Should I do kegels is a questions we hear ALL THE TIME! There is a lot of misinformation out there that creates confusion. Dont worry, you are not alone.

Kegels are a very basic function in a system that is highly complex and responsible for a lot of our everyday functions. While there is nothing wrong with kegels, they are usually just the starting point for someone who has true pelvic floor weakness and they are less than ideal for someone who suffers from pelvic floor tightness.

In order for your pelvic floor to work optimally it has to work with other parts of your body. When the entire system starts working together you experience symptom relief!

The “system” that we are talking about is also known as your core canister and all parts of that core canister need to work together. they need to each do their part so the rest of the system does not get strained resulting in pain, leaking, pressure, etc.

What makes up this core canister:

1. diaphragm: this is the top of the canister

2. pelvic floor: this is the bottom

3. transversus abdominis: this is the front and sides

4. Multifidi and lumbo-pelvic fascia: this is the back

The most basic way they work is with breathing. When you inhale you diaphragm flattens, transversus, multifidi expand and pelvic floor descends. On an exhale, the opposite happens. This allows for pressure to move into and out of the abdominal cavity without stressing any of the muscles.

When these muscles do not work together and one part does too much or too little. It will lead to more strain on the system as a whole. This can result in low back pain, hip pain, leaking with jumping, leaking with sneezing, heaviness/pressure feelings with activity or even pain with sex.

So why does this basic function matter? What happens if part of that system does not move or is tight, for example your pelvic floor. Let’s say it does not descend when you take a breath in. Well now you have more pressure in a smaller area creating more strain on the system as well as the organs sitting in the bottom of the pelvis which can result in leaking, pressure/heaviness or pain. This tightness of your pelvic floor can also lead to its inability ascend up, or react, on the exhale.

Want to put it all together?

Let’s use a sneeze as an example with a pelvic floor that is not moving well. The beginning part of a sneeze is an inhale and without your pelvic floor moving, more pressure will exist within the abdominal cavity overstressing the system.

The second part of a sneeze is a forced exhale. At this point your pelvic floor should ascend up to help offer support but because it is already tight and already just staying in its ascended position it will not be able to react to this forced exhale resulting in leaking.

This is one of the most basic reasons there is so much more to your pelvic floor than just doing a kegel. There is nothing wrong with doing kegels, they just simply may not be enough.

The answer to, should I do kegels is not straight forward. Our pelvic floor needs to move and needs to be able to work with other muscles. In the example above, if you just continued to try and tighten your pelvic floor, you most likely would continue to end up with the same symptoms because you are just looking at one piece of a much larger puzzle.

For some people, kegels may be a part of their plan of care however it should be just that, a part of it. Pelvic floor treatment should not be a generic, one size fits all treatment. Each person is different and needs an approach that looks at their bodies needs.

Hi! We are Dr.Aimee and Dr. Lauren

We are the owners of Empower Physical Therapy and Wellness. We are pelvic floor physical therapists who specialize in helping women from pregnancy, into postpartum and through perimenopause, menopause and then beyond! We believe all women deserve to do all of the things they love without symptoms!

You can contact us via our website, email at hello@weempowerpt.com or social media!

The information provided in this blog is for educational and informational purposes only and is not intended as medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or symptoms. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.

If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately. The opinions expressed in this blog are those of the author and do not necessarily reflect the views of any medical or healthcare institutions.