Why Kegels Aren’t for Everyone, Despite What You May Hear—By Michelle Musial, MPT

Should I do Kegels?  

This is a loaded question—the short answer is that Kegels are not for everyone.  Women need the pelvic floor muscles to have the ability to both contract and relax.  A Kegel is essentially contracting the muscles of the pelvic floor. If you do not have the ability to relax the muscles in general or after performing a Kegel, these can be signs that you should not do Kegels.  If you have a history of pelvic pain, painful vaginal penetration, pain with sex, pain with gynecologic exam, these can also be signs that you should not do Kegels.

The key with any exercise is doing it the right way. A pelvic floor contraction (aka Kegel) needs to be gentle and timed with breathing out, in order to avoid holding your breath.  A Kegel needs to create the correct core coordination, without any compensations of inner thighs, buttocks, or elsewhere.

A pelvic floor physical therapist can help you evaluate whether or not Kegels are right for you.

What is a pelvic floor physical therapist?  Are they covered by insurance?

A pelvic floor physical therapist undergoes specialized training regarding vaginal and rectal treatments for conditions of the pelvic floor and have a greater appreciation for the roles in core coordination and how scar tissue affects the body. Treatments are typically covered within your normal “therapy” benefits from insurance. This coverage varies from insurance network to network, at times requiring a copay, co-insurance, and funds toward deductible.

It’s a good idea for every woman to be evaluated by a pelvic floor physical therapist, especially if she is experiencing discomfort or pain in any way. Our bodies tend to give us small signs at first that they are needing help and retraining, that we tend to ignore until we cannot ignore them any longer. Pain of any nature can definitely warrant pelvic floor physical therapy.  

It is never normal to have painful intimacy, referred abdominal pain, urinary leakage, constipation, sensation of incomplete emptying for urination or bowel movements, tailbone pain, fecal leakage, pelvic organ prolapse, pelvic pain, low back pain, pubic pain, abdominal separation (diastasis recti), etc.  Treatment during pregnancy can be extremely helpful, for getting pain under control and improving progression toward full term pregnancy, especially in cases of pubic pain and any back/hip pain conditions. It is not normal to have pain in pregnancy —it is common, but not normal and should be addressed.”

*This article is for informational purposes only and is not meant to replace medical care. As always, check with your doctor to discuss your feelings when pregnant to make sure the feelings you are having are normal and not antenatal depression.

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