To Kegel or Not To Kegel?

Kegels have been touted as a surefire solution for any folx experiencing pelvic floor dysfunction ranging from prolapse to unsatisfactory orgasms to incontinence. However, not every pelvic floor can actually benefit from kegels and, in fact, many would benefit much more from relaxation. Whereas kegels are the act of tightening and lifting the muscles of the pelvic floor, relaxation requires softening and lengthening of these muscles. Although opposite in nature, both require acute awareness of your pelvic bowl and both are required for overall function.

Your pelvic floor is comprised of many tiny but mighty muscles that can become taut just like any other overused muscle in the body. As the saying goes, a taut muscle is a weak muscle. We tend to believe that pelvic floor dysfunction simply must be due to lack of strength or hypo-toned pelvic floor muscles. However, quite often, it is actually hyper-toned muscles that are impacting the function of the pelvic floor. If you continue to do kegels to “strengthen” a muscle that is too tight, you are simply aggravating the issue. A more fruitful way to approach treatment would be to relax and lengthen the muscle and then begin to strengthen the muscle.

What’s in a kegel, anyway?

When we think of doing a kegel, we most often think of the squeezing action. However, the purpose of a kegel is two-fold: It is not only how much can you squeeze inwards but also how far can you draw that contraction upwards towards the navel. I like to add in a third component to the kegel which is this: How quickly and how much can you relax in between kegels? Ideally, you should be able to squeeze and lift followed by a full relaxation of said muscle within 1-2 seconds. This is what is known as an “olympic pelvic floor.” But what does this actually mean for you? When we have better awareness and control over these muscles, we can experience less incontinence, less discomfort or pain and better orgasms.

So, how do you know if you should stretch or strengthen?

Ultimately, we want to be able to do both! However, when we are just starting to develop pelvic awareness, we should seek an assessment from someone who can tell us what is currently present in the pelvic floor. Even if you feel like you have a good understanding of your pelvic floor muscles, it is still very helpful to practice kegels with biofeedback (either a machine or a practitioner’s gloved finger) so that you can maximize your pelvic function. Not all kegel cues work the same for every body (i.e. pick up a blueberry with your vagina or pretend you just walked into cold water), so

 it is important that you find a practitioner that you trust and enjoy working with to find the right muscle, the right cues and the right frequency for your best pelvic health.

Who can benefit from pelvic floor work?

Every body! Cis-females are more susceptible to pelvic floor dysfunction due to anatomy and the additional challenges that can come with child-bearing and childbirth. However, any body experiencing pain, incontinence, sexual dysfunction and/or the desire to learn more about their pelvis should seek care. If you are concerned about an internal exam, please know that pelvic health extends well-beyond kegels and internal work; there is so much opportunity to support external pelvic work.

It is my experience that folx often wait until dysfunction presents itself before seeking care however it is never too early or too late to meet your pelvic floor!

For more information, feel free to check out my website here.