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Moving Beyond Kegels for Pelvic Health

Submitted by: Margaret "Mags" Matthews, MPT

When faced with pelvic floor dysfunction or pregnancy, many people hear advice to “just do some kegels.”  Unfortunately that may not do the trick. Up to 40% of health women actually do kegels incorrectly when only given verbal instructions. Many men and women squeeze the wrong muscles or will push out instead of drawing the muscles in. Wait, let’s back up a minute, what is pelvic floor dysfunction and what is the pelvic floor?


The muscles of the pelvic floor are the base of your trunk and spine, shaped like a sling or hammock connecting from the pubic bone, tailbone, and sitting bones.  These muscles line the pelvic bowl. When working normally, these muscles, in both males and females, help to stabilize your pelvis and back, work with your diaphragm to breathe, regulate bowel and bladder function, and are active in sexual function.  When things go wrong with the pelvic floor it can affect any of these systems; resulting in back, hip, and pelvic pain; urinary urgency, frequency, or urinary incontinence; fecal or gas incontinence; urinary or fecal voiding difficulty from weak stream to constipation; as well as limit the function of sexual organs, intercourse, and orgasm.


A kegel is a squeeze and lift of the pelvic floor muscles as if you were stopping the flow of urine.  (By the way you should not practice stopping the stream of urine regularly.) Performing kegels can help to strengthen the pelvic floor muscles and lift the bladder and uterus.  First described in 1948 by American gynecologist Dr. Arnold Kegel, these pelvic floor exercises were given to women to decrease prolapse and urinary incontinence.


To use kegels for healing this wide range of ailments only covers a fraction of the healing process.  As a Pelvic Physical Therapist (PT), I specialize in the movement system -- the relationship and health of muscles, ligaments, bones, and nerves.  I look at the whole body and assess what other muscles and structures might contribute to pelvic issues. I ask questions and advise on diet, fluid intake, exercise, posture as that contributes to pelvic health.  We also review how you do everything that might be an issue; from picking up a baby or sack of groceries, to toileting, how you get out of bed in the middle of the night, and to how you walk or run. Normal mechanics of the back and pelvis will foster a normal pelvic floor, so only performing kegels may not help you.  We also need to improve the function and alignment of the back, hips, and pelvis.


Having a healthy pelvic floor will help your sex life, decrease risk of impairment to and improve bowel, bladder, uterine, and sexual health.  If you have further questions please contact your pelvic floor PT or your doctor to see if this is something that might help you.

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