Kegel exercises—most of us recognize the term, but do we fully grasp its meaning and significance? Allow me to clarify. My relationship with Kegels is complex, and I’ll elaborate on that shortly.
The term “Kegel” hails from Dr. Arnold Kegel, a gynecologist who introduced these exercises in 1948 as a non-surgical method for women to strengthen their pelvic floor muscles, particularly after childbirth. As a physical therapist, I appreciate the intent behind Dr. Kegel’s innovation. It marked a significant advancement in supporting women facing urinary incontinence postpartum—an area where healthcare in this country often falls short.
However, Kegels have become a one-size-fits-all solution for various pelvic issues. Experiencing discomfort during intercourse? Kegel. Dealing with urinary leakage? Kegel. Frequent urges to urinate? Kegel. Back pain? Kegel. Expecting a baby? Definitely Kegel. Wanting to enhance vaginal tightness? Kegel. The list is extensive.
Yet, we must recognize that Kegels are not a universal remedy. While they are beneficial for some, they are not suitable for everyone. Surprised? I understand; let’s delve deeper.
A Kegel involves the contraction of the pelvic floor muscles, which function like a hammock at the base of the pelvis. These muscles connect the pubic bone to the tailbone and the sit bones to one another. Within this structure are openings for the rectum, vagina, and urethra in females, and for the rectum and urethra in males. The pelvic floor serves three primary purposes: (1) Support (holding organs against gravity), (2) Sexual (facilitating orgasm and allowing vaginal penetration), and (3) Continence (maintaining dryness).
Ideally, as the bladder fills, the pelvic floor muscles engage to close the sphincters that retain urine and stool. Eventually, when it’s time to relieve oneself, these muscles relax, allowing the bladder to contract and expel urine through an open urethra.
However, numerous factors, such as carrying a baby for nine months and the strain of delivery, can weaken the pelvic floor muscles. In such cases, Kegels can be helpful for strengthening these muscles.
Conversely, some individuals may have pelvic floor muscles that are already too tight or overactive. In these situations, additional contractions can exacerbate dysfunction—similar to attempting a bicep curl with an already flexed arm, which yields minimal progress and potential discomfort.
Another concern is the common advice to perform a set number of Kegels daily—like “200 Kegels a day” or “do them at traffic lights.” However, this approach overlooks individual differences in strength and function. We don’t go to the gym and mindlessly perform hundreds of bicep curls daily, nor do we carry heavy weights around constantly. Each person’s needs vary, and without proper assessment, prescribing Kegels can be misguided. Indeed, some individuals may benefit more from lengthening their pelvic floor muscles rather than contracting them.
Research indicates that roughly 30% of women instructed to perform Kegels do not engage their pelvic floor muscles correctly from the outset. Therefore, the key takeaway is this: If you’re uncertain about your pelvic health, seek professional assistance. A specialized pelvic floor physical therapist can assess your condition and guide you accordingly.
Executing a Kegel effectively is quite challenging. The pelvic floor muscles must coordinate with various other muscles and your breath to provide support and maintain continence. Even highly trained athletes can struggle with correctly performing a Kegel contraction.
In summary, Kegels hold importance, but only in the right context and for the right individual. Seek out a pelvic floor PT in your area to ensure your pelvic floor functions optimally, whether that involves Kegel exercises or other techniques for lengthening.
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