“Do your kegels” is probably the most common advice given to women experiencing any pelvic floor dysfunction and to those who are trying to avoid it prior to, during pregnancy, and beyond. We have patients who sit down and the first thing that comes out of their mouth is, “I know I need to be doing my kegels” like this is some unwritten rule for women to live by.
Where did kegels and this subsequent misinformation even come from?
Well, in the 1940’s a German physician named Dr. Arnold Kegel, began prescribing kegels as a way to help postpartum women stop leaking urine and avoid prolapse. And guess what? It worked. For the time being anyway. He had success and ever since, it has been deemed this magical treatment that every woman should be doing for every pelvic problem…ever.
But, don’t we know more now? Aren’t there better ways?
YES. There is likely not a medical treatment from the 1940’s that we are still prescribing or performing now that hasn’t at least been slightly changed. Kegel exercises as a means to stop leaking or gain strength is no different. There are also newer studies that suggest the symptom improvement is more likely due to awareness of where the muscle is than actual strength gains themselves. Yet, here we are. 2022 and still getting the same, outdated information.
Here are some popular myths and the reasoning for why they’re wrong.
Myth 1- Kegels are the best way to strengthen your pelvic floor
Actually, the pelvic floor never works in isolation. Meaning, it works with your diaphragm, your abs, your hip muscles, your feet, everything. Your pelvic floor is designed to pre-fire in anticipation of movement. This means before you even go to lift your arm, your pelvic floor is responding. With a muscle that works so closely with all the other muscles of the body, it needs to be trained and strengthened functionally for it to carryover into everyday life.
Myth 2- Do (any) number of kegel exercises per day
There is really only a very small percentage of the population who would truly benefit from kegels. A large portion of the remaining population actually needs the opposite. A majority of pelvic floor related symptoms are due to TENSION, not weakness, INCLUDING leakage with sneezing or exercise. Consistently tightening an already tense muscle, will only make things worse.
Myth 3- Do your kegels at stop lights
Now, even if you are a part of the small percentage of people who may benefit from kegel exercise, doing them at stop lights will get you nowhere. If you wanted stronger glutes, would you do a few squats at stoplights and expect to get results? No. You would train them at a specific time, being sure to both load and fatigue the muscle, because that’s how strength is built.
Myth 4- You should practice stopping the flow of urine
This myth can truly cause a lot of problems. First, when you are urinating, your pelvic floor should be as relaxed as possible, to allow for the bladder to completely empty (this is also why you should never hover when you pee). Training your pelvic floor muscles to be “on” when they are supposed to be “off” can interrupt your normal bladder emptying reflex loop and potentially lead to difficulty emptying your bladder, increasing your risk for developing an infection, and increasing urinary urgency. Now, don’t get me wrong, stopping the flow of urine once to identify where your pelvic floor is will not cause issues, but we don’t want it to become an everyday practice.
As always, an individualized assessment of your ENTIRE body is the absolute best way to identify why you’re having symptoms and how to prevent them in the future. A pelvic floor specialist will help you look past these myths and find the most effective, practical solution for wherever you’re at in your pelvic floor journey.
