What are Kegel Exercises?

Kegels are an exercise designed to strengthen the pelvic floor. They are so named after the American gynecologist Arnold Henry Kegel who proposed this as a first line of treatment for urinary incontinence in 1948. Today, we also refer to this exercise as a pelvic floor contraction and use it for various other conditions. 

The aim of a pelvic floor contraction is to train the muscles that run like a sling or hammock from the pubic bone (the bone just above the genitals) down and back towards the tailbone. To properly perform these exercises, it can be helpful to picture the perineal body – the space between the anus and vagina or anus and testicles – lifting up and in towards the belly button. After the contraction, you should also feel the muscles release or relax back to the starting position. 

Why Would Someone Need to do Kegels?

The pelvic floor can become weak for any number of reasons. In men and women some common culprits include a sedentary lifestyle, aging, obesity, chronic constipation/straining with bowel movements, a chronic cough and any surgical procedure that cuts the muscles of the pelvic floor (e.g. prostatectomy or prolapse repair). Women are also at risk from pregnancy, vaginal childbirth, and hormonal changes. 

A weak pelvic floor can lead to some uncomfortable issues. We already mentioned urinary incontinence, but urinary urgency, fecal incontinence, pain, pelvic organ prolapse, and changes in sexual function can also result from weak pelvic muscles. In some cases, a strong pelvic floor can help prevent or treat these issues. 

Not Everyone is Doing Kegels Correctly

An estimated 30 percent of women doing Kegels are performing them incorrectly! When you consider you can’t really see these muscles, it makes sense that so many people don’t know how to do these exercises. Here are some common signs you could be doing Kegels incorrectly:

• Symptoms seem to be getting worse rather than better.
• Lower back and/or abdominal pain increase after a Kegel exercise session
• New pain with intercourse or other negative changes in sexual function occur
• Development of new tailbone pain or pain with sitting

When we see patients in the clinic, we also keep an eye out and screen for some of these common mistakes:

• Clenching or engaging other muscles like the abs, inner thighs or glutes. (Squeezing your butt does not strengthen your pelvic floor!)
• Pushing instead of squeezing and lifting the muscles – usually also associated with holding the breath.
• Strengthening at the wrong time. Often people hear they should do Kegels while urinating, but regularly interrupting the urine stream can set the body up for issues down the road. 
• Overtraining or excessively tightening the muscles. This can occur because of not focusing on releasing the muscles after contracting or for other underlying reasons. 

Your Pelvic Floor Might Be Overworked

Like any other muscle in the body, the pelvic floor muscles can become overly fatigued. In some cases, this leads to even more weakness and in other cases, it can lead to spasms in the pelvic floor. Either can result in a worsening of symptoms. To avoid this, start gradually increasing in intensity and frequency. If you are unsure how to do this, a pelvic floor physical therapist can guide you and help you determine the best way to start a home routine of pelvic floor exercises. 

Should You Try Kegels for Your Symptoms?

Kegel exercises aren’t appropriate for everyone experiencing symptoms associated with a weakened pelvic floor, especially if the exercises are done incorrectly or if the muscles are being overworked. But even if you are doing Kegels correctly, some pelvic floor disorders require more than just Kegels. That’s why it’s important for anyone struggling with symptoms associated with pelvic floor weakness to be evaluated by a trained pelvic health physical therapist.

Where Does Pelvic Floor PT Come In?

Fortunately, 80% of pelvic floor dysfunction cases can be improved through physical therapy. A trained pelvic floor physical therapist can evaluate your symptoms, correctly diagnose issues, and provide you with a personalized treatment plan that will help you see results.

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