Women's Health Dec 11, 2018

Pelvic Floor Pro Says Kegels are NOT for everyone

A UT Health Austin clinician sits speaking to a woman who sits on a Swiss ball.

Arnold Henry Kegel was an American gynecologist who invented the kegel exercise as a non-surgical treatment for genital relaxation in women. This technique caught on like wildfire and has been a go-to fix-all for women everywhere since the 1950s. Turns out, kegels, as widely accepted as they may be, may not actually help prevent you from peeing a little when you laugh or sneeze. What. The. Heck. Right? We’ve been told essentially our entire adult lady lives that fitting in a couple reps of clenching and relaxing when you can has tons of great health benefits, so what’s the deal? Well, kegels might be ok in some cases, but UT Health Austin Pelvic Floor pro and certified Women’s Health Physical Therapist, Maureen Ryan Christian, stresses that before you continue with the kegels, you really should talk to a professional because you could be doing more harm than good.

There’s apparently a whole slew of things that aren’t common knowledge among women when it comes to pelvic floor health. Luckily, Maureen helped us get some answers. Here’s what she had to say.

So first and foremost, let’s talk about the pelvic floor. What exactly is it? The pelvic floor is essentially the soft tissue structures and musculature that close the bottom of the bony pelvis, including networks of nerves, ligaments and connective tissue which aid in the support of the pelvic organs, contribute to core stability and help maintain function of the bowel, bladder and sexual systems. The vagina, urethra and rectum pass through the floor of the pelvis and are surrounded by the musculature of the pelvic floor.

How does someone’s pelvic floor become weakened and why would a woman think they need to do kegels? As postural, stabilizing muscles it’s very rare that the pelvic floor muscles are weak from “underworking” as it’s usually a case of “overworking” (are you as shocked as we are right now?!). When a muscle is contracting too much and never allowed to relax to its intended length, it will become weakened because it can’t lengthen and shorten effectively. When a woman is concerned about leaking urine or has constant pain in the pelvic area, it’s not uncommon for her pelvic floor muscles to be contracting “overtime” in an attempt to keep urine from leaking or in a reflexive guarding response from pain, respectively. Many women think that kegels can help strengthen the pelvic floor to prevent urine leakage and improve pain or sexual function, which is actually not quite the case.

Why might kegels be a no-go? Because it’s a complex structure, pelvic floor dysfunction can contribute to many conditions including urinary and fecal incontinence, pelvic organ prolapse, overactive bladder syndrome, bowel dysfunction, chronic pelvic pain syndrome, sexual dysfunction and vulvar disorders. As mentioned above, many times the pelvic floor can be weakened due to overworking. Since kegels involve repetitive contractions of the muscle, you’re essentially just adding fuel to the fire. It’s very important for anyone struggling with conditions such as this to have an evaluation by a trained pelvic health physical therapist who can accurately assess the appropriate intervention from a neuromuscular perspective.

Where does pelvic floor physical therapy come in? If you are experiencing any of the aforementioned issues, pelvic floor physical therapy could help. It’s important to understand that you do not have to adjust your lifestyle to accommodate these issues when they can be fixed! Typically, a pelvic health physical therapist will conduct a comprehensive evaluation including a postural, spinal and pelvic neuromuscular assessment in addition to a pelvic floor assessment, in order to establish a clear picture of what structures are involved in the patient’s condition. Treatment is dependent on the findings in the assessment, but will almost always include therapeutic activity, exercise and education on the condition and self-management. The ultimate goal is to minimize or eliminate your symptoms by way of appropriate therapeutic interventions and providing knowledge for self-care long term.

So there it is ladies, let it be known, kegels are NOT always the answer. The answer could actually be more complex but you should know that there is help out there, so ask! Pelvic floor physical therapists like Maureen Ryan Christian are here making a difference in women’s health everywhere and can help you lead a happier, healthier life. If you are experiencing symptoms of pelvic floor dysfunction, Women’s Health, a clinical partnership between UT Health Austin and Ascension Seton, offers the comprehensive, compassionate care and ongoing support all women deserve to live healthier more fulfilling lives.

For more information about Women’s Health to make an appointment, click here or call 1-833-UT-CARES

About UT Health Austin

UT Health Austin is the clinical practice of the Dell Medical School at The University of Texas at Austin. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to provide patients with an unparalleled quality of care. Our experienced healthcare professionals deliver personalized, whole-person care of uncompromising quality and treat each patient as an individual with unique circumstances, priorities, and beliefs. Working directly with you, your care team creates an individualized care plan to help you reach the goals that matter most to you — in the care room and beyond. For more information, call us at 1-833-UT-CARES or request an appointment here.