Could Kegels Actually Hurt Me?

Could Kegels Actually Hurt Me?

You’ve seen the claims. A stronger pelvic floor! Fewer Leaks! Better Sex! The kegel craze is hot right now and for good reason. Kegels can do all of these things and we’re a big proponent of doing them for maintaining good bladder health and a healthy pelvic floor. But before you jump on the kegel bandwagon, read this post. Because while kegels can be super effective for all the reasons listed above, they can sometimes cause problems in women who have certain conditions.

Many women suffer from a weakened pelvic floor, the series of muscles and tissues that form a hammock at the bottom of your pelvis, and are responsible for holding many of your organs (including your bladder) in place. A weakened pelvic floor can be caused by many factors, but pregnancy, childbirth, and aging are all high on the list.  This laxity in the pelvic floor can lead to things like incontinence, or even pelvic organ prolapse if not treated properly.  And a great way to treat it (most of the time) is with kegels.   

But not everyone has a weak pelvic floor – some women experience pelvic floor tension, which prevents the pelvic floor muscles from contracting or relaxing at a normal rate, again making them weak, but in a different way.  This can lead to things like constipation, painful intercourse, or the inability to empty your bladder completely.  

People with pelvic floor tension are advised NOT to do kegels, and if you think about it, it makes sense. Trying to tighten something that is already too tight can make your problems worse.

So, how do you know if you should be doing kegels or not?  Our best advice is to see a physical therapist specialized in women’s health.  A trained PT can give you a thorough evaluation and can determine if you have a pelvic floor that’s too tight or too loose.

An added bonus is that if your PT finds you’re a good candidate for kegels, they’ll be able to show you exactly how to do one – something that is actually somewhat difficult for many women.  And, if you’re advised NOT to do a kegel, they’ll be able to help you learn how to relax your pelvic floor and will show you exercises to help with that as well.

It’s also worth noting that while kegels are great for many people, they also aren’t the end all be all move for your pelvic floor. Your muscles are all connected, after all, so concentrating just on kegels won’t be as effective as if you worked your entire core, glutes and thighs. 

Want to find a PT in your area? Try our Specialist Locator

What Is Pelvic Pain Disorder?

What Is Pelvic Pain Disorder?

Pelvic pain is pain that you experience in the lowermost part of your abdomen and pelvis. It can occur in both men and women, however it is more common in women.  Depending on the specific cause of pelvic pain, it can vary in intensity and length.  There are several things that may contribute to pelvic pain.  

Many women experience pelvic pain due to gynecological problems or problems associated with pregnancy.  Some of these include: 

  • Endometriosis

  • Adenomyosis

  • Menstrual cramps (dysmenorrhea)

  • Ectopic pregnancy (or other pregnancy-related conditions)

  • Ovarian cancer

  • Vulvodynia

  • Mittelschmerz (ovulation pain)

  • Pelvic inflammatory disease (PID)

  • Ovarian cysts

  • Uterine fibroids

Some other causes of pelvic pain may be due to:

  • Diverticulitis

  • Appendicitis

  • Fibromyalgia

  • Colon cancer

  • Chronic constipation

  • Inguinal hernia

  • Crohn's disease

How is the cause of pelvic pain determined?

Talking to a doctor is the first step in determining the cause of your pelvic pain.  Your doctor will start off by asking you several questions about the type of pain you are experiencing, and also discuss your medical history to determine the cause.  He or she will also likely perform a physical exam and may perform some tests to figure out what is causing your pain. Depending on what you are experiencing, your doctor may check your blood, urine or stool, perform a pregnancy test, check for STDs, or even perform X-rays or Ultrasounds to better examine some of your internal organs.  

How is pelvic pain treated?

Your doctor will determine the appropriate treatment for your pelvic pain based on the cause, and how serious the pain is. They may recommend medications, or even surgical procedures.  Talk with your doctor about what you are experiencing to find the best solution.

Pelvic Floor Disorders Are Common Among Patients With Multiple Sclerosis

Pelvic Floor Disorders And Multiple Sclerosis

Multiple Sclerosis (MS) is the most common autoimmune disease presently affecting approximately 2 million people worldwide. 

MS is a disease of the central nervous system. The central nervous system is the hub for the autonomic nervous system and the somatic nervous system. These systems regulate many parts of your body’s mechanics. Most notably: blood pressure, heart rate, bowel activity, sexual arousal, skin sensation, and muscle control.  

In patients with MS the immune system attacks the material that insulates nerve fibers. Without insulation the nerves of the central nervous system cannot communicate with the rest of the body.  This faulty communication between the brain and spinal cord often results in muscle weakness, abnormal sensation, psychiatric problems, and difficulty regulating breathing, blood pressure, and temperature.  Loss of bladder or bowel control can be a result of muscle weakness; almost half of MS patients report bladder and or bowel complaints as the first symptoms of multiple sclerosis.

Sixty-eight percent of individuals with MS experience symptoms of one or more Pelvic Floor Disorders (PFD). PDFs are a loss or lack of bladder or bowel control and can include urinary incontinence, urinary frequency and urgency, bowel incontinence, sexual dysfunction, pelvic organ prolapse, and pelvic pain related to a “spastic” pelvic floor.

Among MS patients with PFDs the most common diagnosis are overactive bladder (69%), voiding problems (41%), Sexual dysfunction (42%), and fecal incontinence (30%)[i].  These symptoms represent major detriments to quality of life. 

The good news is that patients with MS can benefit from the same behavior modifications as anyone else with a pelvic floor disorder. Pelvic floor neuromuscular rehabilitation, often referred to as “pelvic floor therapy”, is a behavior modification practice of retraining the pelvic floor muscles using techniques like pelvic floor muscle training, biofeedback therapy and electrical stimulation. 

Modern methods of pelvic floor rehabilitation such as The Pfilates Method™ and The VESy Lab™ utilize movement taken from Pilates and Yoga to provide greater pelvic floor response.  The key to success with pelvic floor rehabilitation is establishing a practice that continues for a lifetime.  Working with a specially trained Physical Therapist provides excellent results and should be considered an element of any care plan for MS patients with bothersome pelvic floor symptoms.

[i] Int J MS Care. 2014 Spring;16(1):20-5. doi: 10.7224/1537-2073.2012-052.

Dr. Bruce Crawford is Dr. Bruce Crawford is a Board Certified Urogynecologist and the creator of the PfilatesTM program of pelvic floor rehabilitation. He has personally trained over 1,500 physical therapists and fitness professionals in North America, Asia, and the UK. Dr. Crawford also originated the VESy LabTM Method of optimizing pelvic floor fitness training.
Dr. Bruce Crawford is Dr. Bruce Crawford is a Board Certified Urogynecologist and the creator of the PfilatesTM program of pelvic floor rehabilitation. He has personally trained over 1,500 physical therapists and fitness professionals in North America, Asia, and the UK. Dr. Crawford also originated the VESy LabTM Method of optimizing pelvic floor fitness training.