To Kegel or Not to Kegel?

Kegels, or pelvic floor muscle contractions, are often the go-to recommendation for pelvic floor dysfunction. But are they always appropriate? The answer is no!

Pelvic floor dysfunction is a broad term that can refer to the dysfunction of the pelvic floor muscles due to many different conditions.  

• Urinary incontinence 
• Urinary urgency and/or frequency
• Fecal incontinence
• Constipation
• Pelvic organ prolapse
• Pain with penetrative activities
• Pain in the pelvis, genitals, hips, low back, or abdomen

Having strong pelvic floor muscles can be helpful, but more specifically we want our pelvic floor muscles to be able to move throughout their full range of motion when needed.

Therefore, it is just as important for our pelvic floor muscles to be able to lengthen or relax when necessary. Sometimes pelvic floor dysfunction is not a result of a weak pelvic floor, but rather a pelvic floor that is tense.

Our pelvic floor relies heavily on surrounding areas such as our core, hips, spine, and diaphragm. We want all these areas to be well balanced and working together to support optimal pelvic floor function. 

The best way to determine if your pelvic floor issue is caused by pelvic floor muscle weakness or tightness is through an evaluation of these muscles by a Doctor of Physical Therapy.  

A weak pelvic floor can cause symptoms such as:  

• • • • Incontinence or leakage (bowel or bladder)
      • A sensation of heaviness in the pelvic area
      • Prolapse
      • Decreased sensation during intercourse
      • Secondary symptoms like hip or low back pain

It can be hard to know where to start. Luckily, pelvic floor physical therapists are trained to evaluate and determine the most appropriate treatment approach. 

During your first pelvic floor therapy visit at Rise, your therapist will perform a thorough medical history review and physical examination to determine the root cause of your symptoms. An internal exam of the pelvic floor muscles can be helpful but is not necessary. Your therapist will ask for consent prior to each portion of the examination.  

Your therapist will recommend exercises and/or hands on techniques to address your specific type of pelvic floor dysfunction. While Kegels are a common exercise that can be effective for low level pelvic floor strengthening, your therapist will recommend a complete exercise program that may include strengthening or mobility work for the pelvic floor and other body areas, such as the hips and low back.  

Functional exercises and breathing drills are also important aspects of a treatment program for pelvic floor dysfunction. While Kegels can be a good starting point, your therapist will work with you to achieve pelvic floor activation or relaxation during functional movements such as squatting or lifting a heavy object from the floor. The goal is to improve your symptoms by addressing the pelvic floor while it works with other muscle groups for more effective targeting and symptom control.  

Katelyn joined Rise Physical Therapy in June 2025. She is originally from Texas. She received her Bachelor of Science in Exercise and Sports Science from Texas State University and her Doctorate of Physical Therapy (DPT) from Harding University. Her special interests include working with the pelvic health population, including but not limited to, pregnancy and postpartum care, pelvic pain, pelvic organ prolapse, urinary incontinence, and pre- and post-prostatectomy care. Outside of the clinic, you can find Katelyn catching up on guilty pleasure TV shows, finding new restaurants in the area, or spending time with friends, family, and dog named Gunner.