Kegels Aren’t for Everyone
Women typically don’t think about the importance of our pelvic floor muscles until something goes wrong. If you’re leaking urine with running, jumping, coughing, sneezing (stress incontinence), can’t quite make it to the bathroom in time (urge incontinence), going more than 5-8 times per day, waking up more than once every night (urinary frequency), or if you have pain with intercourse, you should seek help from a Pelvic Floor Physical Therapist.
The pelvic floor is a group of muscles attached to the pelvis, hips, and sacrum that support the abdominal contents and reacts to changes in pressure created by the diaphragm above. This group of muscles supports the bladder, urethra, uterus, vagina, and rectum. The pelvic floor is responsible for our bladder and bowel function plus sexual function.
Kegels are commonly recommended when a woman reports urinary or bowel incontinence – it’s not a normal part of aging! However, not all women should do Kegels because it may cause more harm than good. And if you are performing Kegels – how do you know if you are doing them properly?
A specially trained Pelvic Floor Physical Therapist can assess your pelvic floor using internal and external techniques to evaluate the function of your pelvic floor muscles. It’s important to assess the surrounding structures of the pelvic floor such as the connective tissue, sacroiliac joint, pubic symphysis, low back, and hips. It is necessary to assess your ability to contract AND relax the pelvic floor muscles. Assessing your patterns of active pelvic floor recruitment of your core and breathing plus function with tasks such as lifting, running, and transfers is crucial.
If the muscles are determined to be tight, you might be experiencing:
- Urinary frequency, urgency, hesitancy, stopping and starting of the urine stream, painful urination, or incomplete emptying
- Constipation, straining, pain with bowel movements
- Unexplained pain in your low back, pelvic region, hips, genital area, or rectum
- Pain during or after intercourse
If the muscles of the pelvic floor are weak, you might be experiencing:
- Vaginal or rectal heaviness or pressure – prolapse
- Urinary incontinence with cough, sneeze, run, jump or position changes
A Pelvic Floor Physical Therapist will determine the status of your pelvic floor muscles and treat any tight muscles until they reach their normal flexibility. Then the strength and coordination will be addressed (which might include a form of Kegels) and monitored to make sure the exercises are being performed correctly.
Our pelvic floor is an area that tends to hold our emotions. Addressing depression, anxiety, and stress plus realizing the importance of our thoughts, attitudes, and beliefs is essential. A mental health care provider can assist in this area, if needed, combined with Pelvic Floor Physical Therapy resulting in a faster and more effective recovery.