Why Kegels Don’t Always Fix Stress Incontinence

January 24, 2022

Stress incontinence is when urine leaks while performing an action or activity. This can happen for many different reasons and here’s a hint: it’s not always weakness! There are three main factors that can be happening at the pelvic floor to cause stress incontinence: weakness, increased muscle tone, or lack of coordination. 

Weakness can result after any injury or trauma to the pelvic floor, or just over time from dysfunctional movement patterns. If there is a lack of strength at the pelvic floor, that means there is not enough tension to combat pressures (i.e. sneezing, coughing, laughing, jumping) throughout the day to keep from leaking urine.

Think of increased tone as a muscle in a contracted state at baseline; it is holding tension before it even contracts. Now think of the pelvis, the muscles that fit in between your tailbone and the pubic bone are mighty, but small nonetheless. So if they are already contracted there’s not a lot of extra strength to help stop urine from leaking with increased abdominal pressure. 

When there is lack of coordination of the pelvic floor muscles, it means they are contracting when they should be relaxing, and vice versa. Our pelvic floor muscles should lightly contract to stop urine from escaping when we sneeze, but if they are relaxing then it is just reinforcing the problem. 

The pelvic floor muscles are tricky. It’s not a part of the body that gets talked about a lot. And unfortunately we don’t know what we don’t know. This is why Kegels aren’t always the answer. As you can see from above, doing 100 Kegels a day would only maybe help weakness. Getting evaluated by a pelvic floor therapist is a must to figure out the root cause, so you can continue enjoying your activities without leaking!

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Dr. Kristine Godsil

Center Director | Physical Therapist
Kristine Godsil is a Doctor of Physical Therapy practicing in sports, general orthopedics, pediatrics, and pelvic health. She works at Activcore in Denver, Colorado, located just one mile from the popular Cherry Creek Shopping District.
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