Since low-tone and high-tone pelvic floor dysfunction often have similar symptoms, such as urinary leakage, it’s best not to assume you just have weak pelvic floor muscles, says Kusturiss.
“If you have tight pelvic floor muscles, doing Kegels can cause increased pain and symptoms like muscle spasms, generalized pelvic ache and discomfort, and urethral irritation,” Kusturiss says.
With both high-tone and low-tone pelvic floor muscles, it’s best to talk with a medical expert who can help you determine the best treatment plan for your situation. Kusturiss recommends seeking out a pelvic floor therapist who is experienced in assessing low-tone and high-tone pelvic floor muscles if you can. She suggests browsing the American Physical Therapy Association website for providers and reading patient reviews for the physical therapist you’re interested in seeing.
Keep in mind that even if doing Kegels on your own is helpful, they might be just one part of your treatment. For example, people with severe constipation may benefit from a more robust treatment plan that includes medication and pelvic floor physical therapy, explains Dr. Millheiser. This makes it even more important to consult with a doctor.
2. Kegel trainers may help you with proper form.
Leah Sharon Millheiser, M.D., an ob-gyn and sexual health specialist at Stanford Health Care, says that Kegels can be deceivingly challenging. “The assumption is it’s easy. You go to the bathroom, you stop that stream of urine, and that’s how you identify your Kegel muscles,” Dr. Millheiser tells SELF. “But a lot of people can’t figure out those muscles. Some people don’t realize where those muscles are, what they’re supposed to be doing, or how hard to squeeze.”
If you have a vagina, you can try to identify your pelvic floor muscles by pretending that you’re trying not to pass gas while inserting one finger into your vagina, according to the U.S. National Library of Medicine (USNLM). Tighten your muscles the same way you would if you were holding in your urine and then relax those same muscles. If you’re doing Kegels properly, you should feel the muscles around your finger tighten. The muscles in your thighs, buttocks, and abdomen should be relaxed, the USNLM explains.
Once you’ve identified the right muscles to contract, you can develop a routine (we’ll cover how to do that in a bit). The tactile sensation from using a lower-tech option like Kegel weights may help you with form, and there are also some “smart” Kegel devices or trainers that offer extra guidance. Generally, these use Bluetooth and a smartphone app to track your muscle movements and give you feedback to help with your form, explains Dr. Millheiser. “If a Kegel trainer is giving you feedback, it tells you whether you’re squeezing the right muscles and can give you a signal of where you should be contracting,” Dr. Millheiser says.
If you really want to be sure you’re doing Kegels the right way, Dr. Millheiser suggests scheduling an appointment with your gynecologist if you have one. During a pelvic exam, the doctor can talk you through properly contracting the muscles and checking to make sure you’re doing it correctly.
3. Kegel trainers can help you establish a consistent routine.
Whether seeing your Kegel trainer in the bathroom offers a visual reminder or you just enjoy using a gadget, Dr. Millheiser says that a Kegel trainer may help you develop consistency with your practice. And some products have the added benefit of including apps that send you alerts and notifications when it’s time to do your workouts and offer data on your progress (useful if you’re a person who’d want a phone reminder to take your birth control).