Do Kegels Actually Work?
The pelvic floor exercise known as the ‘Kegel’ has become a popular exercise in women’s health, and with good reason.
Pelvic floor disorders such as incontinence, prolapse, pelvic pain, pain with intercourse, and others are surprisingly common (for example, 10% of Canadians experience urinary incontinence), and targeted strengthening of the pelvic floor is an integral component of pelvic floor physiotherapy, a recommended first-line treatment.
Having a strong pelvic floor can also be preventative against developing pelvic floor disorders. As an added bonus, Kegels are a discrete exercise that you can do just about anywhere.
So, do Kegels actually work?
The answer is yes! If you perform Kegel exercises correctly and regularly, they will make your pelvic floor muscles stronger and may increase the sensation of tightening your vagina.
Why Kegels may not work.
There is a chance that you are not performing the exercise correctly, and this due to lack of instruction. Kegels are often prescribed but rarely taught. Pelvic floor physiotherapists are the best teachers but unfortunately not many care providers are referring to this amazing women's health resource.
Over 30% of women seeking help for urinary incontinence are at first unable to contract the Levator ani muscles of the pelvic floor when instructed to perform a Kegel, and instead mistakenly contract the abdominals, gluteal muscles or adductor muscles.
Women with urinary incontinence are recommended to seek the guidance of a pelvic floor physiotherapist before beginning a pelvic floor strengthening program. In addition to expert instruction, a pelvic floor physiotherapist can perform external and internal examinations to ensure proper Kegel technique.
You may need more than Kegel exercises to address your challenges. Even if you are doing Kegels correctly, solving some pelvic floor disorders requires more than just Kegels. The pelvic floor works in collaboration with other muscles of the ‘inner core’ (the diaphragm, transverse abdominals, and multifidus) to control pressure within the pelvis and abdomen to stabilize the trunk of the body during movement.
Proper recruitment and coordination of these muscles may also need to be addressed. Not surprisingly, a recent review paper found that women who receive weekly supervision by a pelvic physiotherapist are more likely to see improvement in their urinary incontinence symptoms compared to women who regularly perform a pelvic floor strengthening program with little or no supervision.
Pelvic floor physiotherapists offer a variety of tools including targeted exercise (not just Kegels), manual therapy, and education on postural and behavioural interventions including bathroom routine and diet.
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