Manual Training Mode for Strengthening: Longer Holds

Using the Kehel manual training mode for strengthening may be beneficial if you have pelvic floor muscle weakness. You can adjust the parameters of the number of repetitions, duration of each contraction, and the resting time between each contraction. In the next blogs, we will discuss why and how you should adjust the parameters depending on what your pelvic floor weakness problem is.

We previously described the quick flicks and how they are necessary to stop urine or fecal leakageLonger holds are needed to increase pelvic floor muscle strength for support for the bladder, uterus, and rectum. Weakness in these muscles can result from:

  • Age or menopause
  • Pregnancy
  • Vaginal childbirth
  • Chronic cough
  • Chronic constipation with straining
  • Surgery
  • Weight gain

You can use your Kehel in the manual training mode with longer holds:

  • To prepare for pregnancy
  • To recover from childbirth
  • To prevent or improve prolapse
  • To prevent or improve incontinence
  • To strengthen your core muscles.

Elevator contractions are done to learn how to squeeze and elevate or lift your pelvic floor muscles. You can practice these contractions without the Kehel in place by starting with a 4-second lift and squeeze. You want to isolate your pelvic floor muscles by pulling up and in from your anus as if you are trying to hold back gas. Pull up and in for a 4-count pulling in a little higher with each count, then relax for a 4-count. Counting out loud ensures that you are exhaling as you contract. You can do these in either seated or lying down. If you are seated lean forward with your hands on your knees and you will feel the anterior muscles a little more.

When you are ready to try the elevator contractions with the Kehel inserted you can set your timer for a contraction time of 5 seconds and a rest time of 10 seconds for 10 repetitions. Be sure you fully relax between each contraction and that you are exhaling as you contract.

Here is what your elevator contraction may look like:

Your contractions may not be the same strength, but you should see a consecutive rise to a peak then a decline to a full relaxation. Your strength reading in grams per second will vary and get higher as you get stronger and lower when you are fatigued.

The second longer hold method you can use with the manual training mode is the long hold steady hold that is greater than 5 seconds. You can gradually build up to greater than 5 second holds as your strength improves. You will set your contraction time for 5 seconds and rest time will usually be double the hold time so 10 seconds in this case. When you can easily hold for 5 seconds without pulling in your stomach, buttocks or leg muscles then you can increase your contraction time to 6 seconds and rest to 12 seconds. Continue increasing your contraction time as you get stronger up to a 10 second hold time.

This is what your longer hold time contraction may look like:

You should see one longer contraction. If you see a dip in the center as you do with this one, it may be from where you begin to partially release the contraction either from fatigue or weakness then the peak elevates as you pull the contraction back in again.

Recommended Beginner Manual Mode for Longer Holds Exercise Program

  • Warm up: massage mode for 5 minutes on low intensity
  • 10 repetitions of elevator contractions with 5 second contraction time and 10 second rests.
  • Repeat for 2-3 sets.
  • 10 repetitions of longer hold contractions with a 6 second or longer contraction time followed by a rest time that is double the contraction time.
  • Repeat for 2-3 sets of 10 repetitions or until you begin to fatigue. You will know you are fatigued when you begin to substitute your stomach, buttocks or leg muscles when you are contracting or trying to hold the contraction.
  • Recovery: massage mode for 5-10 minutes on low intensity

You may choose which massage mode you prefer for warm-up and recovery.

You will know if you are getting stronger by performing frequent assessments with your Kehel. As you advance you can increase your sets of repetitions. Remember that whenever you leak during an activity, repeat that activity 3 times while holding your kegel.

Caution: Do not use the Kehel if you have pain or any unexpected symptoms. If you are beginning to exercise, start cautiously and progress slowly. If you have pain or any unexpected symptoms, consult your physician or pelvic physical therapist.


Elizabeth Bell

Clinical Specialist in Women’s Health

Lola Rosenbaum

Doctor of Physical Therapy

Do you have any questions or you want to share your experience? Leave us a comment below, we’d love to hear from you!

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