Pelvic floor physiotherapy seems to many to be a “new” thing and something we haven’t seen before. However in actual fact Dr. Arnold Kegel first described pelvic floor contractions that we now call “kegels” in 1948.

We have come a long way since then and current evidence tells us that Pelvic floor physiotherapy should be our first line of defence in urinary incontinence and pelvic organ prolapse. However we also know that Kegels are not always the best option; if there is an issue with tension in the pelvic floor there can be disfunction including incontinence and pain.

Continually strengthening a tight muscle simply works to exacerbate the issue – if your bicep was tight you would not continue to work in the strength, the same way you would not squeeze into a shirt that was too tight and uncomfortable.

So how will you know the difference? Truthfully your best option is to be assessed by a qualified professional, namely a pelvic floor physiotherapist, who has the specialist skill set to assess the muscles of the pelvic floor (internal assessments are a part of this) and diagnosis what is the cause of your problem and the most effective strategy for treatment.


  1.  Dumoulin, C; Hay-Smith, J (20 January 2010). “Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women”. The Cochrane database of systematic reviews (1): CD005654. doi:10.1002/14651858.CD005654.pub2PMID 20091581.
  2. Jump up^ Hagen, S; Stark, D (7 December 2011). “Conservative prevention and management of pelvic organ prolapse in women”. The Cochrane database of systematic reviews (12): CD003882. doi:10.1002/14651858.CD003882.pub4PMID 22161382.
  3. Jump up^ Kegel AH (1948). “The nonsurgical treatment of genital relaxation; use of the perineometer as an aid in restoring anatomic and functional structure”. Ann West Med Surg. 2 (5): 213–6. PMID 18860416.