Why Kegels Are Not the Only Answer to Healing Your Pelvic Floor
Written By: Dr. Danielle L. Moreau PT, DPT on July 18, 2022
What are “Kegel” Exercises?
Pelvic floor muscle exercises are commonly referred to as “Kegel” exercises. The use of Kegels for pelvic floor muscle strengthening dates to 1948 when a physician named Arnold Kegel first described the exercise.
Kegels involve repetitive contraction and relaxation of the pelvic floor muscles and may be used to improve pelvic floor muscle strength and coordination. To do a Kegel exercise correctly, the goal is to isolate the movement of the pelvic floor muscles as if trying to stop urine or gas without using other muscles such as the buttocks, legs, or abdominals.
The Myth about Kegels for Pelvic Floor Dysfunction
Many people will experience symptoms of pelvic floor dysfunction at some point during their lifetime. These symptoms can include bladder or bowel symptoms, pelvic pain, or sexual dysfunction. Pelvic floor dysfunction can arise because of childbirth, injury, surgery, infection, postmenopausal changes, cancer treatment, or medical conditions such as interstitial cystitis or endometriosis. They can also occur without a known cause. Pelvic physical therapists work with an interdisciplinary care team to help patients who are living with these conditions.
Due to the popularity of the Kegel exercise, it is easy to assume that any symptom related to the pelvic floor muscles could be “fixed” by simply doing these exercises. This assumption is further validated by numerous companies who eagerly market fancy Kegel products and devices to people who are looking for symptom resolution. However, the truth of pelvic floor dysfunction is that it is often more complex than many recognize.
Conditions such as urinary urgency or frequency, leaking, bladder pain, pelvic pain, painful periods, and constipation often include a component of pelvic floor muscle tension or overactivity that drives symptoms. This means that the pelvic floor muscles have become shortened or are unable to relax effectively and lack the adequate capacity for movement. In these cases, the assumption that Kegel exercises are the “cure-all” for pelvic floor dysfunction falls short. If someone is experiencing symptoms due to pelvic floor muscle tension, then performing lots of exercises that emphasize repetitive pelvic floor contractions could make matters worse.
Pelvic Physical Therapy: More than Just Doing Kegels
When you see a pelvic physical therapist, their role is to perform a comprehensive examination to determine exactly where the problem lies in the pelvic floor muscles and their nearby counterparts. This ensures that the treatment plan for a person’s symptoms is tailored exactly to them, not a “cookie cutter” approach where everyone is doing the same exercises.
Pelvic physical therapists provide patients with a wide range of tools including strengthening exercises, stretches, relaxation techniques, manual therapy, dry needling or cupping, educational tools, biofeedback, and much more to guide patients in finding long-term success and freedom from symptoms. Kegel exercises may be a part of the treatment plan for some people but are certainly not the only element to healing pelvic floor dysfunction.
Kegel exercises can be a huge help for some people who are experiencing pelvic floor dysfunction and are often a good starting point. They are a free and simple exercise that people can try at home or that can be used to prevent future problems. If you have tried using Kegel exercises and have seen no improvement or worsening symptoms, it is time to act.
What Do I Do if Kegels Have Not Helped Me?
If this sounds like you, you deserve kudos for being proactive! It is possible that Kegel exercises are not appropriate for you, or that your technique needs improvement. It is also possible that Kegel exercises alone are not challenging enough, and you need a more progressive or functional exercise regimen. Letting your medical provider know about your symptoms and asking for a pelvic physical therapy referral is a fantastic way to get on track to recovery. Your medical provider may recommend additional testing or imaging to be completed prior to starting physical therapy.
Most importantly, do not give up! And remember, Kegels are not the only answer to healing the symptoms of pelvic floor dysfunction.