Kegel & pelvic floor
How to use kegel balls, and the mistake that makes them useless
The common instruction is to insert them and walk around. That is also the reason most people get nothing out of them: holding something in place is not a contraction, and the muscle only strengthens when it contracts and then fully releases.
The pelvic floor is a sling of muscle running front to back at the base of the pelvis. Like any other muscle it strengthens through repeated contraction followed by complete release, and weakens if it is never used. It also, and this is the part product marketing never mentions, can be too tight, in which case strengthening it makes the problem worse.
Weighted balls do one thing: they give you something to feel, so you can tell whether you are contracting the right muscle. That is genuinely useful, because the most common failure with pelvic floor exercises is squeezing the abdomen, the thighs or the buttocks instead and feeling like something is happening. What the balls do not do is exercise anything by sitting there.
What they are and are not for
- They are feedback. Something to contract against and something whose movement you can feel, which makes it possible to know you have found the right muscle. This is the whole legitimate case for them.
- They are not a passive workout. Walking around with them in is not exercise. The muscle is holding a light static load, which is close to what it does all day anyway, and static holding is the least effective way to strengthen anything.
- They are not a treatment for leaking on their own. Stress incontinence is common, it is treatable, and the treatment with the best evidence behind it is supervised pelvic floor training with a physiotherapist, not a product. The balls can be part of that; they are not a substitute for it.
- They are not for a tight pelvic floor, and that is a real condition. Pain during penetration, difficulty inserting a tampon, pain that worsens with exercise, or a sense of constant tension can all point to an overactive pelvic floor. Strengthening it then makes things worse. This is the single most important caveat on the page and almost no product mentions it.
- They are not a postpartum default. They are frequently recommended as one. The sensible sequence after birth is a check with a clinician or a pelvic health physiotherapist first, because a tear, a prolapse or a separation changes what is appropriate.
The two shapes worth knowing about
- 1
The straightforward weighted set
Lelo Beads Plus / Fun Factory Smartballs
Two balls of different weights in a silicone shell with a retrieval cord, so you can start light and change the load without buying again. That is the whole mechanism, and it is enough: the point of a weighted set is feedback, not resistance, and a set that lets you start too heavy is the one you abandon. Non-porous silicone with a declared material and an identifiable maker, which not much in this category has.
- Strengths
- Interchangeable weights, so starting light is actually possible
- One-piece silicone with a retrieval cord, non-porous and easy to clean
- A named manufacturer with a published material and a warranty
- Limitations
- Expensive for what is mechanically two weighted balls
- The weight range is modest at the top end
- Sold through retailers rather than a maker-run store, so there is no purchase link here
- Best for
- Learning to feel the contraction, with a load you can adjust downward.
- 2
If you need to see that you are doing it right
Elvie / Perifit kegel trainer
A sensor rather than a weight: it measures the contraction and shows it on a phone, which addresses the actual failure mode, since most people who get nothing from pelvic floor exercises are contracting the wrong muscles and cannot tell. That feedback is the genuine argument for it, and it is a training aid rather than a treatment.
- Strengths
- Shows whether the contraction is happening, rather than leaving you to guess
- Distinguishes a real contraction from bearing down, which is the common error
- Guided sessions give the exercise a structure, which improves adherence
- Limitations
- Expensive, and the hardware is the cheap part of what you are paying for
- Requires an app and an account, with the privacy consequences that implies
- Sold through retailers rather than a maker-run store, so there is no purchase link here
- Best for
- Someone who has tried the exercises, felt nothing, and wants to know why.
How to actually use them
Find the muscle before you buy anything
The contraction is the one you would use to stop yourself passing wind, or to stop urinating midstream, lifting upward and inward. Your abdomen, thighs and buttocks should stay still, and you should be able to breathe normally throughout. If everything tightens at once, you have not found it yet, and that is the thing to solve first.
Start lighter than you think, and lying down
The lightest ball in a set, lying on your back with knees bent. Gravity is the variable: standing is harder than sitting, which is harder than lying down. People who start standing with the heavy ball conclude they cannot do it.
Use plenty of water-based lubricant, and keep the cord out
Insert as you would a tampon, with the retrieval cord outside. Water-based with silicone balls. Something that will not come out easily is the one genuine hazard in this activity.
Contract and fully release, in sets, rather than just holding
Squeeze for a few seconds and release completely, ten to fifteen times, then a set of quick squeezes. The complete release is as important as the squeeze: a muscle that never releases becomes tight rather than strong, and that is a separate problem. Ten to fifteen minutes is plenty, and more is not better.
Take them out, and do not wear them for hours
Fifteen to twenty minutes of actual exercise, once a day at most. Wearing them all day is not training and raises the risk of irritation. Remove them for exercise, for sleep, and if there is any discomfort.
Expect weeks, and stop if anything hurts
Strength changes in muscle take six to twelve weeks of consistent work, as they do anywhere else in the body. Pain, a feeling of heaviness or dragging, or symptoms getting worse are reasons to stop and see a pelvic health physiotherapist rather than to push on.
Questions people ask
- Can I just wear them around the house?
- You can, and it does very little. Holding a light static load is close to what the muscle does anyway. The strengthening comes from contracting and fully releasing, in sets, which takes about fifteen minutes.
- How long until anything changes?
- Six to twelve weeks of consistent work, which is what muscle takes anywhere in the body. Anything promising days is describing something other than strength.
- Will they help with leaking?
- Pelvic floor training does help stress incontinence, and that is well established. The balls are a feedback aid within that training, and supervised work with a physiotherapist is substantially more effective than any product used alone.
- Can the pelvic floor be too strong?
- It can be too tight, which is a real and frequently missed condition. Pain with penetration, difficulty with tampons or constant tension point to it, and in that case strengthening makes things worse. Get assessed before starting.
- Is there a risk of losing one?
- With a retrieval cord outside, very little. Without one, it is the main hazard. If something cannot be retrieved, see a clinician rather than trying with any implement.