Kegel Exercises: Why, When, When Not

You have likely read the chatter about kegels over the past several years if you have scrolled through social media or the internet. Kegels are exercises used to strengthen pelvic floor muscles. You might also hear them referred to as pelvic floor contractions or exercises. They can be a great exercise for those experiencing symptoms of pelvic floor weakness. But did you know that kegels are not the right choice of exercise for everyone? In some cases, kegels should not be the first go-to exercise for women or men.

Your pelvic floor muscles span from front to back and side to side, creating a bottom base or hammock (see picture). Pelvic floor muscles support bladder and bowel function, affect sexual function and are an integral part of your core function, which we use every day of our lives. Life occurrences, such as pregnancy, childbirth, chronic constipation and aging, can result in weakened pelvic floor muscles. There are various symptoms that can indicate an issue with pelvic floor strength. When those symptoms occur, a thorough evaluation by a primary care provider and referral to a pelvic physical therapist can determine the best treatment plan moving forward.

     Permission to use copyright image from Pelvic Guru, LLC pelvicguru.com

Symptoms That Indicate Pelvic Floor Weakness

• Urine or fecal incontinence (leaking) with coughing, laughing, sneezing or running/exercise
• Feeling of heaviness in the vagina
• Decreased sensation in the vagina
• Difficulty controlling gas
• Tampons that fall out
• Difficulty holding urine or stool in time to get to the bathroom

Many people will google “kegels” and start to do them on their own. This can work for some if the exercises are done correctly. The caution that I share with you today is that kegels are not always the most appropriate place to start. Pelvic floor muscles that are tight (hypertonic) and weak will often not respond well to kegel exercises. I have had many woman come to see me in-clinic for the first time, all with a similar frustration. “I have been doing kegels every day and I am still having symptoms.” In many of those cases, an intravaginal exam displayed pelvic floor muscle tightness, as well as weakness. Pelvic floor muscles can be weak and tight. If you try to contract muscles that are tight, you will not get the full contraction you want for strengthening. It is best to first address the tightness and then begin on strengthening. A pelvic physical therapist can help you figure out if that applies to you and help you begin a program specific to your needs.    

Robyn Wilhelm is a Doctor of Physical Therapy (DPT) and private practice owner of Robyn Wilhelm Physical Therapy in Mesa, AZ. Dr. Wilhelm earned her Master of Physical Therapy degree in 2002 and completed her doctoral degree in 2009.

Dr. Wilhelm specializes in perinatal (pregnancy & postpartum) and core & pelvic health Physical Therapy. She is passionate about whole-body health and one-on-one patient care. Robyn holds an understanding and empathy of the emotional stress that often accompanies pain, dysfunction and a body that feels less optimal than one desires. She believes that postpartum physical therapy care should be part of healthcare for every woman following birth.

Dr. Wilhelm can be reached through her website at www.themomdoc.com