To Kegel or Not Kegel - Is That Your Question?

Should I start doing Kegel exercises if I am peeing in my pants or not making it to the bathroom in time?

The short answer is not always. The long answer is that sometimes it helps solve the problem, but other times, it can do more harm than good. 

woman with pelvic pain

For those unfamiliar with the term Kegel, it refers to exercises created to strengthen the pelvic floor muscles and was first introduced by Dr. Kegel. Before we answer whether we should Kegel, let’s talk about these pelvic floor muscles, often called the levator ani. The pelvic floor muscles are found inside the vagina and anus in women and through the anus in men. 

The pelvic floor muscles have four main functions:

  1. Control of the sphincters about the urethra, vagina, and anus, “ stopping your pee or poop,”
  2. Provide support to the internal pelvic organs: the bladder, uterus, and rectum, “keeping everything up”
  3. Act as part of your core stability muscles and
  4. Enhance sexual function.

A lot of the time, weakness of these muscles can cause you to leak urine or stool. This is especially true when we experience urinary stress incontinence. Stress incontinence usually occurs with a downward force like jumping, running, sneezing, or coughing. In response to this “stress,” the pelvic floor muscles are supposed to resist the downward pressure, support the organs, and prevent leaking of urine or stool. Another type of urinary incontinence is called urge incontinence which is associated with the strong urge to urinate and not being able to control it. The feeling or strong urge “I need to get to the bathroom now,” may be a result of pelvic floor muscle tightness rather than weakness.

Women and men who have tightness at their pelvic floor muscles commonly experience pain in their genital region, inside the vagina, anus, or around the outside of the pelvis. Other symptoms associated with pelvic floor muscle tightness are difficulty emptying while urinating “peeing” or defecating “pooping”.  There is treatment for pain and incontinence linked to tight muscles, but it is not necessarily pelvic floor strengthening aka Kegels. Strengthening a group of muscles that are already tight may aggravate the urinary incontinence, pain, and emptying problems.

nurse with stethoscope

So, in summary, Dr. Google or Dr Kegel may be telling you to Kegel if you leak but this is not the solution for everyone. The best thing to do is to follow up with a pelvic health specialist to learn what is going on at “your” muscles and what is causing “your” leaking before you start strengthening. Physical therapists specializing in pelvic floor treatment will examine your pelvis and spine and design an exercise plan individualized to your body and needs.

If you decide “you have got this,” and you want to try strengthening on your own, start slowly and be aware of how your pelvis and bladder feel with the exercises. If you are having any adverse effects, then stop the exercises. If you feel stronger and are seeing some results but still struggling to stay dry, you may need guidance from a pelvic health specialist. Strengthening with Kegel training may be only part of the solution. Many other factors play a role in urinary continence, and the strength of these pelvic floor muscles is just one of them.