To Kegel or not to Kegel

You might find yourself wondering, are Kegels are right for me? This is a great question! Generally, Kegels are a good first-line treatment for urinary incontinence, specifically stress urinary incontinence, and are important for helping to support bladder function during day-to-day activities. But Kegels are not right for everyone. So, to Kegel or not to Kegel? Let’s dive into this question.

To Kegel?

Are you leaking when you sneeze, cough, laugh, or exercise? Do you find you can’t stop this escape of urine once it starts? Then Kegels might be right for you.

The American College of Physicians recommends pelvic floor muscle training as a first-line treatment for women with stress urinary incontinence (leaking with sneezing, coughing, laughing, exercising, etc). But sometimes we don’t know exactly how to do a Kegel or if we’re even doing them correctly. So you may be wondering, where do I start? Here are some ways to get started:

  • Try starting in a gravity-eliminated position, meaning a position where gravity is not pulling directly down on you. For example:
    • lay on your back
    • use some pillows to prop up your hips so they are raised above shoulder height
    • keep your knees up and your feet on the ground. This position takes some load off your pelvic floor.
  • Watch this video for tips on how to properly contract the pelvic floor muscle
  • An intravaginal device, like Flyte, can be a great tool to improve pelvic floor strength as it not only provides an advanced treatment technology called mechanotherapy, but is also provides a tactile surface within the vagina to squeeze against, which may help you identify which muscles exactly you need to squeeze. Because let’s be real…when was the last time a clinician checked if you were doing a Kegel correctly? Maybe not for a while or even ever! So it’s important we work on quality before quantity. Learn more about Flyte and how it can amplify the benefit of each contraction (Kegel) by 39 times.
  • Finding and isolating the pelvic floor muscles are a key factor to gaining strength and improving bladder control.  For successful pelvic floor exercises, avoid these common mistakes: holding your breath, contracting the wrong muscles (inner thighs, buttocks, abs), squeezing repeatedly too quickly without relaxing between each repetition, and being impatient – we are all so different and we all see improvements at different times.
  • Make sure you continue to be conscious of how you are using your pelvic floor with day-to-day activities. Think of what is causing you to leak and try to remember to squeeze your pelvic floor muscles and breathe out during that activity.

Or not to Kegel?  

Do you have pain with tampons, intercourse, or during a pelvic exam? Do you struggle to start or empty your bladder or bowel? These can be signs of hypertonic, tight, or overactive muscles that are having a difficult time relaxing and may be tender to the touch. Kegels might not be right for you.

Try this: if you try to do a Kegel, do you feel any movement down there? If not, it’s possible your muscles are already so tight they don’t have anywhere else to go.

Relaxation exercises, stretching, and a down training program for your pelvic floor and surrounding muscles would be first recommended. It is also possible to have both stress urinary incontinence and a tight, hypertonic, or overactive pelvic floor. A pelvic floor physical therapist can help you in determining where to start and may use various manual therapy techniques to aid in your recovery (ie. scar tissue mobilization, trigger point release, myofascial release, abdominal and visceral techniques, and many more!). It’s often more than one approach that makes us better.

Not to Kegel…Then Kegel?

Now remember, once you have gained the relaxation of your pelvic floor, then it is time to start getting strong in that new range of motion and learning both directions of your pelvic floor, so you can have your muscles functioning well in the long-term.

It’s important to know the pelvic floor is a muscle like any other muscle in our body, just harder to see. Imagine if you did squats but never fully stood up to rest in between each repetition…you wouldn’t be getting the desired effect for your muscles and may even cause further problems down the road. So, after we do our Kegels it’s just as important to visualize “letting go” so our muscles down there can also relax and rest. We want to be able to control our pelvic floor throughout its FULL range of motion, meaning both relaxing and squeezing. Our pelvic floor is a part of us every day, use it or lose it!

Still have questions? Connect with our on-staff pelvic floor physical therapist through Ask a PT. Browse videos or schedule a free phone call to learn more about the pelvic floor, tips on how to do a Kegel or ask about Flyte. Get answers, not sales pressure.