Why Kegels aren’t always the answer!
When I was pregnant I remember being told by numerous people, friends and professionals, including my midwife, a personal trainer and even the lecturer on the personal training pre and post natal specialist course I did to make sure whatever happened during my pregnancy and afterwards I “DO MY KEGELS!”
From talking to friends who have had children, some don’t seem to even be told that?! Is this really the most appropriate advice we can give pregnant and post natal women? Is this the best we can come up with?
What does a kegel look/feel like? A common explanation is a tightening or drawing up of the pelvic floor. Like you are stopping the flow of urine.
Yes, you do need a strong pelvic floor! BUT, KEGELS BY THEMSELVES may not fix your pelvic floor issues and build the optimal pelvic floor strength that’s needed, although these muscles do need to be strong.
The pelvic floor is designed to function with the body and does not learn how to function optimally by doing kegels alone. We must teach your pelvic floor how to function with your diaphragm, hip rotators, accept outside forces and handle internal forces.
Your pelvic floor is a hammock-like sling of muscles that supports the weight of your pelvic organs. Without pelvic floor strength, you are at an increased risk of SI (sacroiliac) joint pain, lower back pain and hip pain.
What a lot of women don’t realise, if done incorrectly, Kegels could be doing more harm than good. A lot of women who try to do them end up bearing down on their pelvic floor instead or simply squeezing the wrong muscles.
An important part of doing a kegel is actually the relaxing after the contraction. Fully letting go of your pelvic floor is critical for getting a great contraction. If you hold a low level of tension all the time (some people have tight pelvic floors for instance), the muscle cannot relax or lengthen properly, and so it cannot properly contract. This is what can cause leaks as the bladder outlet and back passage can’t close fully when you cough, sneeze or exercise so urine, faeces or wind could leak out.
Furthermore, should Kegels be practiced as an exercise alone? The problem with doing this could be that doing a kegel then works only when you are thinking about it, yet most pelvic floor issues happen when you’re not thinking about it like a sneeze, cough, jump etc. They need to be a natural part of your everyday movements.
Really, the pelvic floor needs to be able to relax and contract in time with the other structures around it. To do this you need to incorporate them into other exercises focusing on diaphragm timing.
I address the following key points with my clients to lay the foundation for better breathing and pelvic floor health.
For good alignment I like to see a tall upper body, a neutral spine and good hip alignment. A gentle arch in the lower back (no bum tucking or constant squeezing of the glutes). The ribs stacked over the hips and good head alignment.
For good breathing I like to see my clients inhale to inflate the trunk and exhale to deflate the trunk. I discourage my clients from engaging their abs constantly, but allow them to release and rebound with the breathing pattern.
For good core and floor connection I teach my clients to imagine lifting their vagina and anus up gently into their body on exhale and to gently release on inhale. Whilst ensuring their alignment and breathing are as mentioned above.
Ensure these simple things are done on a daily basis for everyday activities. It gives the body the best chance of optimal pelvic floor function integrated within an efficient system. Therefore everything is working in response to everything else. Which in turn helps alleviate aches and pains. Not only in your core and pelvic floor but also in your back, shoulders and neck as well.
It is important to do this regularly to maintain good strength, whether or not you have bladder or bowel problems. It’s not only women who are pregnant or who have had vaginal deliveries who will benefit. A longstanding cough, constipation and repeated heavy lifting can also weaken your pelvic floor muscles. So men as well as women can and do benefit from applying these same techniques. As you age your muscle tissues become even weaker and the problem may become worse. There is no age restriction on working on your pelvic floor muscles and you should see results, whatever your age.
Note: Appropriate kegels with good alignment, breathing and core and floor connection can be effective for some. For example those who have a pelvic floor that needs strengthening and re-toning (often later in pregnancy and early postpartum). Please check with your pelvic floor or women’s health physiotherapist to be sure.