Should I do kegels?
Why kegels aren’t always the answer
Most people associate anything pelvic floor related to kegels. They’ve heard the buzz; from their aunt, neighbor, grandma and even OBGYN. Got a pelvic floor problem? Kegel. Leak when you sneeze? Kegel. Pregnant or just had a baby? Kegel.
I can’t tell you how frustrating this can be as a provider. So many women I hear say “but I’ve been doing my kegels…” and yet their symptoms aren’t improving. In fact, they likely get worse. This is like taking random supplements because that Instagram ad hooked you (why are they so good at that?!) but not having any labs done to tell you what your body actually needs.
What is a kegel?
Kegels are associated with the pelvic floor and aren’t always a bad thing. A kegel is just a pelvic floor contraction. It was named after the doctor, Dr. Arnold Kegel, who in the 1940’s recognized the pelvic floor played a larger role in urinary health and pelvic stability than previously thought. Naturally his discovery was named after… wait for it… himself. So we can all never forget how a man made this unremarkable discovery. In all seriousness, we are thankful he was talking about the pelvic floor at all.
A kegel, however, is not the only solution for pelvic floor dysfunction. In fact, for most of my patients, kegels are not even prescribed or indicated. If a muscle is living in a contracted or shortened state, probably like the state of your upper shoulders if you’re a human living in our modern world of technology and smart phones, it’s not going to be able to contract any further if you ask it to. This muscle can appear weak, but is it really?
The answer is it depends, but likely not as weak as it appears.
There may be underlying weakness as the reason for their symptoms, but their muscles are not able to coordinate or relax completely to actually generate strength.
In this situation, patients may benefit from relaxation strategies of the pelvic floor to allow the muscle tone to normalize prior to being able to strengthen to mitigate symptoms.
Sometimes kegels are indicated for weakness, but are they the best way to strengthen?
A research study by Crawford, 2016 found 10 movements that have greater activation than a kegel alone.
I focus on functional movements for core and pelvic floor stability, not only because they are more realistic of what you’re doing throughout the day, but also because they are easier for my patients to show up for themselves and actually do the strengthening they need. They don’t feel overwhelmed and overburdened, and actually see improvement. It’s a win-win for everyone.
So how do you know if performing kegels are for you or against you?
The only way to accurately determine if you can benefit from kegels is to get assessed by a pelvic floor therapist. This is best done in person and involves some level of hands on, but virtual options are the next best option if you cannot locate a pelvic floor therapist in your area.
If local to the Tampa Bay area, Fourth Trimester Wellness is happy to talk through your situation with a free 15 min phone consultation and ensure you’re a good fit for pelvic floor therapy. If not local, virtual may be a second best option or directories such as pelvicrehab.com or pelvicguru.com can be helpful in locating a pelvic floor therapist nearest you.
