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stop doing kegels

Should You Stop Doing Kegels?

Read on for the answer.

In my last post, “Why You Should Be Doing Kegels NOW”, I went over the specific diagnoses that tend to benefit most from doing pelvic floor muscle exercises. However, not all issues related to the pelvic floor are appropriate to prescribe pelvic floor muscle exercises for. In fact, doing Kegels can actually be harmful and counterproductive to your symptoms if you have certain diagnoses, and it may be best if you stop doing kegels depending on your diagnosis.

In physical therapy, there are proper and improper times to strengthen a muscle. When speaking about the pelvic floor, you should only strengthen a muscle that is weak and overly lengthened. If a muscle in a high state of rest (guarded, hypertonic, or with limited flexibility), the LAST thing you should do is continually contract it. This will only further shorten/tighten an already short/tight muscle and likely make your problem worse, or at the very least, prevent if from getting better.

Here are the primary diagnoses that I generally recommend you stop doing kegels exercises (and even core strengthening) with, at least in the early stages of treatment:

1) Vaginismus
2) Vulvodynia / Vulvar Vestibulitis / Vestibulodynia / Provoked Vestibulodynia / Clitoris pain
3) Overactive Pelvic Floor
4) Genito-Pelvic Pain/Penetration Disorder (GPPD)
5) Introidal Dyspareunia
6) Interstitial Cystitis / Painful Bladder Syndrome
7) Urinary Urgency & Frequency

The above diagnoses are frequently in need of muscle relaxation and stretching to get the muscle to a normal state of rest. To continually contract the muscles in the area will only feed into the pain cycle (or make the muscle more short/tight). As physical therapists, our job is to break the cycle of pain. The best way to approach these diagnoses is through advanced muscle techniques, which should include a complimentary home program.

Eventually, strengthening will be needed and balancing out any asymmetries that were identified on your initial visit. If painful intercourse is a part of your diagnosis, the program outlined in Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve offers a comprehensive program to overcoming this type of pain.

What will happen at my first physical therapy visit?

After a thorough history, we will begin the physical exam which will include a postural assessment and a check of associated muscles flexibility and strength. After possible contributing factors have been addressed on a larger scale, the smaller pelvic floor muscles will be evaluated. There is no speculum involved and instead will be an assessment of pelvic floor muscle function, including contraction, relaxation and palpation for tender areas. Once these areas are identified, treatment will begin, and most patients leave their first visit with a home exercise program that will directly influence their symptoms to reduce their pain.

What Our Patients Have to Say

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Testimonial by Carolina J.

I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

-- Carolina J., 12/28/16 via Yelp!

Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

Read more: Testimonial by Mary L.

Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by Ann V.

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!

Read more: Testimonial by Ann V.

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