Are Kegels the Answer???
To Kegel or Not To Kegel
Subjective norms about people’s perceptions of Pelvic Physical Therapy vary, but many think it is all about doing Kegels. So, should Kegels be the plan if there is pelvic floor dysfunction? The answer: it depends. :)
Many people have overactive pelvic floor muscles. With overactivity, Kegels would not be the answer. Think of a muscle in the body being in a constant state of contraction or shortening. If a muscle is already contracted and shortened, doing Kegels will only contribute to more overactivity. Another way to look at it is to think of the pelvic floor like a trampoline. If the springs are too tight, you cannot jump on the trampoline, and if the springs are too loose, jumping is also not possible. You want strength and endurance without overactivity.
Even more people have overactive and weak pelvic floor muscles. That can be a confusing combo. In that case, the goal would be to downtrain the overactive muscles, relieve trigger points, and then move toward strengthening, which would include Kegels and other exercises.
If a person has weak pelvic floor muscles and no overactivity, Kegels can help, BUT Kegels are not the only tool we use to strengthen the pelvic floor. Kegels usually involve a quick contraction and release of pelvic muscles which strengthen the fast twitch muscle fibers (30%). The pelvic floor is 70% slow twitch muscle fibers, so it is important to also work on exercises that strengthen those muscles for optimal outcomes.
We need to normalize discussions and emphasize the importance of Pelvic Health among family, friends, and healthcare providers to empower women and men. Comprehensive Pelvic Healthcare is vital to all people regardless of gender and regardless of whether or not they have had children. If we are talking about it openly, it will lead to more education and information, so Pelvic Health will not be oversimplified into just Kegels.
The pelvic floor is a complex set of muscles that do so much! They support multiple organs, hold emotions (more on that in another blog), allow us to have and enjoy sex, support vaginal delivery during childbirth, and assist with bodily functions such as urinating and defecating.
It is important to see a Pelvic Physical Therapist, like Dr. Madelyn, who can do a thorough evaluation to determine what is really going on in your body and create a customized plan of care specifically for you.
