Kegels- are they the be all and end all of pelvic floor rehab?

A question I am often asked by many women. First let’s define what a kegel is. Basically, a kegel is a contraction of the pelvic floor muscle group. Just like a bicep curl is a contraction of the biceps muscle group. It is called a kegel, because back in 1948, Dr. Arnold Kegel coined the term and it stuck. It’s also easier to say “perform a kegel”, then “contract your pelvic floor muscles”. In a time-crunched society we love our abbreviations.

​You often see those memes, e-cards, or even articles in fitness magazines, toting:  Do your kegels often and regularly to prevent a variety of women’s health issues, such as urinary incontinence, prolapse, or even bad sex. If you follow the general advice, it basically amounts to doing kegels every day, at every spare moment of the day. Do your kegels at every commercial, every red light, when you’re peeing, etc. Basically, there is never a time not to be doing your kegels. It leads women to believe if they are not performing kegels at this high frequency, their vagina will fall out of their body or they will have a lackluster sex life.

This message is inaccurate, and an unnecessary scare tactic for women desperate for any advice to help with these private and personal issues.

The pelvic floor is never at rest, which is why we don’t need to be constantly training it. You would never train any other muscle group that way.

Marathoners don’t run every day.
Cross-fitters don’t dead-lift every day.

These athletes know the risk of overuse injuries when they over train a group of muscles.
So what happens when you over-train the pelvic floor? It can become overactive, and it will develop muscle failure due to fatigue of constantly contracting.  As a result, when it is tasked to perform at a high level, like when you sneeze, you will have failure of the pelvic floor to do its job, i.e. maintain continence.
You can have a perfectly strong pelvic floor, but because it is now overactive it functions as if it’s a weak pelvic floor. This is why the recommendation from mainstream media to “just do your kegels” does not help everyone, and can actually make a problem worse. Pelvic rehab is not a one-size-fits all approach.
 The pelvic floor can be either weak or overactive, and it is important to identify how it is functioning in each individual person.
 Kegels do have their proper time and their place in pelvic floor rehab, but the key is to know when, where, and how often to perform them. A women’s health therapist can give you that answer and help you to design a pelvic floor exercise program that is specific to you and your needs, your individual issues and your long-term goals.
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And it likely will not start with kegeling every time a commercial comes on..........

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