Oh, Kegels- the magical exercise that can be done anywhere without anyone knowing… but are these pelvic floor contractions really as magical as they’re made out to be? If you google the best exercise for urinary incontinence, Kegels, the long-touted go-to solution for pelvic floor health, populates in just about every first-page result. While Kegels may be #trending, in a paradoxical turn of events, these pelvic squeezes may actually be exacerbating your urinary incontinence rather than relieving it.
How Kegels became so popular
Kegel exercises are isometric contractions of the pelvic floor musculature used to improve pelvic muscle strength and coordination. Theoretically, clinicians assumed that bladder leakage is always a result of weakened pelvic floor muscles therefore strengthening these muscles through contraction should lead to better bladder control. Unfortunately, this theory has a few flaws. First off, urinary incontinence is not always a result of weak pelvic muscles. On the contrary, it can actually result from pelvic floor overactivity and poor muscle coordination. If we’re prescribing Kegels to someone with an already overactive pelvic floor, we’re setting them up for failure and will likely make their symptoms worse. Bottom line, while Kegels can be highly effective for a certain population, these exercises may be counterproductive for others so squeeze with caution!
Hyperactive pelvic floor and incontinence
An overactive pelvic floor causes hypertonicity of the pelvic floor muscles. This results in excessive tension in these muscles and can be associated with pelvic pain, poor bladder control, and even incontinence. In these individuals, they will often struggle to properly coordinate their bladder and pelvic muscles making them more prone to more frequent and urgent urination. Assign Kegel exercises to this population and you’re likely going to worsen their condition.
How do I know if Kegels are right for me?
Without an assessment by a specialized pelvic floor expert, it can be tough to tell whether your urinary incontinence is due to hypoactivity or hyperactivity of the pelvic floor. That said if you’re noticing an increased sense of urgency or worsening incontinence since incorporating Kegels into your routine, it may be an indication that your pelvic floor muscles are overworked and need a little “R&R”. Incomplete emptying of the bladder is another sign of overactive muscles. If you feel like you’re unable to fully empty your bladder with urination, it can also be a sign to rethink your pelvic strength routine.
So what’s the alternative?
Pelvic floor physical therapy is a great strategy for those finding failed results from Kegel exercises. By working with a specialist, they can help uncover the true cause of your symptoms and address them appropriately.
For individuals with hypertonic muscles, pelvic floor experts can employ specialized manual interventions to relax muscle tension, biofeedback devices to retrain the muscles, and therapeutic practices like diaphragmatic breathing to further reduce strain for pressure management. The goal of treatment is to help you gain awareness and control over your pelvic floor and avoid practices and activities that led to the tension development in the first place. Similar to most courses of PT care, expect tailored exercises to address your pelvic floor dysfunction and lifestyle education to reduce outside factors contributing to that unwanted pelvic floor tension.
Just because you’ve had a baby or your friends are experiencing it too, urinary incontinence is NOT normal. Similar to most medical conditions, one-size-fits-all does not apply to urinary incontinence treatment, and finding the right treatment strategies for your particular case is essential for getting the best results. If you’ve been squeezing away with Kegels but found your incontinence symptoms aren’t getting any better, consider an alternative approach or better yet, seek the expert guidance of a pelvic floor physical therapist here at mPower physical therapy in Dallas, TX. The key to your success lies in an individualized and holistic approach to pelvic health. Regain control of your bladder and get the relief you deserve today!