There has been a lot of controversy recently over whether or not pelvic floor exercises, aka ‘Kegel’ exercises, are good for you. A few different scenarios seem common: A while ago, we weren’t told anything. Pelvic floor? What’s that? The along came Dr. Kegel. It was a definite improvement to at least acknowledge the pelvic floor. However, as things often do, the pendulum swung completely from one end to the other. Then, we were told to squeeze All. The. Time. Seriously…At every red light. Every time we peed. With almost every breath. OK, their intentions were good. But we went way too far. As one of my fellow PT’s puts it, things became #overcooked. It turns out that squeezing with max force all of the time doesn’t really serve the purpose originally intended.

That brings us to the last 5-10 years. We started getting a little smarter about things. Some correctly recognized that people really took to heart doing those Kegel exercises. Unfortunately, it was a little too much. Think of it this way – if you bend your elbow and touch your shoulder, holding your bicep as tight as you can, will you be able to lift anything heavy with that? The same goes for the pelvic floor! If you are maximally holding all the time, that muscle is not in a position to do it’s thing. Again with good intentions, some advised that ‘all kegels are bad’. Well, that also goes a bit too far. Turns out, there is a Goldilocks principle involved. A sweet spot.

First, knowing what your pelvic floor muscles are doing at rest is needed. Is it already sitting at ‘just right’? A good self-assessment uses your own finger vaginally (about an inch deep) to feel a few clear and distinct movements:

• a contraction both around the finger AND lifting up / into the body
• a distinct relaxation with no further tension
• even further release if you gently bear down
• both sides contracting and relaxing together (one side isn’t doing all the work)
• no pain when you try any of these maneuvers.

If all of those things are happening, you can be pretty confident that Kegel exercises are fine for you to do. If you answered no or unsure to any of those – get thee to a pelvic floor physical therapist!