Since their introduction by Dr Arnold Kegel in the 1940’s, Kegel exercises have been considered the go-to solution for pelvic health issues. Thanks to our Grandmother’s words of wisdom, and more recently Instagram and TikTok, I am pleased to say most of us have heard of them, and a lot of us practice them. But in case you’ve missed this trend, a Kegel ‘simply’ involves contracting and relaxing the pelvic floor, the essential hammock of muscles that sit within our pelvis, and support the bowel, bladder and sexual organs. But how do we know we’re doing them right, and what comes next?
The Benefits of Kegel Exercises
Kegel exercises are vital for our pelvic health, and when carried out with the correct technique, can provide some powerful outcomes:
- Improved pelvic floor strength: When done correctly, Kegels activate and strengthen the pelvic floor muscles, offering better support for the bowel, bladder and sexual organs.
- Prevention of urinary incontinence: Well executed Kegels, can help prevent urinary incontinence and can treat up to 60% of specific forms of incontinence such as stress urinary incontinence.
- Supporting pregnancy: correct Kegel exercises, carried prior to and during pregnancy, will help support the growing weight of your baby.
- Childbirth: being able to ‘tune in’ to the pelvic floor and understand the difference between contraction and relaxation can help facilitate a smoother childbirth process with reduced risk or complications.
- Postpartum recovery: early Kegel exercises will promote blood flow and muscle activation to promote healing and restore function and strength of the pelvic floor following childbirth.
- Treating pelvic pain: Ensuring appropriate technique of Kegel exercises can be the key to treating pelvic pain. As with other muscles in the body, pain can develop when it is either weak and/or tight. A guided and personalised pelvic floor exercise programme can help address this.
- Prolapse prevention & management: developing a habit of performing regular and correct Kegel exercises can prevent or manage pelvic organ prolapse. A prolapse refers to the laxity or one or more of the vaginal walls. It Is commonly treated conservatively but requires an individualised programme developed by a pelvic health practitioner.
We have Dr Arnold a lot to thank for. However, just like any other rehab plan, exercises should be varied, progressive and individualised in order to optimise the outcome. After all, why should our glute workout progress with load, intensity, frequency, but not our pelvic floor?! More recent research in the area has demonstrated the effectiveness of functional full body exercises in activating the pelvic floor. For example, a glute bridge can achieve 56% more activation than a standard Kegel, when completed in line with the appropriate cues for the breath and pelvic floor.
But first we need to get the basics right: we must learn how to activate before we strengthen
Recent research has revealed that many women perform Kegels incorrectly, not only negating their benefits but sometimes leading to additional symptoms:
- Technique: a common misconception is that stopping the flow of urine midstream is an effective exercise; however, this should only be used initially, to identify the pelvic floor muscles. Performing this regularly can lead to bladder sensitivity, presenting as symptoms of increased urgency, frequency and discomfort during urination.
- Range of motion: every muscle has a range of motion, but without being able to see or visualise the pelvic floor, it can be difficult to access. This can often result in an individual being unable to achieve true relaxation and subsequently limited contraction or strength of the muscle. This can lead to symptoms such as leaking, secondary to overactivity or inability to ‘let go’
- Isolation: to optimise rehab outcomes it is important we feel able to isolate the pelvic floor. Without feedback (visual or tactile), this can be difficult to achieve resulting in many individuals clenching their glutes or core rather than pelvic floor. Meaning the time and hard work we put in does not translate to optimal pelvic floor gains.
So before cracking on with your 50 Kegels a day, it would be worth considering a pelvic floor assessment, where a specialised practitioner can assess and ‘coach’ or refine your technique. We can give you the tips to work smart not hard and progress your rehab beyond Kegels to get you back to the sports or activities you love, symptom free.
For more information, please read our upcoming blog on ‘Pelvic Floor Assessments: What, When & Why’. Or contact our clinic on 020 3515 2347.
Written by Matilda Wilkinson, MSc Physiotherapist, Pelvic Health & Rehab Specialist based at Maria Elliott’s Physiotherapy Services
