How Many Kegel Do I Need To Do?
Hint: The answer might be ZERO!
Since I started specializing in pelvic floor physical therapy, it is amazing to me how many people normalize urinary leakage. I hear it often when I’m in a group of adults (women mostly) - “stop making me laugh, or I’ll pee my pants.” Or “since I’ve had babies, I pee myself just a little bit.” Then, as soon as someone in the group learns that I work as a pelvic floor physical therapist, I get the question - “well, isn’t that just doing Kegel exercises?” Nope. If Kegel exercises were the answer to every urinary leakage question, it would be simple to just give every woman a handout after they deliver their first baby explaining how many Kegels to do every day. What every woman SHOULD get after they deliver their baby is information about a local pelvic floor physical therapist to reach out to with any questions or concerns as they recover from the birth.
The truth is, Kegels are NOT ALWAYS THE ANSWER! When someone is experiencing urinary leakage, it’s important to ask some questions and do a thorough examination of the whole person and body in front of you to help find their individual contributors to their leakage. If they are leaking urine when after experiencing a strong urge to use the bathroom, while trying to rush to the nearest toilet - I can almost guarantee that doing 100 Kegels a day will NOT fix this issue. The postpartum mom who is spending the majority of her day in her pajamas, breastfeeding her newborn baby, and is in survival mode while alternating between the couch and the bed (leaking urine with each movement)- doing 200 Kegels a day likely won’t fix her leakage either. What about the woman in her 50’s who has always had “a little” leakage during a strong cough or a sneeze since she had her first baby 25 years ago delivered via a forceps assisted vaginal delivery where she experienced some tearing of the vaginal canal during the delivery, but now in the past few years the leakage has become “moderate” during a cough or sneeze. Again - even if we had this woman do 300 Kegels a day, there *might* be a slight improvement of some symptoms, but she likely won’t be cured of leaking during a cough or sneeze.
I’ve had women ask me, how many Kegels do I need to do? Well, first of all, do you even know if you are doing this pelvic floor contraction correctly? The pelvic floor is an area that many women don’t always have a good brain/muscle connection with. Women might actually be doing the opposite of a pelvic floor contraction when they think they are doing a Kegel - meaning that they are actually pushing downward into the pelvic floor rather than lifting and contracting the pelvic floor muscles- which can actually WORSEN urinary leakage symptoms. Simply asking a woman to “do Kegels” is terrible advice. If you’re experiencing urinary leakage, don’t just “do Kegels” - SEE A PELVIC FLOOR PHYSICAL THERAPIST!
Written by: Renee Hancock, Pelvic Floor Specialist, Physical Therapist
