First things first, let’s clear up the pronunciation of the name. It’s kegel- as in “bagel” with a K. Kegels were named after Dr. Arnold Kegel who performed research on the pelvic floor after child birth. Just a fun fact—Thanks, Tracy Sher! Kegels are contractions and relaxations of your pelvic floor with the goal of strengthening those muscles.
Ok, now that we cleared that up, the true debate is: To Kegel or Not To Kegel?
Many post-partum patients have told me that after the birth of their child, they are never given instruction or care past “perform kegels daily” to address their pelvic floor. They are never taught or checked to be sure they are performing them correctly! You can only imagine the frustration when they learn there is more to the puzzle. Especially after years of leaking with exercise, painful sex or other related symptoms. Others, who may or may not have given birth, read in magazines that the best way to “stay healthy down there” and “please your partner” is by performing kegels daily.
The full spectrum of pelvic floor movement is contraction, relaxation, and bulging. It is important that we maintain all of these functions for optimal strength, control, and length of the pelvic floor. The popularity around kegels emphasizes the contraction and strength part. It seems that women think they tighter and harder they can squeeze, the better. This is true for certain situations- think sneezing. But it is also important to be able to relax the pelvic floor fully.
Re-lengthen before we strengthen
For much of the active population, pelvic floor over-tension is a problem. For these women, we want to focus less on the contraction and more on the relaxation and lengthening. Once full relaxation and length is achieved, THEN kegels are needed to strengthen in the new range of motion achieved. Strength comes in many forms- quick bursts, endurance, holds, etc. These are exercises specific to YOUR needs and deficits that a pelvic floor PT will prescribe to you. There is also a piece to the puzzle of timing of the pelvic floor contraction.
Look back to a blog I wrote about 7 Habits That May Be Stressing Your Pelvic Floor to start addressing these issues now.
How are you performing a kegel?
Remember how we said a kegel is a pelvic floor contraction? Well, all of these muscles are deep so if I can SEE you performing a pelvic floor contraction, you’re doing too much. Sometimes it is hard to know what you are squeezing in the nether regions. Is it pelvic floor? Is it my glutes? Am I just squishing my legs together?
The easiest way to know if you are performing a kegel correctly—see a women’s health PT and learn!
So, to kegel or not to kegel? It depends!
The best place to start - regardless of age, sexual activity, pre or post-partum - is to see a women’s health (aka pelvic floor) physical therapist. We can help you with a plan to decrease pain, improve function, and stay active without you having to guess what is right for you and if you are performing contractions correctly.
Thanks for reading,
Dr. Danny and Dr. Jackie's views on performance improvement, injury prevention and sometimes other random thoughts.