I don’t know how many times I’ve heard, “why would someone need to go to pelvic floor physical therapy? It’s just kegels, isn’t it?”
Well I hate (or maybe secretly love) to break it to you, but NO, it is not just kegels. It in fact is so much more!
We can look at this in 2 different ways.
First, not every patient that has bladder issues is leaking just because their muscles are weak. Yes, their muscles are most likely still weak, but WHY are they weak? It is quite often that I will have a patient with pelvic floor muscle weakness because their muscles actually are TIGHT and OVERACTIVE. In other words, their pelvic floor is tense.
Why does this matter? Well, in the pelvic health world, if we have a patient with overactive muscles “just go and do a bunch of kegels”, their pelvic floor can actually tense even more, making their bladder issues worse!! Why on earth would we like to do this?
The second way to look at “just kegels” is this: YES, bladder leakage can be caused by pelvic floor muscle weakness. In this case will we do kegels? Absolutely!
But let me ask you a few questions about this:
- Are you sure you are doing your kegels correctly? (Especially when research shows that 25-50% of people are NOT doing them correctly).
- Are you sure you are holding the kegel long enough, and doing as many a day as you should be?
- And how many times a day should they be done?
- And in what position?
- Also, have you ever thought of the “supporting role” muscles that help support the pelvic floor?
These include the muscles of the lower back, abdomen/core, hips, and inner thighs. To get the very best results from pelvic floor rehabilitation, we want to work ALL of these muscle groups!
Research has proven this time and time again. Along with making sure the lumbopelvic muscles are strong, we also need to make sure they are all working TOGETHER in the correct way. Coordination between all these muscle groups is essential to ensure they are working together and not against each other. And who better to assess this than the movement expert, otherwise known as the physical therapist?
With all of that being said, having an accurate evaluation of your pelvic floor by a trained physical therapist really is essential in making sure you are doing the appropriate exercises, and doing them correctly, in order to give you your very best outcome!
A pelvic health PT will be able to determine if your bladder issues are from a tight and overactive pelvic floor, or a weak pelvic floor, as well as assess the surrounding “support muscles” and develop a treatment plan that will include appropriate exercises.
So, to answer your question, pelvic floor is not “just kegels.” It is in fact so much more!