3 Reasons Kegels Aren't Helping Your Leaks

Hey there, it's Dr. Kelly, double-board certified Pelvic Physio to the stars! Have you ever been puzzled about hearing that Kegels might not be right for you? Or have you "been doing kegels for ages", and they haven't helped with your pee urges, anxiety or leaks?

Let's break these situations down, and get you the healthy pelvic floor that you deserve :) 

3 Reasons Kegels Might Not Be The "Ace in the Hole" for Managing Leaks:

1. Not nailing the technique:

• At it's most basic level, improving our pelvic function, especially when it comes to leaks, is NEVER just about squeezing--it's mostly about first learning to relax, then later learning to maintain this better "resting tone" with daily activities.   Once you do that, your muscles will have a chance to be healthy.  Their strength will actually improve significantly just because they are healthier, as well as be set up for success for future strengthening, because you are moving them through a FULL range of motion.  

• If it's hard to envision how "something that is too tight can be weak", please picture this: If I asked you to make me a bagel right now...you most likely could....but what if you held your hand in a rock-solid-fist ALL day, without rest...the muscles wouldn’t work too well to make me a bagel after, would they?

• OR...what if I asked you to trot your cute butt up the stairs--most of you could do that right now, no problem.  But what if I put you in a wall sit for 6-hours...then asked you to trot up the stairs....chances are that your muscles might not be so accommodating.  

• It's the same-thing for pelvic muscles.  For most of us they’re too tight all the time, which is what is making them weak because they’re stiff and unhealthy!  So what most of us really need from a kegel, is to learn to relax!  

• If this is confusing to you, no worries--I get it!! Check out these fun Instagram posts using a "wall sit analogy" or a "carrying a bag of flour around all day analogy", to help you see the light!  And if you like them, PLEASE share them in your stories, or to your friends and family!!  Help improve this awareness!!

2. Overlooking the bigger picture:

• In addition to learning to relax your pelvic muscles, so they can be healthier and help with leaks, there is indeed a bigger picture.  Posture, hydration, good eats, sleep, and overall muscle strength all play a role in ideal pelvic function. The pelvic floor muscles are an important role in leaks…but they're not the only player.  In truth, they're responsible for maybe on 10% of “the big picture” upward pressure control, so while that's an important 10%, you won’t achieve your leak-free dreams by doing isolated pelvic work.

3. Coordination with other muscles

• Sometimes you need strength elsewhere or a different coordination pattern. Think of it like a choreographed dance – each body part has to play its part, and hit the right steps at the right time, to control pelvic pressure.  And if the body doesn't know how to do that, we might end up with a leak.  

• Take a squat, for instance.  In a squat, your deep abdominal muscles need to exert MORE pressure, along the SAME MUSCLE LENGTH, the deeper you go in the squat, to match the tension that your leg muscles are exerting, to keep you balanced, and straighten you back up.  Similarly the postural strappy back muscles need to exert more muscle activity along the same range of motion, the deeper you go.  

• ...the pelvic floor, however, needs to exert the same pressure to support the weight, at an elongating length, as they have to get longer to allow you to bend at the hips and "assume the squat position"....then on the way up, they need to maintain that same pressure, while shortening back to their resting length.  

• But if the brain doesn't know how to find the pelvic floor, allow different ranges of motion as you move, or manage the pressure/tension relationship across different muscle lengths...you'll end up with a rigid pelvic floor that leaks.  Knowing how to activate the right muscles at the right time, in the right way, is key, and having your brain "run this program automatically" is necessary. Pelvic Physios, and reputable online programs, can help you do this by giving you simple, specific exercises, to help the brain find access to these automatic movement patterns!

Point: Simply “Telling Someone to do Kegels” is like flipping a coin…50% of the time it won’t work…

 And what’s even more striking, is that just telling someone to do kegels won’t work 50% of the time…25 % of the time it will make someone’s symptoms worse because their issue was that their pelvic muscles were too tight and stiff to begin with…and only, by the grace of God (or a lot of luck), 25% of the time, will “just telling someone” to do kegels actually help their symptoms.

So medical-folks, real people everywhere….if someone tells you to do something that most likely won’t work…but has the SAME CHANCE of hurting you, as helping you? Would you “just do it”? NO WAY, JOSE!!  

So do we give up on them forever??

Counterpoint: “Training Someone” in Pelvic Floor Work is Life Changing.

While “just telling” someone to do kegels is crap, training them in their pelvic floor, their coordination, is absolutely life changing.  We’ve said it once or twice (ha!) around here, that relaxation is key! 

Your pelvic physio, or trusted online program will train you in what YOUR body needs from a Kegel, and under their guidance, 80% of us (that's 4 out of 5!) will see improvement!  That's WAY better than just 1/4 improving (and 2/4 not improving and 1/4 actually getting worse) by "just telling someone to do a kegel."

How to Kegel Like a Pro:

• Explore the blog for various free, step-by-step guides to improve your chances of success.

• Test your pelvic know-how, with Vag Lab, where you'll learn all about what's normal for pee & poop, and how to do self vulvar and pelvic floor muscle assessments, including Kegels, the right way!!

• Take a deeper dive with Pelvic Floored's Flagship Course, The Signature Series. It's the closest thing to at home Pelvic Physio, without actually being Pelvic Physio, that you can find!!  I personally feel that as I progress to each level of exercise, it's like unlocking the secrets to a new level in a video game, as I see my pelvic function flourish!

• Still Stumped? Connect with a Pelvic Physio, or make an appointment with me or my staff (in person or Telehealth available) because investing in your pelvic health is investing in your future!!

Stop investing in things that only cover up the symptom. Start investing in the solution, which is YOUR body, YOUR muscles and YOUR health. You Are Worth It!

Thanks for reading!

xoxo, Dr. Kelly 🌈