To Kegel or Not to Kegel: Insights from a Pelvic Floor Physical Therapist

As a pelvic floor physical therapy clinic, Advanced Pelvic and Spine Physical Therapy has encountered its fair share of patients who have been lead to believe that Kegel exercises are the ultimate solution for all pelvic floor issues. While Kegels can be beneficial for certain individuals, they are not a one-size-fits-all solution. In fact, there are cases where Kegels can be counter-productive or even exacerbate existing problems. In this blog post, I want to shed light on why Kegels may not be suitable for everyone and explore alternative approaches to pelvic health.

Understanding the Pelvic Floor

Before we delve into the limitations of Kegels, let's first understand the pelvic floor. The pelvic floor is a complex network of muscles, ligaments, and connective tissues that support the pelvic organs. It plays a crucial role in maintaining continence, sexual function, and overall core stability. However, the pelvic floor can experience a range of issues, including weakness, tightness, and coordination problems.

What is a Kegel?

The Kegel exercise, named after Dr. Arnold Kegel, is a pelvic floor muscle contraction technique that aims to improve the strength and coordination of the pelvic floor muscles. The pelvic floor muscles can weaken or become dysfunctional due to various factors such as pregnancy, childbirth, aging, obesity, or certain medical conditions. During a Kegel exercise, individuals voluntarily contract and lift the pelvic floor muscles, as if trying to stop the flow of urine or prevent passing gas. The exercise involves holding the contraction for a few seconds before relaxing the muscles. Regular practice of Kegels, when appropriate for an individual, can help strengthen the pelvic floor, enhance muscle tone, improve bladder control, and contribute to overall pelvic floor health. However, it is important to note that Kegels are not suitable for everyone.

Why Kegels Grew in Popularity

The popularity of Kegel exercises for the pelvic floor can be attributed to several factors. First, Kegels are relatively easy to perform and require no special equipment, making them accessible to a wide range of individuals. Additionally, the medical community has historically emphasized the importance of pelvic floor muscle strength for maintaining continence and addressing certain pelvic floor disorders. This emphasis, coupled with the simple nature of Kegels, has led people to believe that these exercises are a one-size-fits-all solution for pelvic floor issues.

The Limitations of Kegels

• Pelvic Floor Weakness is Not Always the Issue

  While Kegels are often associated with strengthening the pelvic floor, not everyone has weak pelvic floor muscles. In fact, certain individuals may have good muscle tone or even hypertonic (overly tight) pelvic floor muscles. For these individuals, performing Kegels can create further tension and exacerbate symptoms such as pain, urinary urgency, and difficulty with bowel movements.

• The Importance of Muscle Balance

  The pelvic floor does not work in isolation; it interacts with other muscles in the body, including the hip, gluteal, and abdominal muscles. Focusing solely on Kegels without addressing potential muscle imbalances can perpetuate dysfunction and hinder overall progress. An approach that considers the entire musculoskeletal system is vital for achieving optimal results.

• Coordination and Relaxation Challenges

  Some individuals struggle with coordinating their pelvic floor muscles effectively or have difficulty relaxing these muscles when necessary. Simply instructing them to perform Kegels without addressing these underlying issues can lead to frustration and ineffective outcomes. A comprehensive approach that includes education, guidance, and targeted exercises is essential for improving coordination and relaxation.

Alternative Approaches to Kegels

Pelvic floor physical therapy is a specialized treatment approach that focuses on assessing pelvic floor muscles internally and rehabilitating them. It offers several benefits:

• Individualized Assessment

  Comprehensive Assessment: It is crucial to consult with a pelvic floor physical therapist who can conduct a thorough assessment to determine the specific needs of your pelvic floor. This assessment may include evaluating muscle strength, tone, coordination, overall movement patterns, and potential contributing factors to develop an individualized treatment plan. By understanding the unique challenges faced by you as an individual, your therapist can develop a personalized treatment plan.

• Relaxation and Stretching Techniques

  For individuals with hypertonic pelvic floor muscles, relaxation techniques such as diaphragmatic breathing, mindfulness, and gentle stretching exercises can be highly effective. Pelvic floor physical therapists can provide specific exercises individualized to you to strengthen weak or under-active muscles and to promote relaxation of tight or hypertonic muscles. This balance is crucial for a healthy and functional pelvic floor. These techniques help release tension, enhance blood flow, and restore muscle balance, leading to improved pelvic floor function.

• Whole-Body Conditioning

  Strengthening the pelvic floor should not be limited to Kegels alone. A comprehensive approach includes exercises that address the entire body, targeting core strength, hip stability, and overall functional movement. This ensures that the pelvic floor works in synergy with other muscle groups, promoting balanced and efficient movement patterns.

To Kegel or Not to Kegel?

While Kegels can be beneficial for individuals with specific pelvic floor concerns, they are not suitable for everyone. Understanding your own pelvic floor needs and seeking guidance from a pelvic floor physical therapist is essential in developing a personalized treatment plan. By exploring alternative approaches and addressing the root causes of pelvic floor dysfunction, you can achieve optimal pelvic health and overall well-being. Remember, your pelvic floor is unique, and an individualized approach will yield the best results.

Advanced Pelvic and Spine Physical Therapy

Advanced Pelvic and Spine Physical Therapy provides people experiencing pelvic pain with expert care in a comfortable environment. You will speak to a pelvic floor physical therapist who is a knowledgeable, experienced specialist who stays up to date on the latest treatment options for pelvic floor issues. If you would benefit from pelvic floor physical therapy, book an appointment today or reach out with any questions.