Most women have at some point in their adult lives heard the word “Kegel”. They have a vague idea of what it is (such as stop the flow of urine), and may have been told by their OBGYN that they should probably be doing many of them every day. For forever. And that is where the conversation usually ends, and the doctor leaves the room.
The problem with this, is that this is often the ONLY thing women hear when it comes to topics like resolving urinary leakage or minimizing pelvic prolapses. Sadly, research has shown us that around 60% of women cannot even do a proper Kegel (and the study subjects were young 20 somethings that had not had babies yet!).
Also, many women actually have issues with holding too much tension in their pelvic floor muscles (as in 40-50% of my patients with urinary incontinence or prolapses). To tell them to contract their possibly uncoordinated and over-tight muscles further, would likely just make their problems worse.
There are many women who are dealing with chronic pelvic pain. They do NOT need to be contracting their pelvic floor muscles all day long when they are likely way past tight and never shut off.
The secret? Our pelvic floor muscles (men too) are designed to do 3 things. Contract, relax, and lengthen. Many people dealing with issues with pelvic floor dysfunction will not have a high likelihood of resolving their issues if they do not FIRST work with a pelvic floor physical therapist (the only medical professionals trained in assessing muscle coordination and strength of this area). Because the pelvic floor muscles area not visible, they can only really be assessed with an internal assessment.
Pelvic PTs are very good at helping their patients understand their muscles, how they function, and make the internal assessment feel as comfortable and quick as possible. Once an assessment has been done, there is much more clarity on what exactly the person needs to turn their pelvic health around. We will know your prolapse risk or status, your muscles' coordination, strength, endurance, as well as any trigger points or tension.
While Kegels may end up being a part of most every person’s program for pelvic health, it most certainly is not the ONLY thing that they need. Your pelvic floor muscles are a part of a larger system called your CORE. And all of the muscles involved with your core need to work together in a coordinated way. Though this may sound a bit overwhelming, once we work to get your muscles in sink with one another, the exercises are quite simple where one exercise can be utilizing all muscles together. Talk about efficient!
So if you find yourself having a conversation about one of these above mentioned issues, don't let the conversation end with "do your Kegels". And if this topic comes up among your girlfriends? Don't let this myth of the Kegel being the cure-all be perpetuated. Now you know better!