Should I be doing kegels?

Considering that kegels have been the “it girl” for the last few years, I find this question a really important one.

The quick answer is no, probably not.

Here’s is the long answer:

Kegels are a contraction of the pelvic floor muscles and the term was coined by Dr. Arnold Kegel in 1948. 

Oftentimes doctors will prescribe kegel exercises for women who are leaking urine (no matter what type of incontinence) in an assumption that the person’s pelvic floor is weak which is why that person is leaking. Unsure about the different types of incontinence? Check out this blog post to learn more.

I am here to tell you that it is not that simple AND not everyone fits into that box. Here are a few examples of patients I have seen:

• I had a patient who was leaking urine with jumping and her pelvic floor was one of the strongest, most coordinated pelvic floors that I have evaluated. Her leaking was due to weak abdominal muscles and poor motor control while jumping - NOT pelvic floor weakness.

• I have had many patients who have increased tone (tightness) of their pelvic floor causing them to leak because the muscles are constantly in a contracted state. Therefore they cannot contract anymore when an urge of going to the bathroom comes which leads to leaking. Doing kegels here would only make matters worse.

• I have had patients who do have a weak pelvic floor and also have difficulty with pelvic floor contractions as well as weakness of the glutes, hamstrings and abdominals. Guess what? I have them doing maybe 10 kegels a day and a heck of a lot more strengthening of those other larger muscles.

The pelvic floor muscles are not very big and more is not always better - it’s just more. Too many kegels can lead to increased tone (ie tightness) of the pelvic floor which can lead to leaking and sometimes pain.

If you are active and not leaking urine, leave well enough alone. If you are leaking urine it is absolutely worth going to see a pelvic floor PT to determine the root cause of your leaking since kegels may not be the right answer for you.