To kegel or not to kegel?
Let’s start by saying - leaking urine is never normal. It is very common, but never normal.
Now, if you are leaking, should you be kegeling? And, if so, how much? And, how do you even do kegels? So many questions..
Leaking urine comes in different forms. The two most common are stress incontinence, which happens with an activity (cough, sneeze, laugh, jump, etc), and urge incontinence, which happens on the way to the restroom. There can also be mixed
incontinence which is when someone has both.
Most people, especially new mothers, assume that if they are leaking urine, their muscles “down there” (the pelvic floor muscles) must be really weak and really loose. This could very possibly be true. In this case, pelvic floor strengthening, what most people think of as kegels, is in order. However, sometimes the pelvic floor muscles are actually too short and tight which means they can’t activate well enough to control urine. If this is the case, then doing pelvic floor exercises could, and often does, make the problem worse. And then there are cases when the pelvic floor muscles are actually working well, but the abdominal muscles and breathing aren’t coordinating well which causes too much downward pressure on the bladder which leads to leaks.
So, how do you know which is happening in your body? By getting an evaluation by a pelvic floor physical therapist! Pelvic PTs are trained to assess your pelvic floor muscles, along with the rest of your body, to determine the cause of the leaking and to offer appropriate solutions to the problem. Your doctor may have told you something about your muscles, but they aren’t trained to assess them the way PTs are. Your PT will develop an individual plan for you (because your friend who saw a PT might have a whole different set of solutions). And, if kegels are needed, your PT will help you to learn the best way to do them, because it is not just about the squeeze!
Whichever type of leaking and whatever the cause, there is no need to be living with it. No matter how long it has been going on, there is help.
Lauren Starace, PT, MSPT
Restore PT & Wellness
Nova Integrative Physical Therapy