To kegel or not?

Probably you’ve heard about the Kegel exercises. You probably don’t know if you are doing it correctly or if you need to do it at all!

Kegels are NOT always indicated for pelvic floor problems.

Here I’m going to explain a little about the functions and dysfunction of the pelvic floor muscles and why Kegels are not for everyone.

Pelvic floor muscles sit between the sits bones, pubic bone, and tailbone. The opening of the urethra, Vagina, and anus go through these muscles. So basically intercourse, vaginal delivery, bowel, and bladder movement happen in this area. These muscles have different functions and here I have listed some of them:

-    Holding the organs up; holding the baby up.

-    They need to be flexible for different functions like intercourse, vaginal delivery, bowel, and bladder movement.

-    They are one of the deep core muscles

Pelvic floor dysfunction can happen if these muscles become tight or weak or tight and weak:

-    Hypertonicity (tight pelvic floor muscles): contributing to Urgency, Urge incontinence, Chronic pelvic pain, Dyspareunia, Vaginismus, Vulvodynia, Pudendal Neuralgia, Interstitial Cystitis and Chronic Prostatitis

-    Hypotonicity (weak pelvic floor muscles): contributing to stress incontinence, urge incontinence (leakage), and Pelvic Organ Prolapse.

Now, if these muscles are tight, we need to work on their flexibility and we shouldn’t do Kegels at all! If these muscles are weak, we work on the activation and strengthening of these muscles along with other deep core muscles.

Now the question is how we know if the muscles are tight or weak. The good news is that a Pelvic Health Physiotherapist can assess these muscles by doing internal exam. A Pelvic Health Physiotherapist has the training for doing the manual work. By assessing the muscle tone and strength, a they can find out if there is any tightness/weakness or a mix of both and can educate and guide you to do the proper exercises.

“The Cochrane Collaboration 2010 concluded that Physiotherapists with specialized training in pelvic floor rehabilitation (using internal examination to teach the exercises) should be the first line of defense, before surgical consultation, for stress, urge, and mixed incontinence in women.”

So to answer the first question “ To Kegel or Not” we should say that we don’t know until we assess the tone and strength of the pelvic floor muscles and a Pelvic Heath Physiotherapist can help you to find out what you need to do and how to do it.

A Pelvic Health Physiotherapist will look at your posture, and breathing and check other deep core muscles as they try to look at the whole picture.

If you are pregnant, going through postpartum, or having some issues like incontinence, pain, prolapse, frequency, and urgency book an appointment with a Pelvic Health Physiotherapist. We can help you with that.