To Kegel, or Not to Kegel, that is the Question.

I said my goal is not always a “strong” pelvic floor. That being said, there is a time and a place for pelvic floor strengthening. Some people say no one should do kegels, aka pelvic muscle strength training on command. I don’t completely agree.

There is a time and place for kegels. When someone has decreased pelvic muscle strength and decreased bowel or bladder control, they may need to retrain those muscles. Sometimes that includes doing a kegel with breathing coordination.

The thing about kegels, is that they do contract the pelvic floor, when you’re thinking about doing them. However, we do not function in a wold where you can THINK about turning on your pelvic floor muscles during activity. SO, these muscles need to be reeducated. Part of that reeducation process may include kegels.

In my personal practice, that typically includes breathing with the intention of contracting and relaxing the pelvic floor muscles on cue, for a bit. This is not a forever exercise for someone.

Back in the day, some doctors used to tell anybody with urinary leakage to “just do kegels”. However, they are not appropriate for everyone. You may have leakage from a weak pelvic floor. You may have leakage due to a tight pelvic floor. You may have a tight pelvic floor because it is weak. There is a lot that goes into figuring out the cause of pelvic symptoms.

Even when they are appropriate, a lot of people don’t know how to do a kegel correctly. My favorite cue for kegels is using your pelvic floor muscles (sometimes specifically your urethra or anus) to suck up a milkshake (with no booty gripping)- hence the picture. However, there are many nuances to doing them and you should see a pelvic floor therapist to asses and then treat you appropriately.

Why am I saying all this? If you have pelvic floor symptoms, seek out a pelvic floor physical therapist that can assess your whole body and specifically tailor a plan for your body and your exact symptoms. So to answer the question- to kegel or not to kegel… my answer is it depends.