Should You Be Doing Kegels? A Pelvic Floor PT Explains
Most of us have heard of kegels, but how many of us were actually taught how to do them correctly — or why to do them at all? I’ve had so many patients come in for pelvic floor physical therapy telling me they’re already doing their kegels at stoplights. So why are they still having pelvic floor symptoms?
What Do Kegels Actually Do?
Kegels are named after Dr. Arnold Kegel, who prescribed them in the 1940s as a non-surgical alternative for women experiencing incontinence after childbirth. At the time, there were no published studies on the pelvic floor or conservative treatment options — his method worked, the name stuck, and doctors have recommended kegels ever since.
But here’s the catch: Dr. Kegel’s original protocol used a biofeedback device and specific parameters for each contraction. Today, kegels are often recommended without anyone teaching patients how to do them, how many to do, or why. So if you’ve ever wondered whether you’re doing yours correctly — or whether they’re even working — you’re not alone.
What kegels are actually supposed to do is strengthen the pelvic floor muscles to help with symptoms like incontinence. There’s solid research behind this, and the best part is you don’t need any equipment or extra space to do them.
How to Do Kegels Correctly
When you do a kegel, you should feel the pelvic floor muscles lift — and when you release, you should feel them relax and lengthen. You shouldn’t be holding your breath, or squeezing your butt, abs, or legs. You can also contract the front (bladder side) vs. the back (rectal side) of the pelvic floor separately, and learning to feel that difference is part of doing kegels correctly.
Common Kegel Mistakes
One of the most common mistakes is holding your breath or bearing down to force a stronger contraction. The fix: pair kegels with your breath — inhale and relax the pelvic floor, exhale and squeeze.
Another common mistake is squeezing too hard and recruiting too many other muscles. Your other muscles should stay mostly relaxed during a kegel. A little core activation is normal since those muscles work together — but you shouldn’t feel like you’re straining.
And then there’s volume. I see this one all the time, kegels at stoplights, kegels during a movie, kegels while doing dishes. All that squeezing adds up, and just like any other muscle, your pelvic floor can get overworked and fatigued. More isn’t always better, the number of reps should match your specific goal, not just “as many as possible, as often as possible.” This is exactly the kind of thing pelvic floor PT can help dial in.
Do You Actually Need to Do Kegels?
Kegels have their place, but having pelvic floor symptoms doesn’t automatically mean you need to do kegels.
For some people, repeatedly squeezing the pelvic floor can actually make symptoms worse. For example, someone who leaks when they sneeze might already have a tight pelvic floor — so when they need a strong, fast contraction, the muscles can’t respond well, and leaking happens anyway. In this case, kegels aren’t the fix — they might even be contributing to the problem.
“Just do your kegels” is well-intentioned advice, but it’s not one-size-fits-all. That’s where pelvic floor PT comes in.
How a Pelvic Floor Physical Therapist Can Help
Pelvic floor PT is about so much more than kegels — in fact, you might go through an entire course of treatment and never be given kegels as part of your home program.
During an evaluation, a pelvic floor PT looks at things like:
- Breathing patterns
- Mid and low back mobility
- Hip flexibility and strength
- Core strength
- Pelvic floor awareness, sensation, strength, and coordination
- Movement patterns — how you walk, squat, and jump
- Stress levels and coping strategies
- Diet, allergies, and fiber intake
- Hydration — including what you’re drinking besides water
Based on all of that, you might be prescribed kegels, or you might not. A real pelvic floor evaluation looks at far more than just the muscles.
Ready to Find Out What Your Pelvic Floor Actually Needs?
If you’ve been doing kegels for months without relief — or you’re not sure if you’re doing them right in the first place — you don’t have to keep guessing. A comprehensive pelvic floor evaluation can tell you exactly what’s going on and whether kegels are even part of the solution for you. Book an assessment with our pelvic floor team in Bend Oregon and let’s figure out a plan that’s actually built around your body.
Meet our Pelvic Floor Physical Therapy team, Denise Jerome PT and Alexa Macías PT, DPT, CSCS.
