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Why Aren't Kegels Helping My Pelvic Floor?

Has a healthcare provider or fitness professional recommended that you do Kegel exercises at home? Did you try Kegels with no success? Maybe the Kegels even made you symptoms worse? This week we’ll talk about who should do Kegels and who should avoid them.


First, what is a Kegel? A Kegel is an exercise designed by a gynecologist named Dr. Arnold Kegel in the 1940s as a nonsurgical treatment for urinary incontinence. A Kegel is essentially a contraction and lifting of the pelvic floor muscles (PFM) to strengthen them.


Kegels can be appropriate for many individuals, but for some, doing Kegels can make their symptoms worse. This is true for most individuals who are experiencing any kind of pelvic pain. With pelvic pain, the PFM are often tight and overactive. (A tight pelvic floor is not the same as a strong pelvic floor!) As we perform Kegels, we continue to tighten those muscles, but forget to relax them back to their resting state. This cycle of continued tightening leads to a pelvic floor that doesn’t work the way it was designed to!


If you do Kegel exercises when your PFM are overactive, you may start to experience pelvic pain (or worsen your existing pain), you may start to notice you have a harder time holding in urine, and you may notice constipation and a harder time going poop!



But there’s good news for everyone out there who is dealing with pelvic pain or an overactive pelvic floor: a specially trained pelvic floor physical therapist can help! When you see a physical therapist, they should perform an assessment of your PFM, back, hips, and more. Often times when our pelvic floor is not working properly, there are other body parts involved that need to be addressed to help you get back to 100%.


A physical therapist can help you to determine if you are contracting the pelvic floor correctly. Many individuals don’t know how to contract/relax the pelvic floor without also engaging other muscles or without holding their breath. In the video below, Jeanice talks about different mistakes that are common with PFM training.



You can ask your healthcare provider for a referral to a pelvic therapist, or find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.


If you have limited access or resources to a pelvic floor physical therapist, you can check out the 6 Week Women’s DIY Pelvic Pain Relief Program with Dr. Susie Gronski, DPT, PRPC, WCS.


Now that we’ve talked about who SHOULDN’T do Kegels, let’s talk about who may benefit from performing them. (Note: It’s important to remember that Kegels aren’t the only exercise for the pelvic floor.)


Some conditions that may benefit from Kegels:

  • Urinary leakage (in the absence of pelvic pain and tightness)

  • Anal (poop ad gas) leakage

  • Pelvic organ prolapse

  • Vaginal laxity (i.e. queefing)

  • Postpartum to rehab the PFM



If you are going to perform Kegels, relaxing or dropping the pelvic floor after is just as important as the contraction and lift.



Here are some great resources to help you learn more about your pelvic floor:

For providers, check our online courses to help your clients with pelvic pain. Consider joining our Ambassador Program and most of our courses are included with your membership!

Written by Emily Reul, PT, DPT


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