Your Pelvic Floor Muscles Don’t Always Benefit From Kegels, According to a Pelvic Floor Therapist
- Heather Jeffcoat, DPT, doctor of physical therapy, owner of Femina Physical Therapy, and author of Sex Without Pain
What are Kegels anyway
Kegels are a repetitive strengthening exercise that involve the contraction and relaxation of the pelvic floor—a combination of muscles that act as a hammock at the base of your groin, bladder, uterus, rectum, and prostate area. To do a Kegel, you clench the muscles and release them. If you’re curious about how to locate this area of your body, one method is to lay down on your back and take a few deep breaths to relax your body. Then clench your groin as if you were trying to stop yourself from peeing. This is your pelvic floor, according to Dr. Jeffcoat.
The problem that arises with Kegels is that not everyone can clench their pelvic floor muscles correctly, and some people don’t need to. In fact, a 2014 study showed that one-third of participants could not contract their pelvic floor for various reasons. “It’s easy to say, ‘Hey, just do some Kegels for your pelvic floor dysfunction,” says Dr. Jeffcoat. “But that doesn’t align with normal muscle function and how underlying dysfunction can be exacerbated by performing inappropriate exercises.”
Pelvic floor disorders fall into two categories and Kegels don't help with both
Hypertonic (non-relaxing) pelvic floor muscles occur when the muscles are overly tight, contracting at the wrong times, and potentially weakened. This is where Kegels could do more harm than good, Dr. Jeffcoat says. Symptoms of a hypertonic pelvic floor include chronic pelvic pain, vulvar burning or itching, painful intercourse or orgasm, constipation or urinary urgency, and frequency with or without bladder pain—all of which could worsen with repeated Kegels.
“When performing Kegel exercises, the contraction creates a shortening of the muscle fibers. If your pelvic floor muscles are already overactive, tight, or non-relaxing, this shortening can worsen symptoms or at least not improve them,” says Dr. Jeffcoat. So if you’re dealing with non-relaxing pelvic floor symptoms like pain in the area, constipation, trouble with bladder and bowel function in general, painful sex, and painful orgasms, it’s best to consult with your provider.
Hypotonic pelvic floor muscles mean that the muscles are over-relaxed, too loose, and likely causing incontinence, according to the Mayo Clinic. This is a situation where Kegels have the potential to help. Pelvic floor looseness is linked to bladder leakage and urination; Kegels help strengthen that clenching reaction and prevent accidents, the Mayo Clinic says.
In these cases, Kegels have shown to be effective with clinical oversight and improve people’s symptoms. For example, providers often recommend Kegels to people healing after childbirth. A 2015 study published in the Iranian Journal of Midwifery and Nursing Research found that eight-week Kegel regimens did help postpartum pregnant people who needed to rebuild their vaginal strength.
There is also some evidence that Kegels are beneficial for sexual health. Still, there isn’t significant, recent research that shows they enhance orgasm satisfaction in instances that don’t also require strength rehabilitation, Dr. Jeffcoat says. “Providers need to take more of an orthopedic approach to treating the pelvic floor, and if they aren’t licensed or trained to prescribe exercise—they should step back from making those recommendations,” she says.
Dr. Jeffcoat adds that over-exercising is harmful for any muscle dysfunction. For example, you don’t start doing a bunch of hamstring curls if you strain your hamstring. Hamstring curls tense the hamstring, which would not be ideal in the event of a strain or injury, she says. “Once you have healed and want to regain some strength, you could proceed with strengthening techniques,” says Dr. Jeffcoat. This applies to Kegels as well.
So even though Kegels are genuinely helpful, they aren’t a blanket solution for every pelvic floor condition. There’s no shame in wanting to be more in touch with your body or improve your pleasure, and there are numerous ways to enhance sexual satisfaction if Kegels end up not being the right choice for you. Dr. Jeffcoat stresses that the pelvic floor should be approached like other muscle injuries and with the same amount of care. One-size-fits-all approaches rarely work, especially in the case of the pelvic floor.
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