Updated: Sep 13, 2020
Kegels are often proclaimed as a cure all when it comes to pelvic problems. They’re not. Here’s why. And here are the real reasons to do your pelvic floor exercises.
Pelvic Floor Exercises, most commonly known as Kegels, are handed out to people (yes, men have pelvic floors too and can do Kegels) to help with pelvic pain, prolapse, incontinence, pelvic floor dysfunction, sexual dysfunctions, low back pain... Basically, if there is something going on in your pelvis, there is a high likelihood that you’ll be told Kegels are your answer. If you are speaking to a knowledgeable gyno, physical therapist, or other pelvic specialist, you will probably also hear about the importance of Reverse Kegels.
Both versions of this exercise are purported to change the tone of your pelvic floor. Kegels (aka Up-Training or Pelvic Floor Contractions) are meant to strengthen and increase tone. Reverse Kegels (Down-Training or Pelvic Floor Relaxation) are meant to relax and decrease tone.
Now, these exercises can be super useful. But why they are beneficial and what we are actually accomplishing by performing them - well, toning isn’t it.
Doing straight Kegels is going to increase pelvic floor strength about as much as repeatedly flexing and straightening your arm will increase bicep strength. If you spend any length of time in an upright position, your pelvic floor is already under the greatest amount of bodyweight stress possible. The effect of adding a little contraction will be minimal, and greatest if you are in state of near complete atrophy, even adjusting for correct performance. (Hint: if you’re clenching your butt, you’re working your glutes not your pelvic floor.)
We need to look at the anatomical makeup of the pelvic floor to further support that bold statement. Of all of the muscle fibers that make up the pelvic floor only 20% of them are fast-twitch fibers, the ones that create force upon contraction. The other 80% are slow-twitch otherwise called postural or tonic. Translation: the deliberate contraction of a Kegel affects only 20% of the muscle fibers in your pelvic floor, mainly the sphincters; the other 80% of these fibers are constantly on and retain a relative sameness in tone under active contraction as they do under their regular postural setting. This is great because it means that you never have to think about how to keep your organs on the inside as you go about your day! Not so great if your organs are already falling out and you’re trying to squeeze them back in with pelvic floor contractions.
So if Kegels aren’t strengthening and toning like we’ve been taught, why do we bother with them?
Our pelvic floor is where all of the taboo things in life happen - defecation, urination, sex. As such, we can easily dissociate from this area of our body. Take a moment to mentally connect with your pelvis. Are you holding tension there? It is easy to drop your awareness into this space? Are you surprised at what you’re finding? When we Kegel, we are bringing ourselves back into this root space, using the movement to spark nervous system activation and cue our awareness. Aside from helping us to identify early signs of dysfunction, cultivating awareness in our pelvic floors can also help to increase our sense of groundedness, safety, and autonomy.
If you haven’t touched your pelvic floor lately… Do it now! (Or when you’re in a private space. Whatever works.) Using Kegels in combination with self intravaginal or intrarectal assessment will show you exactly which areas of your pelvic floor activating optimally and which need a little bit of help.
Increase Blood Flow
There are a massive amount of ligaments in your pelvic bowl. Ligaments that hold our organs up, ligaments that keep your bones together, ligaments that provide stability. Over the course of our lives these ligaments are strained (trampoline effects like when running) and stretched (uterine expansion during menstruation or pregnancy). These structures will bounce back, but it can become more difficult with age especially as ligaments are avascular and do not get as much of the revitalizing oxygen and nutrients that blood ritch muscles do. Kegels help to increase this blood flow to the pelvis mitigating this problem. It is probably this increase in blood flow helping to rejuvenate the ligaments that helps to reverse prolapse.
Retrain Your Fast-Twitch
Sometimes our nervous signals can get a little mixed up, firing when we don’t need them or reacting too slowly when we do as in the case of some stress incontinence. Kegeling in conjunction with deliberate increases intra abdominal pressure can retrain your nerves to activate those fast-twitch fibers appropriately, preventing leaking with coughing, sneezing, and laughing.
Prep for Weights
Just like you want to practice good form for squats with body weight before you start adding weights, it is wise to master the squeeze and lift motion of a Kegel before adding weights and other pelvic floor exercise tools into the mix.
Kegels are not the Golden God of the Pelvic Floor as we’ve been taught. But they can still be marvelously useful in many situations. Talk to your pelvic floor person (shameless self promotion inserted here!) to find out what is best for your pelvic bowl health and to make sure you are performing your Kegels properly.