Developing a Healthy “PC” Muscle

By on March 1, 2012

By Sherrie Palm –

There’s so much controversy over Kegel exercises, do they work or not and what’s the point of Kegeling if they won’t adequately address UI (urinary incontinence) or POP (pelvic organ prolapse) concerns. I thought I would throw my two cents in for whatever it’s worth; every woman needs to make the decision on her own whether or not it’s worth investing the effort in either Kegels or Kegel Breathing. I’ll give an explanation on technique for each of these at the end of this article for those of you who are confused about Kegel method.

Part of the problem with Kegels is that we aren’t addressing this exercise technique from the right perspective. The PC muscle is muscle tissue similar to other muscle tissue. There is no point in doing any type of exercise whether strength training external muscles like biceps, quads, or glutes or internal muscles like the PC unless you are going to do it properly. Utilizing the wrong Kegel technique is about as beneficial as going to a fitness club and just standing around looking at the weight machines.

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Kegels or Kegel Breathing should be approached as being helpful and beneficial in your UI/POP prevention or maintenance regimen, not as a one stop “fix-it”. Whether you are in early stages of UI or POP and are trying to avoid surgery or you’ve already had surgery and have shifted to the maintenance mode (seriously, all women who’ve had surgery for POP should have a maintenance ritual), continuing with Kegels is pivotal for life-long pelvic floor health.

If Kegels assist pelvic floor strength and function, even to some little degree, and they are so easy to do, why wouldn’t you want to do them? Even if they don’t eliminate your UI or POP completely, they can impact the degree of leakage or bulge and wouldn’t you rather leak or bulge a little bit less even though the problem isn’t eliminated completely? Women who are waiting to make the decision whether or not to go forward with surgery should experiment with treatments & exercise regimens they can do to make themselves more comfortable.

On top of a reduction in leakage and bulging is the added benefit of increased sexual sensation and who doesn’t want that? For women who truly enjoyed intimacy prior to UI/POP, recapturing PC muscle strength has the potential to “bring back that loving feeling”. I can’t begin to tell you how much this benefits relationships that are suffering from lack of intimacy fueled by sexual pain or lack of sensation. Relationships frequently shift sideways as a result of bedroom scenarios where you “weren’t that into it” because you’d lost sexual sensation. Since most of us are continuously multi-tasking and are running on empty to begin with, engaging in intimacy when there is no physical satisfaction translates to   like just one more job to do.

Let’s also talk about the impact being full of poop has on your ability to do Kegels. Seriously. Constipation is both a cause and a symptom of POP that women commonly experience. For women who have both IBS (irritable bowel syndrome) or other causes of constipation plus incontinence or the IBS/POP combo, the ability to do Kegels can be compromised. When your bowels are full of fecal material, your ability to contract your PC is radically reduced. As a woman with long term IBS issues, believe me when I say that some days it is simply impossible to get much contraction if any at all. It gets a bit frustrating and at times I’ve wondered if I was losing PC contraction strength, but as soon as I have one of those lucky days where everything “comes out alright”, my ability to contract is fully restored. Rest assured ladies, you should continue to do your Kegels even on the days when you feel like nothing is happening.


Here’s a how-to for Kegel exercises; once you have mastered the technique and understand the sensations, you can do them anywhere/anytime. Your PC muscle is like a trampoline that sits below your pelvic organs. When you stop the flow of pee, the muscle you are contracting is the PC muscle. Empty your bladder if possible prior to doing Kegels. When you are initially trying to figure out proper Kegel technique, you should do them lying down. Once you have your technique perfected, you can do them lying down, sitting, or standing.

Take a full breath in and let it out completely; the more you relax prior to doing Kegels, especially when first trying to figure out technique, the more you will be in touch with the sensations you experience. Take another full breath in, letting your tummy expand out-this is important. It is natural for most of us to contract our tummies when breathing in and you may need to retrain this habit. As you let the air out, let your tummy go flat and slowly contract the muscle that causes the same sensation as when you stop the flow of pee, contracting it as tightly as you can. Contract slowly, deliberately, trying to pull your belly button up and in while tightening the PC muscle within your vaginal/rectal area. Try to hold this contraction as tightly as you can for as long as you can; it may only be a very short time initially but your ability to contract should improve as time goes on. Release and repeat 5-10 more times. Do not go beyond 10 contractions; fatiguing your PC muscle is not beneficial. You can alternate between sustained contractions and fluttering contractions (contract, release, contract, release) once you have some control in your PC muscle. After you understand the sensations, you can advance to doing Kegels at a time and place that is easy for you to remember. Personally I like to Kegel while stopping at stop signs and stoplights because I am on the road nearly every day. It has become a habit to contract when I roll up to a stop sign, quite subliminal. I also occasionally Kegel using a ceramic egg or a stainless steel dumbbell, Kegel devices you can utilize for additional strengthening. When using Kegel assist devices you will insert the device and contract against it; it acts like a weight for more resistance.


The steps are very basic with Kegel Breathing. This is a technique you can use when you are doing stretches, Pilates or Pfilates. You can also utilize this technique during regular exercise routines or for that matter whenever the whim strikes you. Simply take in a long, deep, relaxed breath with your belly loose and sticking out, then on the exhale you contract your PC or pelvic floor. Be aware of the sensation, you want to contract as tightly as you can and hold the contraction for as long as you can. That’s it, not much to it! Every time you contract your PC you are helping establish the subliminal habit. Do it often enough and you will start to do it without conscious thought.

We all have so much on our plates today; who has time to put into an extra “workout”? The great thing about Kegels is you can do them anytime, anywhere; you can adapt the technique to fit your personal needs. You can Kegel when you are brushing your teeth. (Come on now, you know you multi-task all the time!) You can Kegel when you are pushing a shopping cart at the grocery store. You can Kegel when you are driving in your car; every time you stop for a stop sign or traffic light, Kegel. You can Kegel when you are riding your lawnmower. You can Kegel when you are weeding your flower bed. You can Kegel when you are sitting on the couch watching TV. How about when you are sitting at your computer; we certainly do that often enough! The list of potential times to Kegel is endless. It doesn’t matter when you Kegel, what matters is that you do it consistently. As you establish the Kegel habit in whatever way works best for you, you will find Kegeling becomes a subliminal ritual in a very short period of time.

Sherrie Palm Founder/President
Association for Pelvic Organ Prolapse Support
Author, Pelvic Organ Prolapse: The Silent Epidemic

About Sherrie Palm

Sherrie Palm is the Founder/President of APOPS, Association for Pelvic Organ Prolapse Support Inc, a 501(c)3 nonprofit foundation for pelvic organ prolapse, the author of the award winning book Pelvic Organ Prolapse: The Silent Epidemic, and the Community Leader of the Pelvic Organ Prolapse Forum. As a grassroots women's pelvic floor health advocate, she devotes her time to all avenues of establishing recognition of pelvic organ prolapse and providing support pathways for women in various stages of POP. For more info about APOPS or pelvic organ prolapse support, go to:

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Developing a Healthy “PC” Muscle