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

Patient Perspective: How Acknowledging My Pelvic Floor Changed My Life

How Acknowledging My Pelvic Floor Changed My Life. Pelvic Strengthening

I’ve experienced bladder leaks for about 5 years. After I had my second daughter, I started noticing leakage here and there. I always assumed it would go away, but it never did. I spent the first year attributing it all to childbirth, and let’s be honest, I didn’t really have the time to worry about myself much with a newborn baby. But, after my daughter’s first year, what I thought was a problem that would clear up on it’s own continued, and I began to take more notice. The leaks were more frequent, not less, and I started to feel ashamed about it. I’d never heard any of my friends talking about this side effect of motherhood – why was it happening to me?

I finally decided to visit my OB/Gyn to see what he recommended and he referred me to a Physical Therapist who solely focuses on the pelvic floor (yes! there really is such a thing!). The PT did a thorough evaluation and said the cause of my problem was due to a weakened pelvic floor that most likely occurred during childbirth.

I’ve never been what you would call athletic. I have a gym membership but don’t visit all that often. I sit at work all day, and get most of my exercise running around after my two girls. And God knows I could stand to lose a bit more of the baby weight.  So when my PT said that she was going to put me on a workout program to get things back in shape, I was a bit worried. But her workout was low intensity – lots of walking to get my weight down (which would help put less pressure on my bladder and pelvic floor) and simple exercises that would strengthen not just my pelvic floor, but my core muscles too.

After 3 months of doing the workout I had lost about 8 pounds and my stomach and glut muscles were noticeably more toned. I also was noticing much fewer leaks and was able to control my bladder much better than before. And after 6 months of performing the workout, the leaks had stopped all together.

I can’t tell you what a difference this simple workout routine has made in my life – not only do I feel stronger and more in control, but it’s given me more confidence in the ability to change my body both in look and in function. I’m so proud of myself and my only regret is that I didn’t do something sooner. Ladies – if you’re experiencing bladder leaks, visit a PT and get on a workout program! It will literally change your life. It did for me!

Kimberly V., Englewood, CO

Incorporating Biofeedback Into Your Pelvic Floor Strengthening Routine

Incorporating biofeedback into your pelvic floor STRENGTHENING routine 

Incorporating biofeedback into your pelvic floor STRENGTHENING routine 

The pelvic floor is made up of a series of muscles that act as a “sling” and support different organs in the body.  Keeping those muscles strong is important for a host of reasons – they help to prevent prolapse, reduce or prevent the symptoms of incontinence, and can even lead to more satisfying sex.  But how do you strengthen those muscles?  And how do you know what you are doing is effective for the long run?

We recommend starting your pelvic floor exercise search with a trained physical therapist (PT) specializing in women’s health.  Your PT will educate you on what muscles connect to the pelvic floor (there are 45!) and how to work all of them in order to keep things working properly.  Many people know of kegels but are unaware of the variety-- and combination-- of workouts that can benefit the pelvic floor. Because the pelvic floor connects to so many other muscles in the body, a workout plan that incorporates strengthening all of these muscles will ensure that you are not placing too big of a strain on any one muscle group.

In addition to specific movements or workouts, your PT may also incorporate biofeedback into your sessions. Biofeedback is a system that reports how well you are performing kegel contractions and can be an indicator of how strong your pelvic muscles are. 

Biofeedback is a great way to actually see how you’re performing in the moment.  Typically, a probe is inserted into the vagina, and sensors on the probe relay information back to a screen or meter.  When you contract your pelvic floor muscles, a reading appears on the screen that tells you how tightly you are squeezing, and for how long. 

Talk to your doctor about biofeedback to see if it might be an option for you.

What is Biofeedback?

Biofeedback is a treatment option for individuals needing assistance understanding where and how to activate their pelvic floor.

Biofeedback treatment is primarily composed of two types of sensors that are placed on the body to measure muscle activity by detecting and recording electrical activity. Patients work with biofeedback therapists to flex and relax muscles to gauge muscle strength, and also help the patient become aware of activating these specific muscles. By better identifying these muscles and learning how to activate them, patients learn how to more easily control their incontinence.

what is biofeedback

Two types of sensors can be used in biofeedback therapy and both are effective in measuring muscle activity. Either small tampon-like sensors are placed in the vagina or an external “stick-on” type of sensor can be placed just outside the anal opening. The most common error that some individuals make in performing pelvic floor muscle exercises is using their abdominal muscles instead of the pelvic floor muscles.

While this whole thing may sound a bit intrusive, improvement in symptoms may be seen in as little as three sessions. With biofeedback, you can learn to stop using the wrong muscles and start using the correct ones.

If this treatment interests you or you’d like to talk to a specialist about this treatment option, click here to find a NAFC-approved specialist.

And if you’re still a little uncomfortable discussing the subject for your own treatment but want to learn more, click here to ask people in our community who have been there before.