Is there incorrect information still out there about our pelvic floor muscles? ABSOLUTELY.
If I am having problems leaking, then all I have to are Kegels and I will be fixed
INCORRECT – Kegels are great but they aren’t great for everyone for everything
What are Kegels?
Kegels are exercises for strengthening our pelvic floor muscles (PFM’s) and are named after Dr. Arnold Henry Kegel.
When are they a good choice?
Kegels are a great choice when we have PFM’s that are weak and need strengthening. Weak PFM’s can happen after having babies or just from not using them very well.
When should we be doing these exercises?
Basically everyone, including women and men should intentionally strengthen their pelvic floor muscles. Oftentimes people assume their PFM’s are strong because they work out, but I have assessed many people who, though they are in fact very strong, their PFM’s are very weak. They do need to be ‘intentionally’ strengthened. If you or someone you know is experiencing stress incontinence (leaking when laughing, sneezing, coughing, running, etc.), there is a strong chance that their PFM’s are weak as they aren’t able to withstand the pressure exerted during those activities and so urine leaks. This is another common time that people should choose to strengthen their PFM’s.
When should we not be doing Kegels?
Kegel’s are not a good choice if our PFM’s are too tight. Too much stiffness in these muscles and surrounding tissues does not allow for the proper flexibility, stability and strength that is needed to perform all the functions the PFM’s are responsible for.
The first problem is, if someone is leaking they often assume it is because of weak muscles. But, if they are leaking more from an urge incontinence (feeling a strong urge to go constantly throughout your day and sometimes not making it to the bathroom in time), this is more indicative of tight muscles. They are likely weak as well, but the tight factor must be tended to first. We should never be strengthening tight muscles. So, the treatment is completely different and will involve release work first, before strengthening.
The second problem is, rarely does someone know their PFM’s are tight especially because this isn’t a widely known or talked about subject. So, how can you find out? Well, if you have any tenderness/pain during intercourse, that can be a sign that some muscles are a little tight. Otherwise, book an assessment with your neighbourhood pelvic floor physiotherapist and find out exactly what is going on inside. In British Columbia, Canada, visit www.bcphysio.org and in other areas, phone the physiotherapy college, google or phone your nearest physiotherapy clinic and ask them to send you in the right direction.
For more information and videos on pelvic floor issues, please visit my youtube channel at Cathy Watson Physiotherapy.