Should I Do Kegel's During Pregnancy? | HER Body PT

I talk to a lot of women who are very concerned about the health of their pelvic floor during pregnancy (as one should be)!  Many first time moms incorporate lots of Kegel's into their exercise routine because that is the number one word most women associate with pelvic floor health. 

The purpose of a Kegel is to strengthen the pelvic floor muscles, which in turn, can help with issues like incontinence and prolapse.  That said, many first time mommas actually have a pelvic floor that is already fairly strong.  In that situation, if a women does dozens and dozens of Kegel contractions per day, you actually run the risk of creating too much tension in those muscles, which can contribute to difficulty birthing vaginally.  During delivery, the pelvic floor muscles need to lengthen and relax.  If the pelvic floor muscles are super tight and wound up, relaxing them can prove challenging for some.

I think it is incredibly important to be able to identify and isolate your pelvic floor muscles during pregnancy.  Engaging them correctly, followed by full relaxation and lengthening of those muscles, is just as important.  Picture doing a bicep curl.  You bend your elbow all the way up, contracting your muscle, and then you straighten your elbow fully, allowing that muscle to stretch out.  A pelvic floor contraction should be no different.  If you just emphasized the contract piece repeatedly, without fully lengthening your arm, I bet your bicep might start getting sore and angry at you!

If someone is having lots of pelvic pain and pressure, pelvic floor strengthening may not initially be indicated.  If someone is leaky, pelvic floor strengthening may also not be the first course of action.  That is why consulting with a physical therapist who specializes in pelvic floor health is so important.  A well versed PT can help you decide where to start.  For some, it will be emphasizing the lengthening and relaxation of the pelvic floor and for others, it will start with strengthening. 

As is often the case, the answer to this question is not straightforward!  At the end of the day, remember that a happy and healthy pelvic floor is one that is not only strong, but also flexible.