Oh Kegels … these pelvic floor exercises certainly get a lot of press, but do they work? And are they actually helpful?
I recently saw a specialist to get my pelvic floor evaluated after six pregnancies. One of those oh-so-fun things we get to do as women. The good news? Shockingly – no diastasis or pelvic floor problems for me. But I had a fascinating conversation with the therapist about Kegel exercises and what actually works to improve pelvic floor health.
Turns out that Kegels have their place, but they aren’t for everyone and they were never intended to be a stand alone exercise as many women use them today. Strengthening the pelvic floor is important, but Kegels may not be the best way.
What Are Kegels?
Kegel exercises are one of the many exercises that can strengthen the pelvic floor (also known as the pelvic diaphragm). These exercises are named after gynecologist Dr. Arnold Kegel who published a paper in 1942 explaining the benefits of strengthening the pelvic floor. He found that improving muscle tone in this area helped stop urinary incontinence but also seemed to improve orgasm in women.
Dr. Kegel’s also invented a device for measuring pelvic floor strength. The original exercises he recommended included the use of a resistance aid (like these) and were not just simple contract and release exercises.
This is the reason that many pelvic floor therapists recommend Kegel exercise weights or even stone eggs in conjunction with Kegel exercises. My physical therapist explained that Kegels without weights are somewhat like just squeezing your arm muscle, while adding the weight is like using a dumbbell in arm exercises. Both can be effective, but adding a weight will provide better results over the long term.
Benefits of Kegel Exercises?
The pelvic floor is actually composed of several layers of muscles that connect in opposite directions. Many people envision the vagina as a tube that simply squeezes and releases, but the pelvic floor is much more complex and has several layers that all work together. In some cases, Kegels are helpful to tighten the pelvic floor. But some women have a pelvic floor that is too tight and needs to be relaxed.
As Dr. Brianne Grogan, DPT, explains:
Kegels are not for everyone. Some women hold chronic tension in the pelvic floor muscles and their muscles are short and tight most of the day. This often results in pain with intercourse, difficulty initiating urination, a feeling of tension or pain in the pelvic area, and the feeling that “no matter how many kegels I do I still don’t see results!”
For these individuals, kegels should be avoided.
I recommend seeking the care of a women’s health physical therapist who can help you release the pelvic floor muscles and re-balance pelvic floor length and tension using other, more appropriate, exercises.
Now before we throw out kegels altogether, we need to remember: kegels are not “bad.” They are simply an isolated contraction and relaxation of a muscle group, similar to a biceps curl or a hip extension! And for many women (barring the women described above), knowing how to “kegel” can be a great way to improve body awareness and even to spice up one’s sex life.
Successful isolation and contraction of the pelvic floor muscles helps functionally, as a “back-up” to prepare for a big cough/sneeze, when you really have to hold your bladder because there’s no bathroom nearby, or when lifting/pushing/pulling something heavy.
If you’re wondering what category you fall in, Dr. Brianne talks you through a step-by-step self assessment of the core and pelvic floor in this YouTube video.
Do Kegels Work?
This is where things get a little more confusing. The answer really depends on what is actually causing the pelvic floor problem, how the Kegel exercises are being performed, and a variety of other factors. Dr. Grogan’s experience indicates some of the times these exercise are appropriate and when they aren’t:
When I was in clinical practice as a women’s health physical therapist, I had the distinct advantage of being able to physically examine my patients to determine their level of pelvic floor strength and muscular control. Most of the women who presented with complaints of incontinence truly did have weak, uncoordinated pelvic floor muscles and responded well to kegels. I saw some amazing results in women who practiced kegels as part of a total core strengthening program.
However, there was definitely a subset of women for whom kegels were NOT appropriate. Luckily, I was able to identify these women during their physical exam, and my focus with these patients was to teach them how to relax and release the pelvic floor muscles.
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