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Why Your Kegel Exercises Aren’t Working
by Tara Galles, MS, OTR
It’s estimated 1 in 3 US women wear a hygiene product to manage the accidental leakage of urine, too many while hopelessly doing their “Kegels.” A Kegel (pronounced kee-gull) is a pelvic floor muscle exercise that may be effective to stop the flow of urine as you pee or prevent you from accidently passing gas (or worse, a shart). But “Kegel” exercises are mostly ineffective by themselves to prevent leaky or overactive bladders, also called mixed urinary incontinence, for several reasons.
“KEGEL’S” ARE FROM THE 1940’S. EXERCISE SCIENCE HAS ADVANCED SINCE THEN.
It’s estimated 1 in 3 US women wear a hygiene product to manage the accidental leakage of urine, too many while hopelessly doing their “Kegels.” A Kegel (pronounced kee-gull) is a pelvic floor muscle exercise that may be effective to stop the flow of urine as you pee or prevent you from accidently passing gas (or worse, a shart). But “Kegel” exercises are mostly ineffective by themselves to prevent leaky or overactive bladders, also called mixed urinary incontinence, for several reasons.
“KEGEL’S” ARE FROM THE 1940’S. EXERCISE SCIENCE HAS ADVANCED SINCE THEN.
Dr. Arthur Kegel was a gynecological physician who is largely credited with developing “Kegel” exercises in the late 1940’s. In his 1948 publication, he explains Kegels are “progressive resistance exercise in the functional restoration of the perineal muscles.” While his work was groundbreaking to the medical world in helping women take control of their bodies, most postmillennial women (and men) would not accept such antiquated medical advice for other health issues. Exercise science has advanced aplenty in the last 80 years. The pelvic floor is made of up of muscles, and just like any other muscle group of the body, they can (and should) be trained and conditioned with more than one archaic exercise.
THERE’S MORE THAN ONE MUSCLE IN THE PELVIC FLOOR.
The pelvic floor is comprised of multiple muscles. These muscles work together to coordinate functions such as urination, defecation, sexual activity, sitting in a chair for more than 30 minutes, etc, and can be disrupted when one muscle is injured or strained. Kegels tend to activate specific sphincter muscles instead of all the muscles needed to coordinate pelvic functions. Most women perform Kegel exercises incorrectly. In fact, one study found up to 70% of women incorrectly performing Kegels without therapeutic instruction [source]. Ouch!
THE GENERAL PRESCRIBING OF KEGEL’S DO NOT TYPICALLY FACTOR MUSCLE TONE.
Most pelvic floor dysfunctions result from the muscles being too tight (hypertonic) or too loose (hypotonic). In the clinic, I see way more hypertonic (too tight) pelvic floor muscles associated with bladder issues than hypotonic (too loose). While hypertonic (too tight) pelvic floor muscles may still be weak and eventually in need of strengthening, the muscles must first be trained to have a normal resting tone: not too tight or too loose. Exercising a hypertonic (too tight) pelvic floor with Kegel exercises trains these muscles to become tighter, which creates more dysfunction whether it be painful urge, leaking urine, etc. When to start pelvic floor muscle training and how to grade the exercise have the best results when prescribed by a trained pelvic floor therapist.
A DEAD WHITE MAN SHOULDN’T DESCRIBE ANY ACTION OF WOMEN’S PELVIC FLOORS. JUST SAYIN’.
In 1936, over a decade prior to Dr. Kegel’s “groundbreaking” publication, Margaret Morris, a woman’s health physiotherapist out of St Thomas’ Hospital in London, introduced pelvic floor muscle training to the medical world. Her paper discussed the need for conscious control of pelvic floor muscle relaxation and contraction in order to prevent urinary and fecal incontinence. There are documented gymnasts and dancers who taught women’s pelvic floor function prior to Morris, and midwives have taught pelvic floor muscle rehabilitation throughout history. Dr. Kegel’s publications did communicate to gynecologists the need to address incontinence in women; however, it was essentially mansplaining how women should operate their most private parts.
THERE IS NOT A MAGIC BULLET EXERCISE THAT CURES PELVIC FLOOR DYSFUNCTION. SORRY ABOUT THAT!
There are active and passive treatment approaches for pelvic floor dysfunction. Passive treatment options include medical prescriptions or pills, surgery, and wearing hygiene products to manage incontinence. Passive treatment options are typically more expensive, have poorer long-term outcomes, and are more invasive than active treatment options. Pelvic floor therapy is an active treatment option with a success rate of up to 97% for urinary and fecal incontinence. In therapy, we take an individualized approach prescribing each woman a different set of exercises to help her meet her rehabilitation goals.
If you are struggling with a leaky overactive bladder or other pelvic floor issues, talk to your provider about therapy. Make an appointment with us at 765.319.8420 to learn which set of exercises will help you take control, and we promise we won’t just prescribe Kegels!
Tara Galles, MS, OTR
Tara Galles, MS, OTR, is owner of You’re in CONTROL! With over 20 years of clinical experience she compassionately moves each woman to take CONTROL! of their body and rehabilitates them to feel like a natural woman again. As a mother of four children she also understands what it’s like to be a pelvic rehab patient. You may contact Tara about your pelvic issue at (765) 319-8420, or make an appointment using the button at the top of the page.