By Corrie Pikul
Women's health physical therapists swear these pelvic workouts help forestall all kinds of female-specific problems. One's a classic, and the other will forever change how you look at your watch.
If you have never felt pelvic pain, a "little spritz" (thank you, Whoopi Goldberg, for that phrase), or organ prolapse, you probably want to keep it that way. The best strategy for shaping up "down there"? Yep, that old standby, the Kegel. We know you've heard this before, but that's because experts agree that Kegels are the most effective exercise to improve the muscle tone of the pelvic floor. "After the age of 35, we lose 5 percent of our muscle mass every 10 years," says women's health physical therapist Kristi Latham. This reduction occurs in muscles everywhere in the body -- including those in our most private regions. Here's a full pelvic workout, including Kegels and "pelvic clocks."
Keep in mind: Just like you wouldn't run sprints with a sprained ankle, you shouldn't do these exercises if you have a painful pelvic condition (like vaginismus) without first checking with a women's health physical therapist.
A Kegel Refresher Course
These wonder clenches can increase sexual arousal, improve your ability to reach orgasm, help you master control of your bladder and, says Latham, support your pelvic organs in avoiding dreaded conditions like prolapse.
Fitness instructor: Kristi Latham, PT, CLT, is the pelvic health and lymphedema program director at Metro SportsMed Physical Therapy in Brooklyn, New York.
Warm-up: When you're just starting out, it's best to lie down so that you can concentrate solely on your pelvic floor.
The exercise: Squeeze the muscles around your vagina and anus. These are the muscles you use to prevent gas from passing, stop the flow of urine and the muscles that contract during orgasm. Think about trying to pull the muscles up and in (if your pelvic floor is weak, you will only faintly feel this contraction). You'll know you're doing these exercises correctly if you feel the muscles tightening but don't have movement in your abs or buttocks. Isolate your pelvic floor so if somebody looked at you while you were doing the exercise, they wouldn't think you were moving at all.
The routine: For healthy women without symptoms of pelvic floor impairment, do the following three times per week: 5-second squeeze followed by a 10-second rest period, 10 times, 3 times per day (30 total). With practice, you should be able to do them while sitting at your desk or driving.
Endurance training: Increase hold time and decrease rest time: 10-second squeeze followed by a 3-second rest period.
Sprints: Add in what Latham calls "quick flicks": Squeeze and relax 5 times, as fast as you can, followed by a 5-second rest period. Do 30 per day, 3 times per week (as above).
Form drills: Try any of the above routines while standing up.
Note: You've probably heard that you should practice Kegels by stopping the flow of urine while going to the bathroom. Using Kegels to frequently stop or slow the flow of urine can cause backflow, which creates infection, and can also disrupt your pelvic muscle coordination. Most WHPTs discourage practicing Kegels while urinating. Latham suggests paying attention to how your muscles feel just after urination, then follow up later with a Kegel to feel the difference between relaxed and contracted.
These exercises can improve circulation to the pelvic organs; decrease tightness, stiffness or congestion from prolonged sitting or standing; increase pelvic flexibility; improve balance and -- not enough for you? -- help you gain a better awareness of spinal stability.
Fitness instructor: Gail Wetzler, PT, EDO, is the owner of Wetzler Integrative Physical Therapy Center in Newport Beach, California, and instructor of pelvic physical health courses for the American Society of Physical Therapists.
Warm-up: Lie on your back to be sure that the back side of the pelvis has a full range of movement. Bend your knees and keep your feet flat on the floor. Keep your spine in a neutral position. Imagine that there is a clock on your lower abdomen, where 12 o'clock is at the bellybutton, 6 o'clock is at the top of the pubic bone and your hip bones are at 9 and 3.
The exercise: Bring the bellybutton down to the spine. This will make the "clock" tilt, down at the 12 position (bellybutton) and up at the 6 (pubic bone). Move your hip and pubic bones to rotate your clock to the side so that 3 o'clock hip is lower. Move around the clock, tilting the pelvis until the 6 o'clock position is lowest. Continue around the clock, hitting every number, until the 12 position is again the lowest position. Repeat two or three times, then reverse to repeat the cycle in the opposite direction, two or three times.
The routine: For healthy women without symptoms of pelvic floor impairment, the clocks should be done once per day to keep the pelvic girdle in shape. Those experiencing movement restrictions can try these two times per day (a.m. and p.m.).
Advanced: Vary up the routine each day: Try going from 1 o'clock to neutral, then 2 o'clock to neutral, and continuing like that around the clock. Wetzler suggests repeating one movement, such as 4 o'clock to 5 o'clock, five to six times "to really feel the pelvic activity."
As a reminder, always consult your doctor for medical advice and treatment before starting any program.