The Real Truth About Doing Kegels
I'm guessing you have probably heard about kegels a time or two in your life. Perhaps you were told by your physician or other healthcare provider to "just do some kegels" after you had a baby. Or maybe you've Googled solutions to your incontinence issues and saw that more kegels might be the answer. Kegels are a pelvic floor contraction used to strengthen the pelvic floor. While kegels do help strengthen the pelvic floor, simply doing kegels is not quite that simple. And it may not be the best solution if you want to put an end to incontinence or prolapse.
Most Women Do Kegels Incorrectly
First, research has shown that over 60% of women are doing kegels incorrectly. If you aren't doing them properly, then they aren't doing anything for you. It is essential that you perform a kegel correctly if you want to strengthen the pelvic floor and stop having issues with incontinence. Part of my job as a pelvic floor physical therapist is to teach women how to do them properly so they can do them on their own.
Want to find out if you're doing a kegel correctly? Check out this quick video for an at-home test.
How You Perform a Kegel Matters
The pelvic floor muscles are composed of both fast twitch and slow twitch fibers. These are essentially quick contraction fibers and endurance fibers. Both types of fibers should be strong in order to prevent incontinence or prolapse. This is why we specifically check both the strength and the endurance of the pelvic floor during a kegel.
The Pelvic Floor Needs an Exercise Program
Furthermore, in order to strengthen the pelvic floor, it must be progressively overloaded. Similar to how you would increase weight at the gym while doing bicep curls, the pelvic floor needs the same type of training. Most people don't realize that the pelvic floor consists of muscles similar to everywhere else in our body. In order to strengthen those muscles, there has to be an appropriate exercise program for them. If you only had the strength to do 5 bicep curls, you wouldn't try to do 20. There's no way you could have good form for all 20 repetitions. The same theory applies to the pelvic floor muscles.
Kegels Aren't Always the Answer
It's also important to note that resolving pelvic floor dysfunction is oftentimes not quite as simple as just strengthening the pelvic floor. Once evaluated by a pelvic floor PT, many women will have hyperactive pelvic floor muscles (aka tight and in spasm). In that case, kegels can make things much worse. Since the muscles are already working too much, kegels would be contracting them even more.
The best way to know what is best for you is to have it assessed by a pelvic floor physical therapist. Not all physical therapists are created equal. There are some professionals out there who say they treat incontinence but have not taken additional classes for it (which is needed to treat it effectively). If you have any questions about kegels or incontinence, please contact us.