Why Kegels are Bad for your Tight Pelvic Floor

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Note to Readers: Yesterday we posted a blog summarizing an article titled “Stop Doing Kegels: Real Pelvic Floor Advice for Women (and Men)” written by Nicole Crawford and published on BreakingMuscle.com. There was some confusion that resulted from the post about when kegels are and are not appropriate. The article advises that women (and men) should never do kegels. I do not completely agree with the article. While women and men with tight pelvic floors should never do kegels, they are appropriate for a certain patient population, patients that have weak pelvic floors.

But what about patients who have weak and tight pelvic floors?

This updated edition of the post, will fully explain when kegels are and are not appropriate, including what is appropriate in situations when the pelvic floor muscles are both weak and tight. I apologize for any confusion, but am thankful for the opportunity to add clarity to this issue that I know is super-confusing to so many!

Kegels are no good for a hypertonic or “tight” pelvic floor.

For decades doctors, PTs, trainers, therapists, you name it, have been hammering away at women—and men too—that if they want to strengthen their pelvic floors, they must do their kegels.

Getting folks to stop doing kegels is a bit of an uphill battle because it’s advice that’s seeped into the mainstream consciousness. On an episode of “Sex in the City” Samantha jokes about doing her kegels; Oprah Winfrey had experts on her show dispensing the advice to her zillions of viewers, and if you google “kegels” you’ll come up with about 1.3 million hits.

So you can imagine my delight when I came across an article that went against the party line, and actually delved into the potential harm kegels can do to the pelvic floor. An issue that PTs who treat the pelvic floor are all too familiar with.

The article is titled “Stop Doing Kegels: Real Pelvic Floor Advice for Women (and Men)” is written by Nicole Crawford and published on BreakingMuscle.com.

Ms. Crawford’s article is a Q&A with Katy Bowman—a master’s level Biomechanist whose focus is the mechanical causes of disease. In the past, Ms. Bowman has made waves advising folks against doing kegels.

Ms. Bowman says that at the heart of the problem with doing kegels to strengthen the pelvic floor is a theory in biomechanics called: “Overgeneralized Theory of Strength.” When you do a kegel, she explains, you are doing a muscular contraction, and if you already have a tight pelvic floor, contracting these muscles will only make it tighter, making your pelvic floor problems worse.

Here I agree with Ms. Bowman 100%. If you have a tight pelvic floor, or even a pelvic floor with active trigger points, you should not do kegels. Doing kegels under these circumstances will compound your pelvic floor problems.

Ms. Bowman goes on to say that kegels are never appropriate. In her prior writing on the topic, she’s held that doing kegels can actually cause weakness. As an alternative to kegels for pelvic floor strengthening, Ms. Bowman recommends deep squats. Her reasoning is that deep squats strengthen the glutes, which in turn “pull the sacrum back, stretching the pelvic floor from a hammock to a trampoline” and thus providing for a stronger or more stable pelvic floor.

Here is where I am forced to disagree with Ms. Bowman both on her assertion that kegels are never appropriate and her advice that deep squats are a better way to combat a situation where the pelvic floor is weak.

Please click the following link to read the remainder of the post:

pelvicpainrehab.com/blog/20...