Half of us squeeze wrong

Here is a study I think about a lot.

Researchers gave 47 women brief spoken instructions for a Kegel. Then they checked each woman's squeeze.^[1]

23 did it right. That is 49%.

12 pushed down instead of lifting. That kind of squeeze can make leaks worse.

So if a Kegel feels confusing, you are in good company. It is a skill. Here is how I teach it.

Step 1: find the right muscle

Imagine you need to hold in gas in a quiet room. Gently squeeze and lift that spot, inside.

That squeeze and lift is your pelvic floor. The muscles around your urethra, vagina and anus work together.

Your buttocks, thighs and belly stay soft. If they tighten, you are borrowing the wrong muscles.

Step 2: the 5 cues I use

1. "Lift, like holding in gas."
2. "Breathe out as you lift." A held breath pushes down.
3. "Small and inside." From the outside, a good Kegel is invisible.
4. "Buttocks soft, thighs soft."
5. "Now let it all go." The release counts as much as the squeeze.

Step 3: check yourself

The finger check. Wash your hands. Lie down and place a clean finger just inside your vagina. Squeeze and lift. You should feel a light hug around your finger, and a pull inward and up.

The mirror check. Hold a hand mirror between your legs. On a good lift, the skin between your vagina and anus draws in and up. If it bulges out, you are pushing. Lighten the effort and think "up and in."

The 6 common mistakes, and the fix for each

• Holding your breath. Count out loud or hum during the lift.
• Squeezing your buttocks. Let them go heavy. Squeeze smaller and deeper.
• Pushing down. Use half the effort. Think "lift and in."
• Squeezing your thighs. Keep a pillow loose between your knees.
• Tight shoulders or jaw. Soften your jaw. Breathe into your ribs.
• Skipping the let-go. After each lift, take 1 full breath just to let go.

When to get hands-on help

Guidelines ask a clinician to confirm your squeeze with a gentle internal exam before you train.^[2] A letter or an app can teach you the steps. A pelvic floor physical therapist can feel what your muscle does.

One visit can set your technique for life. Then the daily practice does the rest.

Next: why the let-go is half the exercise.

A correct Kegel takes 2 seconds and 0 equipment. Which cue made it click for you?