Kegels are not the only answer

“That’s okay, I don’t need physical therapy. I do my kegels.”

We’ve heard this may times before, and don’t get us wrong, we absolutely love that you are being proactive with health and trying to stay fit! Unfortunately, doing your kegels is not the be-all end-all of pelvic health. The mere performance of kegels has no direct correlation to having a reduction in prolapse symptoms (or sensation of heaviness/bulge in the vagina), decreased urine leakage (incontinence) or less pain. 

The reason why, you ask? 

• Because 24% of women are unable to perform kegels when they try. 

Want to know what’s worse? 

• Another 23% of women who think they are doing it correctly are actually doing it incorrectly — and not only that, but are doing it in a way that can make their problem worse!

That’s a huge chunk of the population who is spending time trying to improve their health and getting no results. 

What happens during pelvic floor physical therapy?

There is no need to be scared by these numbers! Like many scary things in life, once we are aware of the concern, we can make an action plan to improve it. That’s where pelvic floor physical therapy comes into play.  

The first thing you need to do is find a good pelvic floor physical therapist. You’ll want someone who will take the time to explain to you the anatomy of not only the pelvic floor muscles but the other muscles within the core and how the whole system functions together.  

Next, you will want that pelvic floor physical therapist to perform an external and internal pelvic floor muscle assessment for you. This will provide invaluable information regarding how the three layers of muscle (yes  — there are 3 layers of muscle in the pelvic floor) are working together and how strongly they are working. 

The muscles of the pelvic floor have many functions but 3 main functions are:

• Sphincteric: close and open holes

• Supportive: support your body organs

• Stability: help transfer force and momentum throughout the body to keep any one specific area from taking on all of the force which can lead to injury/dysfunction

When your physical therapist checks these muscles, they are looking for a squeeze and lift motion without any compensation happening in your inner thighs, buttock, hips or abdominals. In a recent study, 71% of women demonstrated at least 1 inappropriate accessory muscle activation when performing a kegel attempt and 50% of women demonstrated 2 inappropriate accessory muscle activations. This is important because when we have these compensation patterns in place, we are more likely to experience symptoms of prolapse, incontinence and pain. 

The good thing is that with the help of a pelvic floor physical therapist, you can learn how to perform a pelvic floor contraction correctly. Even better news is that they can show you how to build this into your movements throughout the day at the most appropriate intensity to provide you with support instead of symptoms. Believe it or not, it’s not all about whether or not you can do a kegel, it’s about doing it at the appropriate level of intensity for the task you are performing. As mentioned earlier, merely performing kegels will not reduce your symptoms. If kegels are appropriate for you to perform (many times when experiencing pain, this is not the intervention you should consider at the beginning of recovery), doing so correctly can make all the difference in the world!