Pelvic Floor Exercises: How to Effectively Perform Kegels in Bed

Can you do pelvic floor exercises in bed?

Yes, you absolutely can perform pelvic floor exercises, commonly known as Kegels, effectively while lying in bed. This position can even be advantageous for beginners or those recovering, as it minimizes the influence of gravity and promotes relaxation, allowing for better muscle isolation and focus.

The Pelvic Floor: A Quick Anatomical Review

The pelvic floor is a complex group of muscles, ligaments, and connective tissues that form a sling or hammock-like structure at the base of your pelvis. These muscles are essential for several vital functions:

• Support: They support the pelvic organs, including the bladder, bowel, and uterus (in women), preventing them from prolapsing.
• Continence: They play a crucial role in maintaining urinary and fecal continence by controlling the opening and closing of the urethra and anus.
• Sexual Function: They contribute to sexual sensation and orgasm in both men and women.
• Core Stability: They work in synergy with the deep abdominal muscles (transversus abdominis), diaphragm, and multifidus to form the "inner core," contributing to spinal stability and posture.

Why Consider Exercising in Bed?

Performing pelvic floor exercises in bed offers several distinct advantages, making it an excellent starting point for many individuals:

• Reduced Gravitational Load: Lying down minimizes the effect of gravity on the pelvic organs, which can make it easier to isolate and activate the pelvic floor muscles without the added challenge of supporting the organs against gravity. This is particularly beneficial for those with pelvic organ prolapse or severe weakness.
• Enhanced Relaxation: Being in a comfortable, supine (lying on your back) or side-lying position can help relax other muscles, such as the glutes, inner thighs, and abdominals, which can otherwise inadvertently compensate for weak pelvic floor muscles.
• Improved Focus and Awareness: The relaxed environment of your bed allows for greater concentration on the subtle sensations of pelvic floor contraction and relaxation, fostering a stronger mind-muscle connection.
• Accessibility and Consistency: For individuals with mobility limitations, pain, or those recovering from surgery (e.g., childbirth, prostatectomy), exercising in bed makes it highly accessible and easier to incorporate into daily routines, promoting consistency.

Proper Technique for Pelvic Floor Exercises in Bed

To ensure effectiveness, proper technique is paramount. Follow these steps for performing pelvic floor exercises while lying in bed:

• Finding the Muscles: This is the most critical first step.

  • For women: Imagine you are trying to stop the flow of urine mid-stream, or trying to stop yourself from passing gas. Feel a lifting and squeezing sensation around the vagina and anus.
  • For men: Imagine you are trying to stop the flow of urine or trying to lift your scrotum without moving your legs or glutes. You should feel a lifting sensation at the base of the penis and around the anus.
  • Important Note: Do not actually stop urination to practice, as this can disrupt bladder function. This is purely for identification. The sensation should be an internal lift, not a bearing down or outward push.

• Preparation and Positioning:

  • Lie on your back with your knees bent and feet flat on the bed, hip-width apart. Your spine should be in a neutral position, not overly arched or flattened.
  • Alternatively, you can lie on your side with your knees slightly bent.
  • Ensure your neck and shoulders are relaxed.

• The Basic Contraction (Kegel):

  • Slow Contraction: Gently squeeze and lift your pelvic floor muscles upwards and inwards, as if you are drawing them up into your body. Aim for a smooth, controlled lift rather than an abrupt clench.
  • Hold: Hold the contraction for 3-5 seconds initially. Focus on maintaining the lift without tensing your abdomen, glutes, or inner thighs.
  • Relaxation: Slowly and completely release the contraction. Allow the muscles to fully relax and return to their resting state. This relaxation phase is as important as the contraction itself, as it allows the muscles to recover and prevents fatigue. Match the relaxation time to the contraction time (e.g., 3-5 seconds).

• Breathing: Maintain normal, steady breathing throughout the exercises. Do not hold your breath. Exhaling gently as you contract can sometimes help facilitate the movement.

• Repetitions and Sets:

  • Start with 8-12 repetitions per set.
  • Aim for 2-3 sets per day.
  • As your strength improves, you can gradually increase the hold time up to 10 seconds.
  • You can also incorporate "quick flicks" – rapid contractions and relaxations – for 10-20 repetitions, which train the fast-twitch muscle fibers for sudden urges or coughs.

• Progression: Once comfortable and proficient in bed, you can gradually try performing the exercises in other positions (seated, standing) to challenge the muscles against gravity.

Common Mistakes to Avoid

• Holding Your Breath: This indicates excessive tension and can increase intra-abdominal pressure.
• Using Other Muscles: Avoid squeezing your glutes, inner thighs, or tensing your abdominal muscles. The movement should be isolated to the pelvic floor.
• Bearing Down or Pushing Out: This is the opposite of a proper contraction and can worsen pelvic floor dysfunction.
• Overdoing It: More is not always better. Overtraining can lead to muscle fatigue or pain. Stick to the recommended repetitions and sets.
• Lack of Full Relaxation: Incomplete relaxation between contractions can lead to muscle tightness and dysfunction.

When to Perform Pelvic Floor Exercises in Bed

The flexibility of performing these exercises in bed means you can integrate them into your daily routine at various times:

• First Thing in the Morning: A great way to activate your core and pelvic floor before getting out of bed.
• Last Thing at Night: Helps to relax and strengthen the muscles before sleep.
• During Recovery: Ideal for post-partum recovery, post-surgical rehabilitation (e.g., prostatectomy), or after periods of illness where mobility is limited.
• As a "Check-in": Use it as an opportunity to assess your pelvic floor strength and awareness throughout the day.

Benefits of Consistent Pelvic Floor Training

Regular and correct execution of pelvic floor exercises, whether in bed or elsewhere, yields significant benefits:

• Improved Urinary and Fecal Continence: Helps manage and prevent stress incontinence (leaking with coughs, sneezes, jumps) and urge incontinence (sudden, strong urges).
• Support for Pelvic Organs: Reduces the risk and can help manage symptoms of pelvic organ prolapse.
• Enhanced Sexual Function: Can lead to stronger orgasms and improved sensation for women, and better erectile function and ejaculatory control for men.
• Better Core Stability: Contributes to overall trunk stability and can alleviate some types of back pain.
• Post-Natal Recovery: Aids in the recovery of pelvic floor muscles stretched and weakened during childbirth.

When to Consult a Professional

While pelvic floor exercises are generally safe and beneficial, it's advisable to consult a healthcare professional, such as a pelvic floor physical therapist (PFPT), if:

• You are unsure if you are performing the exercises correctly.
• You experience pain during or after the exercises.
• You do not notice any improvement in your symptoms after several weeks of consistent practice.
• You have specific pelvic floor concerns, such as persistent incontinence, prolapse symptoms, or chronic pelvic pain.

Conclusion

Performing pelvic floor exercises in bed is not only possible but can be a highly effective strategy, particularly for those new to these exercises or with specific physical considerations. The supine position aids in muscle isolation, promotes relaxation, and enhances the mind-muscle connection, laying a solid foundation for stronger, more functional pelvic floor muscles. Consistent, correct practice is key to realizing the full range of benefits for continence, support, and overall well-being.