Let’s talk about Kegel’s!
Usually, it goes something like this...
Women: Well, yes one more thing. I am having some trouble leaking when I exercise and lift, and I feel like I am barely making it to the bathroom these days.
Provider: Oh, you have urinary incontinence, that is very common. Take this brochure and do these Kegel exercises. Have a nice day.
Women leave thinking, “Wait…what? Um, ok? We’ll I guess I’ll try that.”
Using this approach will help about 1/3 of women that do need strengthening and can activate their pelvic muscles properly. Unfortunately, the other 2/3 of women see no change or have WORSENING urinary incontinence and pain.
I had a woman come in just yesterday telling me this was her last experience when she mentioned pelvic floor problems. This approach in my opinion is not helpful. Many have even more questions, “What is a Kegel?” “How do I do a Kegel?” “Why are these supposed to help?” “What exactly is wrong with me?” … then a couple weeks later…” Why are these not working!!!”
I’d like to share information about when Kegel’s are helpful and when if done too soon, or incorrectly, can cause more harm!
So, when we say Kegel, what does that mean? Kegel exercises are pelvic floor contractions with the goal of building strength. Strengthening the pelvic floor is very beneficial to women who have a weak pelvic floor. It can build support and strength to help with prolapse, pain or incontinence issues. Strength is important but is not always what our bodies needs initially.
For instance, if my pelvic floor was resting too tense or was painful, doing more strengthening could make me have more pain and more problems! This can be tricky because pelvic floor appears weak since there is leaking happening, but that is because the muscles are resting too tense or tight. Think of a spring that is shortened with no more room to spring. When you cough or sneeze, there is no more muscle strength to give because the muscle already as tight as it can get. In this case, more of a relaxing and stretching approach may be used at first. We all need good healthy range of motion and comfortable resting length of our pelvic muscles. Beginning only strengthening exercises without stretching the muscles first won’t fix our problem either.
Sometimes we can have good strength and good flexibility, but have leaking due to a timing issue, or the inability to manage pressures in the body. Ask yourself, do you hold your breath when you lift? By holding your breath, we increase the intra-abdominal pressure in our body. In areas of weakness (back, abdominals, pelvic floor), we can see an escape of pressure in the form of disc herniations, hernias, and urinary leakage!
Proper breathwork with activity is A MUST when we want to manage incontinence. Our core works as a system, with our breathing being the foundation for managing this system.
So, back to Kegels, yes, they can be helpful, but sometimes another approach may better suit you. We are all unique and a one size fits all rarely works for any of us.
Also, Kegels are confusing! Performing a good Kegel without using surrounding muscles can be difficult and can require education to be done properly.
Please reach out to me with any questions you have about pelvic floor physical therapy! I would be happy to help ❤️”