Integrating Japanese Eastern medicine with Western medicine.

Hi my name is Nidhi Sharma.

I am a Women’s health physical therapist here at FuncPhysio  physical therapy.

Today I’m answering one of the most common question asked by my patients. If I’m leaking, do I need to Kegel’s. Or Is Kegel’s exercise is good if you are leaking.

So to answer this question we have to dive a little bit deeper into why you leak and what our Kegel’s exercise supposed to do.

Are kegels always good if you’re leaking ?

If you look inside there is the bladder. And when we take these organs out. There is the pelvic floor.

OK. It looks like a big sling of a muscle inside. So what it basically does is when there is increased. Sac

When there’s increased pressure on the bladder because you cough or sneeze or jump the bladder gets squeezed a little.

That pressure gets translated to the pelvic floor at which point the pelvic floor should contract and fight the pressure coming from the top so that it can keep keep the urine end.

you feel unable to do that. If you’re unable to contract and fight the pressure you can leak. So yes when the pelvic floor is not functioning well, You need to make the function better and that will help you in leaking. But sometimes the Muscle is Weak But more than that it is tight.

I’m going to try to explain that with a different example. So it’s a little bit clearer. So let’s say this is your bicep, right and you’re trying to lift 20 pounds.

If you cannot lift 20 pounds what will we do we’ll tell you you have to try to lift slowly eight pounds a bunch of times and nine pounds and over a period of time you’ll get enough strength in the biceps to lift 10 pounds.

Yes. So you need strengthening. But what if. What if your bicep cannot even straighten. What if your bicep is stuck in this position is so tight that it’s keeping your arm here so it cannot even go straight and then come back to lift 20 pounds or 10 pounds.

This is often the situation with many women who are either over trained to do the pelvic floor or were always holding tension and keeping their pelvic floor tight because they’re able to create that tension to create  the pelvic floor tight.

They sometimes they lose the ability to let the muscles relax to let the muscles stretch every muscle in the body has two phases to it it needs to be able to contract and be able to relax or stretch.

Contractility and flexibility are both needed for the function of a muscle. So a lot of times women especially women who are at active athletic, dancers, and swimmers.

Very high intensity weightlifters they sometimes don’t have weakness of their big floor but they have tightness of their pelvic floor and their pelvic floor orbit is holding like this.

So it cannot do the function of lifting the bladder up keeping it supported and they tried to add more key goals on top of it and get even tighter sometimes making the leak worse.

So, to answer to your question is no all the time leaking is not related to pelvic floor weakness you sometimes leaking is related to pelvic floor tightness or sometimes it is related to poor coordination of the pelvic floor.

So. You first need to get diagnosed why you are leaking. If you’re leaking because you’re weak then Kegel’s and all things pelvic floor strengthening will help.

But if you’re leaking because of tightness you need to do some flexibility work you might need to get some internal work done to get flexibility in that muscle before you start to strengthen it.

And if you try to strengthen it before that you tightness your symptoms can get worse.

So hopefully that answers your question if you have leaking go do a pelvic floor physical therapies and first get diagnosed first get properly assessed to find out why you’re taking.

Thank you

Dr. Nidhi Sharma, Board Certified Women’s Health Specialist