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To Kegel Or Not To Kegel

Updated: Dec 4, 2022


Let's get a few things straight. The word Kegel refers to the contraction of the pelvic floor muscles, and was named after a dead guy.


Dr. Arnold Kegel was the first to publish research about kegel exercises being a non-surgical solution to urinary incontinence and pelvic organ prolapse in women.


But was he really the first person to figure this out?


I'll let you answer that...


The truth is, being able to perform a pelvic floor muscle contraction is very important for your pelvic health. If you have no brain/body connection to your pelvic floor, and are unsure if you are even able to perform a kegel correctly, we need to fix that right away (through an evaluation with a pelvic floor PT).


But should we all be doing kegels, 30-40x a day, for the rest of our lives?


Well, I doubt cavewoman was doing kegels all day...it would be a very strange design in human anatomy if we needed to actively perform kegels daily to avoid leaving a trail of urine everywhere we went.


I like to break this discussion down into a couple of categories.


Those that should kegel


There are not a lot of people in the world that need to be doing kegels at every stop sign or red light for the rest of their lives.


But there might be some.


Generally speaking, elderly women who do not participate in regular physical activity and are suffering from urge incontinence and/or symptoms of prolapse might fall into the "just strengthen the pelvic floor" category.


This is because we do lose estrogen post-menopause, which can accelerate atrophy of pelvic floor muscles, and if we do not maintain regular fitness we are even less likely to have muscle tone in our pelvic floor.


Individuals who are simply lacking strength in their pelvic floor often resolve their symptoms very quickly with just kegels alone, or with just a couple of visits to pelvic floor PT to learn how to correctly perform kegels.


Those that should not kegel


But there are many individuals who should not start kegels. These include people experiencing pelvic pain, pain with sex, or bladder pain symptoms.


This group of people more than likely already have tight pelvic floor muscles, and more kegels are likely to make their symptoms worse.


Those that should maybe kegel


Everyone else is going to fall into the grey area on this one.


Pregnant women should not necessarily do kegels simply because they are pregnant. Pregnant women may have tight pelvic floors that they are bringing into their pregnancy, and some instances of bladder irritability, constipation, and pubic symphysis pain during pregnancy are the result of an overly tight pelvic floor.


Being pregnant does stress the pelvic floor, but in many ways this creates even more tension in the pelvic floor, and the best solution is to maintain healthy abdominal pressures and hip strength during pregnancy in order to avoid over-stressing the pelvic floor.


Postpartum women may benefit from kegels, especially those that tore during childbirth, however I often see postpartum women having very tight and painful pelvic floor muscles, and need to downtrain their pelvic floor muscles before strengthening can occur.


So with this population, it really just depends. The best way to keep your pelvic floor healthy during pregnancy is to work with a pelvic floor PT.


Conclusion


The bottom line is sometimes kegels are an important part of a treatment plan, and sometimes they can completely derail your progress.


Whether or not kegels are indicated for you and your specific situation depends on the underlying WHY of your issues.


This is true no matter what the diagnosis. There are very few people who benefit from kegels alone, and they are generally not in the pregnant and postpartum population.


This is why it is so incredibly important that you enlist a pelvic floor PT to guide your pregnancy and postpartum journey, and come up with a preventative and treatment plan that is very specific to your body and your needs.


Make sure you book your appointment with your pelvic PT today!




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