Do I Need to Do Kegels?

The answer is: probably not. True confession here: I don’t do kegels! I know, shocking, coming from a pelvic floor physical therapist.

I think kegels are this vague idea out there that is over prescribed and not always with appropriate knowledge and education. It’s another thing to make women feel guilty for doing, or not getting done!

So many of my clients come in telling me their doctor told them to do kegels, but without really explaining how, why, how much or how often. Many patients I see don’t know how to do kegels properly, and they may have been doing them improperly for years if they were told to do them without any further explanation.

The pelvic floor muscles are constantly working. Every breath we take and every move we make they are active. They are supporting all the organs above them. Any time we are upright they are working. They work when we get the urge to go pee or poop, but we aren’t at the toilet yet. They also work when we sit down to go to the bathroom. They are active during sex for both men and women.

Here is a list of who may need to do kegels:

1. During pregnancy it’s good to do some kegels, but not too many. It’s good to get a sense of your pelvic floor and to have some increased strength and support from the bottom as there will be more pressure as the baby grows. But, I don’t suggest too many kegels because when it comes time to deliver the baby the muscles need to relax in order to push the baby out vaginally.

2. Newly postpartum moms. No matter if you had a vaginal or cesarean section birth the pelvic floor muscles are likely weak at this time.

3. If you have urge incontinence, meaning you leak urine before you make it to the toilet. Likely your pelvic floor muscles could use some strengthening.

Here is a list of who doesn’t need to do kegels:

1. If you have any back, hip or pelvic pain the pelvic floor muscles are likely already too tight

2. If sex is painful

3. If you leak urine only while exercising, coughing or sneezing, kegels may not be the answer for you (for some people they may need strengthening, this could go either way).

4. If you are constipated

5. If you are peeing many times throughout the day likely the pelvic floor muscles are too tight and not allowing the bladder to fully expand and fill up and causing you to have to urinate more frequently

6. If you have to get up a lot at night to pee, this may be a different cause entirely unrelated to your pelvic floor

7. If you tend to be highly stressed or anxious and find yourself clenching your jaw, neck or shoulders, guess what? You are likely clenching your pelvic floor muscles as well.

8. If you don’t have any pelvic floor issues you don’t need to do kegels because those muscles are already working.

As you can see the list of who DOESN’T need to do kegels is almost 3x as long as those who DO need to do kegels. If you aren’t sure your best bet is to schedule an appointment to get assessed by a pelvic floor therapist. If you aren’t local to Southern California check out my previous blog on how to find a pelvic floor PT near you.

We can address all the issues listed above, but only a thorough evaluation will tell us if you need to do kegels or not. Much of the treatment for pelvic floor issues is through exercises, stretches and techniques outside of the pelvic floor. We treat you as a whole person not just looking at your pelvic floor and prescribing kegels.

Let me know by commenting below or emailing me if you were told to do kegels or have felt guilty because you had this idea you were supposed to do kegels. I would love to hear from you.

Share this blog with your friends who feel guilty for not doing their kegels. Also, share this with your ob/gyn who prescribed you kegels without any other explanation.

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