Are Kegels bad is a question I see frequently debated online and in pelvic health circles. If you’ve read my blogs on best exercises for prolapse or how to fix pelvic organ prolapse you’ll know it’s very rarely a definitive yes or no answer! Kind of annoying right?
But here’s the thing, bodies and pelvic floors and their symptoms, and how those muscles connect and work with others is going to be different for everyone.
For some, Kegels will absolutely form the main or important part of improving symptoms. The NICE Guidelines on pelvic floor dysfunction published in 2021 suggest pelvic floor exercises to improve and prevent symptoms.
However, if you are experiencing a hypertonic pelvic floor or experience pelvic pain, you may need a relaxation strategy before your strengthening strategy. The best way to find out what your pelvic floor muscles need is to book an appointment with a pelvic floor physio (I’ve written a blog about that too!). Not only can they recommend which strategy is right for you but they can also assess your technique. Around 30% of women perform pelvic floor exercises incorrectly.
5 reasons you are performing Kegels incorrectly
- Only lifting without relaxing. This can create an accumulation of tension in the pelvic floor muscles. They shorten and tighten and may lead to a worsening of symptoms or a feeling of heaviness/pulling in the vagina
- Squeezing glutes, inner thighs or abdominals instead of the pelvic floor. Less is often more as you rarely need a 100% maximal contraction, but a gentle lift and squeeze.
- Breath holding. It’s very easy to hold your breath (especially if you are concentrating on the exercises themselves) but you should continue breathing. Breath holding can lead to added intra-abdominal pressure.
- Doing too many Kegels. You don’t need to spend all day doing Kegels! Find a couple of moments across the day where you have the time and focus to complete 8-10 quick lifts and 8-10 x 10 second holds. The Squeezy App is a great place to start as you can set reminders.
- Straining or bearing down instead of lifting and squeezing. Again, seeing a women’s health physio is a great way to assess technique. You can also self-assess by inserting a finger into the vagina and performing a Kegel. You should feel a gentle squeeze and lift versus a pushing down or pushing your finger out.
What if you've done months of (correctly done) Kegels but you still have symptoms?
It can be beyond frustrating to still be experiencing symptoms, even though you’ve been totally dedicated to your Kegels.
This is a slide I used in a presentation to show how we can build on Kegels if we feel they aren’t enough/providing relief from symptoms.
Aside from Kegels, we can also look at the following:
- Doing pelvic floor exercises in more challenging positions
- Coordinate them with movement
- Specific training for symptoms that occur in a specific exercise
This approach ties the pelvic floor in with exercise and movement (because the pelvic floor doesn’t just work alone but is part of a wider system) and allows sport specific training. E.g. leaking with a particular movement, when it’s often not a ‘strength thing’ but affected coordination, tension and breathing.
Want to know how this approach could work for you?
If you feel like you are a Kegel Pro but still experiencing pelvic floor symptoms such as leaking with exercise or prolapse heaviness, you can book a 15- minute call using this link and we can have a chat about how I can help.