Should Everyone Do Kegels?

"Shouldn't everyone do kegels?"
"A 'tighter' pelvic floor is always better, right?"
Find out the answers in this post!
First of all, what is a kegel?
Before we get into the main question of this post, “Should everyone do kegels,” let’s first look at what a kegel actually is.
A kegel is a pelvic floor muscle contraction. When you perform a kegel, you are essentially tightening your pelvic floor. The pelvic floor is a group of muscles located in your pelvic region that are important for urinary, bowel, and sexual function. These muscles support organs like the bladder and rectum (and uterus for women).
You can learn more about the pelvic floor muscles by clicking here!
The purpose of a kegel is to strengthen the pelvic floor muscles.

If a kegel strengthens the pelvic floor, shouldn't everyone kegel?
Everyone has their own unique body and while some exercises may be beneficial for some people, we can never really generalize to everyone.
Many individuals (especially women), tend to think that they have to do kegels to keep everything “healthy down there”.
While doing kegels and keeping the pelvic floor strong can be beneficial for many people, there are some men and women that may not benefit from doing kegels.
There’s a common misconception that kegels can fix all pelvic floor problems. It’s common to think, well I have pain in my pelvic region or I leak urine, so I guess I should do kegels, but this is not necessarily correct.
If you have pelvic pain, the pelvic floor muscles are more commonly tight as opposed to weak. If the pelvic floor muscles are tight and you consistently kegel, you could be making things worse. When the pelvic muscles are tight, you need to teach these muscles to relax before starting to strengthen them.
"Ok so if I leak urine I should kegel then right?"
Well not necessarily. There are different types of urinary incontinence (loss of bladder control) which could change the answer to this question.
It’s also true that your pelvic floor muscles can be both tight and weak. I know it sounds weird, how can a muscle be tight and weak at the same time, but it does happen and it’s not that uncommon.
Basically, if your pelvic floor never relaxes and is always in a shortened state, it loses the ability to contract through its full range which can lead to weakness.
Here is an example I like to use that may make this more clear. Think about your bicep, the muscle in the front part of your upper arm. This muscle is responsible for bending your elbow. If your bicep was super tight, your elbow would be stuck in a bent position. If your elbow was stuck in this position, wouldn’t your bicep be weaker than if you could move your elbow through its full range of motion?
When this happens in the pelvic floor and the muscles are both tight and weak, you need to learn to relax your pelvic muscles before moving on to strengthening.

Is the pelvic floor ever just simply weak?
Yes, there are times when the pelvic floor is only weak.
If you have only weakness in the pelvic floor and no tightness, then kegels are probably going to be your go to. But with that being said, many people actually don’t know how to kegel!
As a pelvic floor physical therapist, I’ve assessed a number of pelvic floors. Some people do know how to do a kegel correctly, but some do not. Sometimes people think they are kegeling but nothing is actually happening in the pelvic muscles. Another thing that can happen is that people bear down when they try to kegel which is the opposite of what we want when we are looking to strengthen the muscles!
So after all that you're probably thinking, ok well what do I do then?
You really need to see a pelvic floor physical therapist. They will be able to tell you if you have tightness or weakness (or both) in the pelvic floor and will be able to tell you if you are performing kegels correctly.
Going to see a pelvic floor physical therapist doesn’t need to be scary and it doesn’t need to be a life long thing. They will be able to treat you as needed and guide you in the right direction for working on things by yourself at home!
On a final note, if you’re not experiencing any symptoms, then most likely kegels are fine to perform and can keep your pelvic floor muscles healthy if you’re doing them correctly. My biggest suggestion with kegels is to make sure you fully relax after each contraction to make sure these muscles keep their full range. It’s also important to breathe as you kegel; do NOT hold your breath.
I know that the pelvic floor isn’t talked about all that often and that many people don’t know much about it, but it’s a super important part of our body. I hope this post helped you learn a little bit more about this area of your body. Learning about the body is a great way to improve body awareness and your overall health.
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