Kegel exercises are often the first recommendation when it comes to strengthening the pelvic floor. These exercises, which involve contracting and then elongating the pelvic floor muscles, can be beneficial for many individuals, particularly those dealing with urinary incontinence due to weak or slow pelvic floor muscles. However, Kegels aren’t for everyone. Performing pelvic floor tightening exercises may do more harm than good if you have a chronically elevated or tight pelvic floor. Understanding how these exercises work and whether they are appropriate for your condition is crucial to maintaining pelvic health.
What Are Kegel Exercises?
Kegel exercises involve the muscles around the anus and vagina, where you repeatedly contract the muscles, which involves elevating them, then lowering and elongating them to enhance strength and endurance. These muscles support the bladder, uterus, prostate, and bowels, which are crucial for urinary and bowel control, as well as sexual function. By incorporating pelvic floor lifts into a routine, many individuals experience improved pelvic health and symptom relief from conditions like stress urinary incontinence, fecal incontinence, and pelvic organ prolapse.
To perform a Kegel exercise, follow these steps:
- Identify your pelvic floor muscles by closing and lifting the anus as if to stop gas from leaking out. The same muscles can stop the flow of urine, but it is not recommended to practice stopping urine mid-stream due to the possibility of promoting a bladder infection.
- Once identified, contract these muscles and hold for a count of three to five seconds.
- Relax the muscles completely for an equal amount before repeating the contraction.
- Aim for three sets of 10.
- It’s important to perform Kegels correctly, as incorrect technique, such as using surrounding muscles, like the buttocks or legs, can reduce their effectiveness. While these exercises can be incredibly beneficial for those with weak pelvic floor muscles, they are not always suitable for every individual.
What Is a Hypertonic Pelvic Floor?
A hypertonic pelvic floor occurs when the pelvic muscles stay contracted and fail to relax properly. Tight muscles can also be weak and lead to urinary and or fecal incontinence. Unlike a purely weak pelvic floor, where the muscles lack strength, a hypertonic pelvic floor is overactive, leading to chronic tension and potential pain and dysfunction. This condition can develop due to stress, trauma, poor posture, or excessive pelvic floor exercises without proper relaxation techniques.
Individuals with a hypertonic pelvic floor may experience symptoms such as:
- Chronic pelvic pain – Discomfort or aching in the lower abdomen, back, hips, or perineal area.
- Pain during intercourse (dyspareunia) – Tight muscles can lead to difficulty with penetration and discomfort.
- Urinary urgency or frequency – The sensation of needing to urinate often, sometimes with difficulty starting the flow.
- Constipation or difficulty with bowel movements – Tight muscles can restrict normal bowel function and lead to straining or incomplete evacuation.
- Lower back or hip pain – The pelvic floor is an integral component of your core and communicates with hip muscles, so excessive tension can contribute to musculoskeletal pain.
Since Kegels involve contracting these muscles, they can exacerbate symptoms rather than provide relief if the pelvic floor is excessively tight. Instead of strengthening already tense muscles, individuals with a hypertonic pelvic floor need strategies to promote relaxation and muscle balance.
What to do instead of Kegel exercises?
If you suffer from pelvic floor tension or dysfunction, performing Kegel exercises without proper guidance can worsen your condition. Instead of strengthening already tight muscles, you may need to focus on relaxation and lengthening techniques, such as:
- Diaphragmatic breathing – Deep belly breathing helps release tension in the pelvic floor by encouraging relaxation and improving oxygen flow to the muscles.
- Pelvic floor stretching – Gentle stretches, such as child’s pose, deep squats, or happy baby pose, can help lengthen the pelvic floor muscles and reduce tension.
- Myofascial release therapy – Hands-on techniques performed by a trained physical therapist can target trigger points and break up muscle restrictions.
- Guided physical therapy interventions – A professional pelvic floor therapist can assess your condition and create a personalized plan that includes relaxation exercises, manual therapy, and lifestyle modifications.
Ignoring hypertonicity and continuing with inappropriate exercises can lead to worsening symptoms, increased discomfort, and prolonged dysfunction. If you suspect that you have a hypertonic pelvic floor, it’s essential to seek professional guidance before engaging in any pelvic floor-strengthening exercises.
Finding the Right Approach
If you’re experiencing pelvic floor issues, it’s essential to consult a qualified physical therapist who specializes in pelvic health. At Evolve Physical Therapy, our experts assess your needs and create a personalized treatment plan to help you achieve optimal pelvic function, eliminating leakage or pain and improving core control.
A professional evaluation can help determine whether your pelvic floor is weak, overly tight, or functioning optimally. Treatment plans may include biofeedback using surface electromyography and rehabilitative ultrasound imaging, manual therapy, movement retraining, and lifestyle modifications tailored to your specific condition and goals.
Take the Next Step Toward Pelvic Health
Not sure if Kegels are right for you? Schedule a consultation with our pelvic health specialist at Evolve Physical Therapy today. We’re here to help you regain control, reduce pain, and improve your quality of life with the right approach to pelvic floor therapy. Whether you need strengthening exercises, relaxation techniques, or a combination of both, our team will guide you toward the best treatment plan for your pelvic health needs.
Thank you for reading: The Truth About Kegel Exercises: Are They Right for You?
Our women’s health physical therapists have advanced training for pre- and postpartum, perimenopause through post-menopause, and pelvic floor dysfunction. Our comprehensive evaluation and one-on-one treatment go beyond alleviating symptoms; we strive to determine the root cause of the problem.
For a thorough evaluation and individualized treatment, contact our Sherwood or Bethany clinic today and be seen within 48 hours or less.
