To Kegel or Not To Kegel–that’s the question you may be asking yourself. If you’re reading this, chances are you have been told to do Kegels (pelvic floor muscle contractions) following prostate surgery, prostatectomy, or even to improve sexual function. But do they work? The short answer: not usually.
Let’s get straight to it: For some men, Kegels DO work. If that’s you, fabulous! Keep it up. On the other hand, you may be doing Kegels now and they’re not working. Or you may be preparing for prostatectomy and wondering if Kegels are really the magic answer. For many men, they do not deliver the results. Here’s why:
Kegels are only about strength. But there’s a lot more involved than just strengthening the pelvic floor muscles when you’re talking about bladder control or sexual function. After prostatectomy, the prostate is no longer there. In its absence, the pelvic floor now has to assume a “new identity” as the main structure to maintain bladder control. You really need to retrain it in a more complex way than just doing Kegels. The muscles need to be able to contract, relax, stretch, and coordinate with other muscles. If you are only practicing contractions (aka Kegel exercises) then you are missing the boat.
Your pelvic floor muscles might actually be too tight. This problem, called pelvic floor hypertonicity, happens more often than you would think. Holding tension, “power peeing”, pain, or poor sitting habits can all contribute to this problem. In this case, Kegel exercises could make the problem worse!
Most men are given no training or guidance on how to do a Kegel.Going into the doctor’s office, and then getting a pamphlet, or maybe a few words amongst a long list of post-op instructions does not help you learn how to activate those muscles. It does not help retrain the diaphragm, pelvic floor and deep abdominals to work together as a system.
It’s kind of like learning how to play golf by reading a brochure about it. How effective would that be?
I harp on this because probably 99% of the men who come here to our practice for treatment have been doing Kegels (some for over a year), and we find out that they’re exercising every single muscle BUT the pelvic floor!
So what do you do now if this sounds like you? Partnering with a pelvic physical therapist is your best next step. We can help you retrain your pelvic floor, get your bladder, bowel and sexual function back, and get back to enjoying the activities you love — without leaking.
Yes, it is possible to go beyond Kegels. In fact, we recommend it! Even if you’ve been doing Kegels for a while and haven’t gotten any results, there is still hope to get that bladder control back. What have you got to lose-except for a drawer full of Depends?