What’s the Deal with Kegels?
Kegels are a buzzword these days, and it can be confusing with all the information out there! As pelvic floor physical therapists, we often get questions about them:
What are Kegels?
Do I need to be doing Kegels?
How do you assess a Kegel?
Are Kegels good or bad for me?
At Foundations Pelvic Health, our pelvic floor PTs answer these questions for our patients all the time - so let’s break it down here!
What is a Kegel?
A kegel is a contraction of the pelvic floor muscles. A contraction involves the closure of our openings (urethra, vagina, and anus), as well as the lift upwards of the pelvic floor. Some of our favorite ways to visualize kegels are:
picking up a blueberry with your vagina
stopping the flow of pee
an elevator going up
Kegels aren’t the end all be all when it comes to pelvic floor PT, but they are still important!
When are Kegels important?
Our pelvic floors contract, often automatically, when under strain. We need our pelvic floors to contract when changing positions, lifting, coughing/sneezing, jumping, running, etc. This helps us keep us from leaking (urine, gas, or stool) and helps to manage pressures within our abdomen.
Do I need to be doing Kegels?
It depends!
It used to be a blanket statement that EVERYONE needed to do Kegels - however, that’s not actually the case. Some people may need to do Kegels for their pelvic health issues, but others may find that pelvic floor strengthening makes their symptoms worse.
The best way to see if you should be doing Kegels is to be assessed by a pelvic floor therapist. Via a vaginal assessment, your pelvic floor PT can help you figure out what your pelvic floor muscles actually need!
How are Kegels assessed?
Your pelvic floor PT will assess your pelvic floor strength in a few ways. The most accurate way will be via an internal vaginal exam to directly feel what the pelvic floor muscles are doing.
We will ask you to contract and assess the level of overall strength, then test your endurance by seeing how long you can hold a kegel. We may also check how your pelvic floor contracts with a cough or a crunch and its ability to fire quickly with a series of contractions. Your pelvic floor therapist will also check to see how you’re coordinating your pelvic floor movements with breathing - it’s harder than it sounds!
Your pelvic floor PT will start by assessing your pelvic floor strength in a lying down position, but a standing or upright assessment may be performed as this is a position that most people have symptoms. Your pelvic floor must work harder against gravity in upright positions!
Kegels are a targeted way of strengthening the pelvic floor muscles, but during your visits we will be sure to focus on breathing coordination, core and glute strengthening as well. All the muscles work together to support you and your pelvis.
Kegels are not the only answer for pelvic floor health:
While we hear so much about Kegels, we hardly ever hear about pelvic floor relaxations or pelvic floor muscle ‘lengthening’. Think about if your pelvic floor muscles were always kegeling/contracting - similar to having a hamstring cramp, your pelvic floor muscles can also cramp or spasm.
Pelvic floor relaxations/lengthening are required so that your pelvic floor muscles can actually kegel. For any patients that we are reviewing Kegels with, our pelvic floor PTs ALWAYS address pelvic floor relaxations as well.
Glute strengthening, core strengthening and hip/low back mobility are also very important in pelvic floor health!
Our philosophy on Kegels at Foundations Pelvic Health:
Your whole body is connected and your pelvic floor does not work in isolation, meaning that everything affects everything else.
While Kegels can be part of your treatment plan, our pelvic floor physical PTs will work with you through a whole-body lens to get you back to doing the activities you love. We will help you determine how your pelvic floor is contributing to your issues, and prescribe the appropriate exercises and homework for you and your symptoms!