To kegel, or not to kegel? Who knew that was even a question.

Since we were old enough to do the quizzes in Cosmo, we’ve been lead to believe that the more kegels we do, the better our sex life will be, and we won’t pee ourselves when we laugh or run after having kids.

Turns out, it’s not quite that simple.

Like all exercise, kegels should be prescribed based on what’s going on inside you. You wouldn’t walk into a gym and do 100 bicep curls without working up to it first. Same logic applies down there.

What is a kegel anyway?

Essentially, a kegel is a tightening or clenching of the pelvic floor — the group of muscles found at the base of the pelvis below the abs. And because it’s made up of muscles, the pelvic floor can get tight or weak. When that happens, a lot can go wrong. But it’s critical to know which category you fall into first. Don’t just assume you need your vagina to get jacked.

There’s a common misconception that kegels are related solely to sexual pleasure and performance. But we’re not in seventh grade anymore. The reality is, kegels work your pelvic floor to help it hold all your organs in and help prevent back pain by stabilizing your pelvis, on top of preventing you from peeing your pants if you’ve had a watermelon-sized human (or two, or more!) bearing down on your pelvic floor for months (a.k.a. been pregnant.)

Why do we need to do kegels?

Kegels increase the tone in the pelvic floor and improve your grip down there. You do them for the same reason you torture yourself at the gym and Barry’s — to make your muscles perform better. Many people need to do them to overcome weakness so when they sneeze, cough, crack up, jump or run, nothing leaks out. (Let’s be clear. Leaking is never OK. Not even a little bit. And if it’s happening to you, it can be fixed.)

Kegels aren’t the same for everyone.

For some people, the pelvic floor muscles are already super tight, and need to be lengthened before they can get stronger. If having sex or putting in a tampon or your annual GYN exam is painful, your muscles are most likely in a shortened position, and kegels will only make things worse by shortening them even more. If that’s you, put the kebosh on the kegels altogether and seek out a pelvic floor PT.  

Proper kegel technique.

If you’re sure that kegeling is right for you, let’s discuss technique. It should feel the same as stopping your pee mid-stream. But never practice kegels while actually going to the bathroom. That could lead to a UTI, and no one wants that.

Eventually, you can kegel anywhere, but it’s best to start out lying down. Try to hold your kegel for 3 seconds, 10 times. Progress to a hold for 5-10 seconds, 30 times a day. To find that kind of time, you’ll have to fit in some stealthy squeezing on the go. But like any other training plan, the exact protocol differs for everyone. Some pelvic floors are built for endurance and can be held for 10 seconds right away. Other pelvic floors might be able to sprint a 5K, but can’t survive a marathon. So leaks might happen at the end of a workout class or run, or at the end of the day. It’s important to be mindful of when your muscles work — and when they don’t.

Like all other muscle training, form is everything and more isn’t always better. The relaxation of the muscle is just as important as the contraction. A kegel should have two phases —pulling up and in, then letting everything go and dropping back down. If you feel like you can’t do that last part — you can’t relax your pelvic floor muscles — consult with a PT. Similarly, if kegeling hurts or makes you feel like you need to pee, your pelvic floor is likely jammed up and too tight. See a pro.

Pelvic floor physical therapy can help.

A pelvic floor physical therapist has specialized training that allows her to evaluate your kegel externally AND internally. From the outside, she can tell if the pelvic floor muscles are able to contract and relax. But an internal exam can reveal a lot more about what’s going on. Getting up in there is really the only way to check out your technique, assess the strength of your pelvic floor contractions, check the integrity of the tissue, locate scar tissue, and tell if the muscles are too tight or too weak. Armed with all that detail, a pelvic floor PT can give you the right training plan to address whatever symptoms you have.

Men have a pelvic floor, too.

Fellas, if you’re still with us but thinking all this kegel talk is solely lady business, you’d be very wrong. Dudes have muscle covering the space underneath their pelvis, too. Everyone has a pelvic floor, which means guys can also benefit from a little squeeze-and-lift action, especially if they lift weights.

Regardless of whether you’ve had kids, or never intend to, or simply can’t because you have a penis, you need a strong pelvic floor. Find a pelvic floor PT who can customize a training plan just for yours. We’d be happy to recommend a great one.

Be well!

— Team Clutch PT