To Kegel or Not to Kegel?
The History of the Kegel
Let’s start with the term, “Kegel.” Dr. Arnold Kegel, a USC OBGYN, was the first to publish (note I didn’t say discover, only publish) a non-surgical “treatment” for urinary incontinence for those recovering from vaginal childbirth in 1948. And like most White Men in our violent gynecological history, he proceeded to name the exercise after himself. ** I will share more about gynecologic history in a later post.
What is a Kegel?
Presently, the average American (60-90% of American women) have heard of “kegels,” as the exercise of “squeezing your ‘pelvic floor’ muscles in order to strengthen ‘down there.’” Pelvic Physical Therapists, OBGYNs, and Urogynecologists have gone on to study the now thousands of published research, including high quality studies, validating that exercises of the pelvic muscles does in-fact improve leakage of urine, pelvic organ prolapse, pelvic pain, back pain, pubic symphasis dysfunction, posture, rectal function, and sexual functions.
Kegels Aren’t a One-Size-Fits-All
We now know that these muscles behave similarly to other muscles under conscious control in the body. They need not only strength, but also, mobility, motor control, endurance, coordination, quick response-time, power, eccentric lengthening, and the ability to fully relax.
The stand instruction that came with Kegels, of “just squeeze your muscles,” is reductive, and doesn’t begin to include all the subtle needs of this vast network of connective tissue (fascia), muscles (there are 3 layers!), nerves, organs, ligaments, and tendons.
Kegels Can Be Harmful
I’m sure you have read Pelvic specialists now trying to correct this understanding of kegels by warning against the idea that kegels are right for everyone. And it’s true— here are some examples of when kegels can be harmful:
With Unexplained Pelvic Pain
With Nerve Entrapment or Nerve Injury
With Upper Motor Neuron Hypertonicity like with Cerebral Palsy
With a generalized more Sympathetic Nervous System— like if there is a baseline tendency towards clenching the pelvis, jaw, and breath.
With Pelvic Trauma
So Where Does That Leave Me? Should I do Kegels or Not?
I understand this can feel like a dilemma— and can make anyone overwhelmed. Just like what foods you body needs, how much water your body needs, how much sleep your body needs, what kind of movements your body likes and needs are all unique to you— same goes for pelvic exercises.
A good place to start, is with curiousity around your pelvis. Do you have a strong sense of where you pelvis is in relationship to your hips? How about to your back? Do you sense the difference between the front of your pelvis (where you pee from) to the back of your pelvis (where you poo from)? **For anyone using colostomy bag, or bladder bag, you can just imagine the front of your pelvis by the pubic bone and the back of the pelvis by the tailbone.
Next, check in with your breath. When you breathe IN, do you feel your breath travel to your chest? Your belly? Your back? Your pelvis? When you breathe OUT, do you feelt your pelvis relax?
When Trauma is Present…
Trauma can keep the nervous system feeling numb, empty, separate from, avoidant, ambivilant, pain, or tense in the pelvis. It can be hard to even pay attention to the breath let alone, the pelvis. If this feels like it might be you, I first offer you compassion. Healing will need to move slow, but help is available. Pelvic exercises likely need to start with brain, and grounding exercises. If you’re interested in learning more, consider 1:1 sessions with Dr. Grace.
Pelvic Exercises—
You will notice, in future blog posts, on my website, and in-person, I always refer to pelvic exercises as Pelvic Exercises and no longer use the term Kegel. This is in an effort to reclaim the spectrum of care that is needed for such a complex part of our bodies. If you are interested in learning more about pelvic exercises, keep an eye out for my membership library that will be coming Summer of 2026! I will include easy, follow-along videos to explore and learn about your own pelvis and what it might need.