoms. Doing exercises does. Full body exercise can help strengthen the pelvic floor independent of kegels, but if you have a particularly weak muscle (e.g. the pelvic floor) it should be isolated. Furthermore, if you already have something like pelvic organ prolapse, maintaining a degree of strength might help manage symptoms and slow the progression. This post isn’t about convincing you to kegel. It’s about simplifying it.

My Kegel Story

A. Physical Therapy

Kegel and I go waaaay back. I took some (unhelpful) Bradley classes before I had my first child in 2010. The instructor had us kegel an insane amount, which, in retrospect, wasn’t particularly helpful because my pelvic floor wasn’t yet weak, and she did not emphasize the relaxation portion of the kegel, which meant I wasn’t helping an already hypertonic pelvic floor. Oops. Cue not so fun childbirth.

After I had my giant daughter who got stuck, I needed to kegel, so I haphazardly did some, but soon gave it up after I read some blog posts telling me the kegel would make pelvic floor problems worse (shock horror). Instead, I started to do some stretching and deep squatting based on this bloggerly advice (dumb).

I had my son 19 months later, an even bigger baby who also got stuck. My pelvic floor was not happy. I thought I needed to do some more deep squatting and hip releases or other nonsense like that, so I still didn’t kegel.

After waiting too long, I went to see a pelvic floor physical therapist who told me I had a simultaneously weak and tight pelvic floor. Honestly, I’m not sure of the accuracy of this statement because her EMG machine was all over the place, but either way the intervention was the same — slow, controlled, thoughtful kegels. I needed to build strength and become aware of any unnecessary tension in my pelvic floor. This helped. Quite a bit actually. I didn’t make a miraculous recovery, but physical therapy rekindled my relationship with the kegel, although this time it was a more educated and nuanced affair.

During physical therapy, I was diligent about kegeling, mostly because it was homework my therapist had given me, and I always do my homework. Always. In college I took a philosophy class pass/fail as a way to give myself a break, but couldn’t stop myself from doing all the homework, so I got an A (much to my chagrin since it didn’t count toward my GPA). Call something homework and I’ll do it asap.

B. Weights

However, after my sessions were over and my homework ended, I kept “forgetting” to kegel. I decided I needed to up the ante, so I bought some pelvic floor weights. They never stayed put, which disheartened me. Instead of giving up, I tried a couple other brands, some worked better than others, but I didn’t use any of them consistently because this meant finding time to discretely insert a weight and walk around with it as I squeezed my vagina. Ultimately, I didn’t like the weights and felt they weren’t adding much to the kegel experience, other than causing my husband to ask me awkward questions.

C. Resistance

I gave up on the weights, but did I give up on making the kegel more complicated than it needed to be? Of course not. I decided I needed something that created resistance for my muscles to push against, as opposed to the unhelpful constant strain of a weight. Through the years I have tried the Kegelmaster and Gyneflex since each offered different levels of resistance. The Kegelmaster is more expensive and has springs, whereas the Gyneflex comes in different levels. Unlike the weights, they seemed to help, but I still had the discretion issue. I couldn’t just pop in the Kegelmaster whenever I felt like it, especially with three busybody kids always at my heels. I carved out time over a couple months (locked the bathroom door as my children banged on it), but then I just gave up.

Also, kegel makers need to stop making their devices look like penises. It’s weird.

D. Shower

After giving up on uncomfortable weights and penis shaped strengthening devices, I started kegeling in the shower while I washed my hair. The downside was not having added resistance, but the upside was I actually remembered to kegel. I had built sufficient strength (i.e. didn’t pee myself with most sneezes) that I didn’t feel the need to kegel multiple times a day.

E. Biofeedback

Eventually, however, I felt like I wasn’t giving the kegel the attention it was due. I bought my most expensive kegel accessory yet – the Elvie. The Elvie is a non-penis shaped device that acts a sensor. It’s not a weight, but rather a biofeedback machine. It connects to an app via bluetooth. You follow prompts and it provides biofeedback on your ability to contract and relax. Cool, right.

It WAS cool at first. I’d excuse myself for 5 minutes a couple times a week and give it a go. I liked seeing my progress on the app, but I found the biofeedback wasn’t totally consistent. Plus, I also had to wash and recharge the device. And then the app had trouble connecting to the bluetooth. It never fails that even the coolest technology will make life more complicated. I didn’t feel like troubleshooting a finicky bluetooth connection between my vagina and my phone as my kids were still banging on the bathroom door (at what age do kids leave their moms alone in the bathroom?). Eventually I dropped my sessions to twice a week, then to once a week, and finally I just got rid of it.

I didn’t hate the Elvie, but I also didn’t love it enough to make me feel good about spending 200 dollars on it. That’s a lot of money!

After thinking about what went wrong with the Elvie, I had another groundbreaking discovery. Okay, again not true. I realized the obvious: I like structure.

I preferred the Elvie to the weights or resistance machines, but not because of its inconsistent biofeedback. Rather, I liked that the app told me when to squeeze and when to stop. That’s it. And I paid hundreds of dollars for this realization. My shower kegeling was haphazard, but the Elvie gave me a system. Therefore, I needed to find something that systematized kegeling but that didn’t require me to lock myself in the bathroom and shove anything up my vagina (or spend too much money).

F. Apps

Enter the kegel app. At first I had shunned the lowly app for not providing me with biofeedback or added resistance. After years of experimenting, I’ve learned too much fuss creates a consistency barrier.

Oh glorious simplicity! On an app, I press play, follow the prompts, and stop when it tells me to. I’ve tried a couple apps and all are fine, but the one I use about 6x a week is Kegel Trainer by Olson Apps (FYI, I’m NOT affiliated with them, just like the app). The pro version is currently 5.99, which is more than free but much less than 200 dollars. You can set up reminders, so my phone alerts me in the morning and evening. You proceed through predetermined levels that gradually become longer. The app varies the duration of the squeezes and cues rest. You can also create custom routines, helpful if you want to emphasize the release over the squeeze or vice versa. I now kegel most evenings as I wait for my tea to steep. Livin’ the dream.

What if Kegeling Isn’t Enough

If you struggle with pelvic floor disorder, kegeling most certainly won’t be enough. Too often it’s treated as some sort of cure-all or conversely as some sort of villain. It’s neither. It’s helpful and doesn’t take much time, as long as you remember to do it and don’t make it too complicated. If you need to build a lot of strength, investing in a contraption that adds resistance or in a biofeedback device MIGHT be worth the money. I have kept my Gyneflex around because it is the least fussy of the devices. However, extra equipment isn’t necessary. A simple app or even 5 minutes in the shower will suffice. If only everything could be so simple (like parenting the three kids who made these kegels necessary).

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