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Why you should be doing Kegels

Wondering why you should be doing Kegels?

In my early days of being a pelvic floor PT, I was convinced I had the answer to all the woes of the pelvic floor. One word – Kegels. As I’ve developed professionally, I certainly realized Kegels have their place.

However, they do not have their place with all things related to the pelvic floor. There are specific instances when Kegels (also known as PC or pelvic floor muscle contractions) are the answer. I’m a firm believer in doing a Kegel program combined with a core strengthening program that will address the bigger picture. Here’s why you should be doing Kegels if you meet certain criteria:

  1. Most women that experience urinary incontinence

    1. A thorough physical exam can identify if postural dysfunction and weakness in your pelvic floor and what I call “pelvic floor accessory muscles” that are contributing to your incontinence.
    2. There are 3 primary types of urinary incontinence that physical therapy can treat:
      1. Stress Urinary Incontinence (SUI)
        1. Involuntary urine leakage with coughing, laughing, sneezing, exercise
      2. Urge Urinary Incontinence (UUI)
        1. Involuntary urine leakage associated with strong urge sensation and the inability to maintain continence on the way to the bathroom.
        2. Also associated with constant leakage (i.e. with walking, not necessarily associated with an urgency sensation)
      3. Mixed Urinary Incontinence (MUI)
        1. Having both stress urinary incontinence and urge urinary incontinence
    3. Stress Urinary Incontinence most often is accompanied with significant muscle weakness in the pelvic floor muscles, and often in the pelvic floor accessory muscles (such as the gluteal or adductor muscles). There may be poor posture associated as well that is inhibiting (preventing) proper pelvic floor muscle function.
    4. Urge Urinary Incontinence may or may not be associated with weakness in the pelvic floor muscles. These muscles need to be evaluated for trigger points and high tone that may be inhibiting normal muscle function.
    5. In Mixed urinary incontinence, both realms need to be evaluated and a treatment plan appropriate to the findings developed
  2. Women with pelvic organ prolapse

    1. his is when a pelvic organ (such as your bladder, uterus or rectum), drops (prolapses) from it’s normal place and pushes against the walls of your vagina, which can happen when your muscles get weak or stretched from childbirth or surgery (WebMD). This can also occur with constant or repetitive straining, such as what occurs with chronic constipation.
    2. It is often associated with discomfort and has a wide variety of presentations from from pain with sitting, dyspareunia (deep pain with intercourse), difficulty with voiding or bowel movements, pain with standing/walking/running or a report of a “pelvic pressure”.
    3. Depending on the level or grade of the prolapse, appropriate pelvic floor muscle strengthening alongside a pelvic floor muscle facilatory program can lend itself to significant improvements in the discomfort or pain associated with the prolapse. In part, because these muscles are acting to support the falling organs. However, sometimes ligament tearing is so significant or the prolapse so severe that surgery may be required to further reduce these symptoms.
  3. Women with diminished orgasm intensity

    1. Yes, stronger Kegels=better intensity orgasm, generally speaking. Yippee!!

Basically, if weakness contributing to a lack of support or a reduced ability to close around your openings to maintain continence is to blame, you should learn how to do your Kegels correctly NOW and begin a program that specifically addresses your contributing factors to weakness.

A trained pelvic floor physical therapist is the best person to evaluate all potential contributing musculoskeletal factors. At our offices, licensed physical therapists will go over a complete history or your condition. Once we have your background, a physical exam will begin that will address your posture and look at your muscle strength and flexibility of all the muscles that primarily influence your pelvic floor. Lastly, a pelvic floor muscle examination will determine your pelvic floor muscle strength and endurance, two important components of muscle function. We will also look at muscle coordination address any abnormal findings.

Classic stress urinary incontinence will typically take 6-8 visits to achieve 90-100% resolution of symptoms. These visits are often spread out over 3-6 months and is discussed on an individual basis. Urge incontinence has more variation, and can take as few as 4 visits up to 12 visits, again spread out over time. In all instances, we are able to spread out visits as a home exercise program is developed to address your specific areas of weakness and dysfunction.

However, just because you have incontinence, does not 100% guarantee that Kegels are the answer. In my upcoming article “Why You Should STOP Doing Kegels NOW”, I’ll go over why this magical muscle contraction is not all it’s cracked up to be.

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I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

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I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

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Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

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Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

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Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

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