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Why You’re Doing Kegels Incorrectly and Why There’s a Chance You Shouldn’t Be Doing Them At All

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The word “Kegel,” probably sounds familiar to you. Countless blogs, magazines and TV shows recommend Kegels for a variety of reasons—everything from improving bladder and bowel function to having better sex—but it’s important to know that there’s a time and a place for Kegels and they almost certainly shouldn’t be universally prescribed. It is also quite common for women to unknowingly perform Kegels incorrectly. This will be the first of multiple times we’ll mention: It’s important to have an evaluation before beginning any type of pelvic floor exercise program. As we get into this topic, let’s tackle a few common FAQs surrounding Kegels.

First of all, what exactly is a Kegel?

Coined by gynecologist Arnold Kegel, “Kegel exercises” refer to a contraction of your pelvic floor muscles, i.e.: the muscles located at the base of the pelvis, part of what we consider the “core.” Pelvic floor muscles serve a few different, important functions. For one, they keep the abdominal contents right where they should be. They also aid in the function of urination, defecation and sexual function. Quite a valuable part of the body! Performing Kegels involves the contraction of these muscles which results in a slight lift up towards the abdomen. During a pelvic floor contraction (aka Kegel), the bladder, uterus and intestines are all slightly lifted.

As mentioned above, the pelvic floor musculature plays an important role in core strength and pelvic stability. The goal of performing Kegels is to strengthen these muscles to prevent incontinence, low back/SI joint pain, pelvic instability and to help manage pelvic organ prolapse. During pregnancy, there is a lot of pressure pressing down on the pelvic floor muscles. Without proper strength in these muscles, women can easily develop the above mentioned conditions.

Is there any danger of doing too many Kegels?

Absolutely there is. Just as some people have chronically tight neck and back muscles, others can have chronically tight pelvic floor muscles. This creates imbalances and can sometimes lead to nerve issues and pain with sex. During pregnancy, when so much of the body is loosening and stretching, pelvic floor muscles that are too tight can also increase the risk of low back and SI pain. Furthermore, towards the end of pregnancy before you deliver, it would be beneficial for the muscles to be loose and able to stretch to help with delivery and reduce the risk of tears.

Why are Kegels so commonly performed incorrectly?

The main reason Kegels are so often performed incorrectly is because you can’t see the muscles and the movements they are creating. This is not typically the case when we think of exercising. Take your bicep for example. When you flex your bicep, you can easily see that muscle activating and you can clearly see the bending of your elbow. Same with an exercise like the squat. You can watch the movement in your hips, knees and back and then you can feel the muscles causing these movements. The muscles of the pelvic floor are internal so it’s more difficult to ensure that they are being activated correctly. It comes down to how this movement is described and whether or not that makes sense to you. Everyone describes Kegels in their own way so what one woman feels and would describe as a Kegel, may not hold up to what another woman would say. It’s important to state again that a full assessment from a physical therapist specializing in the pelvic floor is important and necessary.

When women are typically told to do Kegels, it is a contract and then relax type of description. Pelvic floor muscles, being part of the core, should be endurance muscles so Kegels should actually consists of a contract and HOLD then relax. When women come in for a physical therapy pelvic floor assessment, PTs are looking for patients to be able to hold for 10 seconds.

Can Kegels make things worse?

If the muscles are too tight, doing too many Kegels can exacerbate pain symptoms and cause more dysfunction. Also, if you’re not correctly contracting the pelvic floor muscles then you are most likely using other muscles like the adductors, glutes or abdominals. You may also be increasing pressure in the abdominal cavity which can cause sudden increases in BP, hernias or other organ-related issues.

Is it bad advice to stop your pee midstream to “practice” Kegels?

Yes, doing that too much can cause urine retention and may lead to UTIs or even urge incontinence/general difficulties with urination. Do not use this practice. At most, maybe 1x/month a woman can do this to determine if she is contracting the right muscles but absolutely no more than that.

Finally, we asked Therapydia Physical Therapist Cami Hatch, DPT, about Kegel exercise apps and she had this to say: “I have mixed feelings about these apps. I think they may be appropriate for two types of women. 1) Someone who has already completed pelvic floor physical therapy and who has been told by a PT that this is a good option to maintain the gains made during PT and to prevent issues from recurring and 2) Someone who has no symptoms/issues and would like to know if they are contracting the muscles correctly. That being said, it will always be a better option to have someone check to make sure the muscles are being contracted correctly.”

Learn more about Pelvic Health Physical Therapy.

Dr. Cami Hatch enjoys treating all patients but has a particular interest in women’s pelvic health and runners. She has taken courses in pelvic floor assessment, visceral mobilization and running gait analysis and injury prevention. In partnership with Mile High Mamas.

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