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Pelvic Floor: Where Kegels Come in

Posted By Bailee Burningham, PT


Stop me if you’ve heard this advice from a well-meaning person in your life: “Do your Kegels…” but with no other instructions on how to do them or how often. What even is a Kegel anyway?.

This exercise was developed by gynecologist Arnold Kegel who first published his ideas in 1948 as a treatment against urinary incontinence in women.

Kegel exercises’ effectiveness stems from the fact that the pelvic floor produces two main movements: a “squeeze” and a “lift.”

  • The first two layers of muscles  are the “squeezers” and the third, deepest layer of muscles is home to the “lifters”
  • Kegel exercises require all of these muscles to coordinate and create combination a squeezing and lifting motion. This controls your bladder and bowel functions while also providing a stable base for your abdomen and spine.

Correct Kegels

How do you know if you’re doing a Kegel correctly? Some helpful cues include:

  • Pretend like you’re stopping the flow of urine.
  • Pretend like you’re holding back flatulence.
  • Imagine a string lifting from your pelvic area towards your head.

How do you know if you’re doing a Kegel  incorrectly? If you’re doing the following:

  • Squeezing gluteals or inner thighs together.
  • Tucking your pelvis.
  • Holding your breathing.
  • Bearing down or pushing out (in fact, this is actually the opposite of a Kegel).

Should you be doing Kegels? In general, the answer is yes. The pelvic floor is an important muscle group that needs to be utilized and exercised just like any other muscle in the body. However, this answer comes with two huge asterisks.

  • Asterisk #1: As you can see from the two lists above, the Kegel involves many different muscles and coordination of movements. Very frequently, people who are trying to do Kegels aren’t actually engaging or utilizing the correct muscles in the most useful way.
  • Asterisk #2: Sometimes, the pelvic floor muscles are already so tight and tense that a person’s muscles can essentially be “Kegeling” 24/7! Naturally, this can create muscle imbalance, muscle fatigue and, very often, pain. The best way to know if you fall into this category is to be evaluated by a physical therapist. If you do, you will likely require pelvic floor therapy in order to decrease muscle tension and imbalance before moving on to a strengthening program.

The pelvic floor is much more complex than simply “doing your Kegels.” It is a dynamic muscle group that plays a role in many of your essential daily functions. Pelvic floor dysfunction can manifest itself in many different ways. If you suspect that your pelvic floor isn’t working correctly, reach out to our specialized team of physicians and physical therapists who are trained to identify and address pelvic floor issues. They will be able to help you determine if pelvic floor physical therapy is appropriate for you.

Shirley Ryan AbilityLab is now offering physician and therapy TeleHealth appointments to provide patients easy access to our expert clinical teams. New and existing outpatients can schedule and appointment at 312.238.1000 or here.

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