Traditional Kegel exercises, long recommended for improving pelvic floor function, may not be suitable for everyone and could potentially worsen symptoms for some individuals. Experts suggest that a technique known as reverse Kegels might offer a better alternative for those experiencing pelvic floor tightness.
Pelvic floor muscles act as a sling, supporting organs such as the bladder, reproductive organs, and intestines. While standard Kegels aim to strengthen these muscles, persistent tension from these exercises can lead to problems. Monica V. LoConti, a pelvic rehabilitation practitioner, noted that for individuals with existing tightness, strengthening exercises can exacerbate the issue, preventing the muscles from relaxing properly.
Symptoms of overactive pelvic floor muscles can include pain during urination, frequent urination, difficulty with bowel movements, pain during sexual activity, or challenges with orgasm. These symptoms can stem from various factors, including habitually holding urine or feces, prolonged sitting, stress, depression, and conditions like endometriosis. Pregnancy and childbirth can also cause trauma that affects muscle function, leading to either underactive or overactive pelvic floors.
While traditional Kegels are designed for hypotonic, or weak, pelvic muscles, reverse Kegels are recommended for hypertonic, or tight, pelvic floors. Identifying the specific condition of one's pelvic floor muscles typically requires a physical examination by a urogynecologist or urologist.
Performing a reverse Kegel involves a relaxation or exhalation motion, contrasting with the tightening or inhalation motion of a traditional Kegel. To execute a reverse Kegel, one first performs a standard Kegel by squeezing the muscles used to stop the flow of urine and gas, and for women, the vaginal muscles. Instead of holding this contraction, the user then releases the tension, exhaling and allowing the pelvic floor to relax outward. This is sometimes referred to as a "pelvic floor drop" or "down-training." LoConti suggests aiming for approximately 10 repetitions daily.