To Kegel or Not to Kegel?

Kegels, kegel, all about kegels

Hey girl, let’s talk about Kegels! 

Kegels. There’s so much conflicting information out there, and it can be tough to know what to believe. But don’t worry, I’ve got your back. Let’s break it down logically and figure out what’s best for your pelvic health.

First things first, let’s address the elephant in the room: pain. Some people say that if you experience pain during Kegels, you should stop doing them altogether. But here’s the thing – completely avoiding Kegels isn’t the answer. Your pelvic floor muscles are just like any other muscle in your body, and you need to know how to control and coordinate them properly.

Think about it this way: if you tore your hamstring and it was causing sciatic nerve pain, would you just quit using your leg altogether? Of course not! You’d work on rehabilitating and retraining that muscle. The same goes for your pelvic floor.

“By the way… a quick note about the word “kegels.” In our field of Physical and Occupational Therapy, lots of experts love to argue about whether we should indeed event call them kegels. Recent trends have been leaning toward calling them “pelvic floor contractions” instead. For the purposes of this article we are referring to them as kegels. These popularly point to a “concentric” contraction. Regardless of what we call them, we should think of it as pelvic floor muscle retraining.” – Dr. Hollie Neujahr

Let’s talk about the difference between concentric and eccentric Kegels, and why both are important for maintaining optimal pelvic health. In one of my videos, I explain the difference between concentric and eccentric Kegels. Concentric Kegels involve contracting the muscle, while eccentric Kegels focus on the release and relaxation. Both are important for overall pelvic health.

Concentric Kegels involve contracting the pelvic floor muscles, which means actively squeezing and lifting them upwards. This is the type of Kegel that most people are familiar with, and it’s often described as the “squeeze and lift” motion. When you do a concentric Kegel, you’re essentially strengthening the pelvic floor muscles by creating tension and increasing muscle tone. This can be especially helpful for women who experience stress urinary incontinence (SUI), which is when you leak a little bit of urine when you cough, sneeze, or laugh.

On the other hand, eccentric Kegels involve releasing and relaxing the pelvic floor muscles. This is just as important as the concentric phase, because it helps to promote flexibility, also builds strength,  and prevents muscle tension and spasms. When you do an eccentric Kegel, you’re essentially lengthening the pelvic floor muscles,  and allowing them to return to their resting state from this position. This can be especially helpful for women who experience pelvic pain or tension, as it can help to reduce muscle tightness and promote relaxation.  

So, why is it important to do both concentric and eccentric Kegels? Well, just like with any other muscle group in your body, it’s important to have a balance of strength and flexibility. If you only focus on the concentric phase and neglect the eccentric phase, you may end up with tight, overactive pelvic floor muscles that can lead to pain and dysfunction. On the other hand, if you only focus on the eccentric phase and neglect the concentric phase, you may end up with weak, underactive pelvic floor muscles that can lead to incontinence and other issues.  Avoiding kegels altogether can lead to loss of control in the muscles, because whether you are actively working with them or not, they are going to contract and relax to help with how you use the restroom, breath, hold your posture, and more.

The key is to find a balance between the two and to practice both concentric and eccentric Kegels regularly. A good place to start is by doing 10-15 reps of each, holding each contraction for 5-10 seconds and then releasing slowly. You can gradually increase the number of reps and the hold time as you get stronger and more comfortable with the exercises.

Dr. Hollie Neujahr, Founder, N2 Physical Therapy

It’s also important to remember that Kegels aren’t just about strength – they’re also about coordination and control. When you do Kegels, you’re not just strengthening the muscles, but you’re also training your brain to communicate with them more effectively. This can help you to have better control over your pelvic floor muscles during activities like sex, exercise, and even just daily life.

So, there you have it – the lowdown on concentric and eccentric Kegels! Remember, both are important for maintaining optimal pelvic health, and it’s all about finding the right balance for your body. And if you ever have any questions or concerns, don’t hesitate to reach out to a pelvic health professional for guidance and support.

The key is to approach Kegels intuitively and tailor them to your individual needs. 

There’s truly no one-size-fits-all approach. Some people may need to focus more on relaxation, while others may need to work on strengthening.  Labeling an exercise that is just as important as a deadlift or chest press as negative and one to avoid, is also not the answer.  It’s all about finding the right balance for your body and your situation..  

Remember, Kegels should be part of a comprehensive approach to pelvic health. They’re not a magic cure-all, but they are an important piece of the puzzle. So don’t be afraid to incorporate them into your routine, even if you’ve experienced pain in the past. With the right guidance and a little patience, you can learn to control and coordinate your pelvic floor muscles like a pro.

So, to Kegel or not to Kegel? The answer is a resounding “yes!” Just make sure you’re doing them correctly and listening to your body. 

Resources and Further Reading on Kegels:

https://www.sciencedirect.com/science/article/abs/pii/S0031940620300195

https://www.sciencedirect.com/science/article/pii/S2050052121000123?via%3Dihub

https://n2physicaltherapy.com/wp-content/uploads/2024/05/PDF-Kegels-Post-Pelvic-Floor-Physical-Therapy-for-Pelvic-Floor-Hypertonicity-A-Systematic-Review-of-Treatment-Efficacy.pdf


And if you ever have any questions or concerns, don’t hesitate to reach out to us here at N2 and our fabulous team of pelvic health professionals. We’re here to help you on your journey to optimal pelvic health.

About Dr. Hollie Neujahr

N2 Physical Therapy | Denver (Uptown), Boulder, Centennial

N2 Physical Therapy is a practice focused on the individual’s whole health. Comprising a team of skilled and empathetic Doctors of Physical Therapy and Doctors of Occupational Therapy, our physical therapy practice comprises an extensive array of recognized certifications and advanced education in pelvic health. Our N2 Team is characterized by our ongoing drive for personal and professional advancement, united by a supportive team ethos that prioritizes both internal camaraderie and the well-being of our patients.

Dr. Hollie Neujahr, pelvic health pt, physical therapy for women, physical therapy near me, PT near me, Denver PT, centennial PT, Boulder PT, pelvic health physical therapists

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