Do you kegel?

Pelvic floor health is on the rise, as is perinatal fitness, so how do the two go hand-in-hand? Pregnancy and childbirth can strain your PF muscles and if left unconditioned during this time of your life can lead to complicated and embarrassing issues down the road.

Let’s get personal here. “Do you kegel?” If you answered yes, fantastic, and I’ll follow up with, “How often?” If you answered no, then pay attention. Kegels play an important role in developing pelvic floor strength which is vital to a woman’s health, but especially women who are pregnant or have given birth.

What is the Pelvic Floor?

Your pelvic floor is a collection of muscles, connective tissues, and ligaments located at the base of the pelvis and stretch from your pubic bone to your tailbone and span side to side to the sit bones. If you’re more of a visual person, imagine a sling or a hammock. These muscles are considered part of the “core” and work in conjunction with the transverse abdominals, diaphragm, and multifidus (deep back muscles) to stabilize the spine.

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What purpose do they serve?

The pelvic floor muscles support your internal pelvic organs (bladder, bowel, and uterus), control your sensitivity during sex, assist in regulating abdominal pressure when exercising, and during pregnancy assist in labor and delivery.

Clearly, these not so sexy yet strong muscles are hidden inside your body and not exposed for the world to see, therefore, they are often neglected and overlooked when it comes to strengthening them with exercises. So why should you train them?

Remember that sling? Picture it nice and tight and then start to add items on top of it like pregnancy weight gain, a growing uterus and the increased weight and pressure on the PF muscles, the hormone relaxin, and then there is the actual act of giving birth. During labor and delivery, you require entire body strength, stamina, and endurance, but pushing out a baby is also incredibly taxing on your pelvic floor muscles since they are stretched to the max to help baby exit the womb. All these elements weigh down the sling, aka the pelvic floor, and cause the muscles to become overstretched and weak. A weakened pelvic floor can lead to health issues like urinary and fecal incontinence, prolapse, chronic pain and even sexual disfunction. (Say What…?)

Expecting and new Mommas benefit from pelvic floor exercises, otherwise known as kegel exercises, because they help prevent urinary incontinence that commonly happens in the third trimester and life postpartum. In fact, up to two-thirds of women experience this issue during their pregnant and postpartum life.

Postpartum ladies, if you’re reading this and you had a C-section, don’t think this won’t affect you because you didn’t push. Surgery and pregnancy can weaken the muscles as well so you should be doing these too.

How do you perform a Kegel?

First, find your pelvic floor muscles. To do so, you'll want to squeeze both front and back (vaginal and anus) as if you were trying to stop the flow of urine or passing gas. Go ahead and try it. Seriously. Did you do it? Was it successful? Fantastic, you found them! 

Now that you found the muscles think about the actual technique.To properly master the kegel, you need to know it's a two-part process. Thinking about squeezing and then lifting the muscles up all while maintaining a normal breath. As you do this, some tensing of the lower abdominals will occur and that’s okay, but you don’t want your upper abdominals or glutes to tighten as well. If that happens, change from your seated position to lying on your back or standing. This will help you focus on properly engaging the PF muscles.

Another thing to keep in mind is your breath. When you perform a kegel, you’re engaging your PF muscles, your transverse abdominals activate and draw in, and breathing should remain normal. If you suck in your stomach and hold your breath you aren’t properly performing the exercise.

TIP: One mistake people often make is that they squeeze their glutes when they perform a kegel. Remember, a proper kegel is the contraction of the pelvic floor muscles (vagina and anus at the same time) and not the glutes.

Now let’s get to the exercises. Here are three ways you can strengthen your pelvic floor.

1. Strength (Slow Contractions): Squeeze the muscles and hold for 5-10 seconds. Gently release. Repeat for 3 sets of 15. At first it will be hard to hold the muscles for 10 seconds so start with 3-5 seconds and as your muscles get stronger hold the squeeze longer.
2. Endurance (Fast Contractions): This is a squeeze and release method, quickly pulsating the muscles for an endurance exercise. Squeeze, hold for 1 ct. release and repeat again. Do 3 sets of 15.
3. The Elevator – Just like the name of the exercise, squeeze your pelvic floor muscles and think about lifting them up to the highest level in your pelvis. Slowly release (and lower) your muscles as if you are making a stop at two to three floors as you descend.

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Try to perform these exercises every day – aim for about 80. Sounds like a lot, it can be so just pick two variations of the exercises and make the effort to get them in; even if it means breaking them up throughout the day. After you mastered the technique, you can easily do these when you’re cooking, showering, driving, working at your desk, or even scrolling through your Instagram.

Like any exercise, however, you need to perform them properly in order to see (or in this case, feel) the benefits. If you’re unsure about kegels or you’re experiencing incontinence, pain when you exercise or during intercourse, or have difficulty emptying your bladder or bowels, I highly recommend seeking help from a pelvic floor therapist. They’ll perform an internal exam, provide exercises that are tailored to your needs, and give insights into other treatment methods depending on your situation.

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Resources:

Pelvic Floor First of Australia (www.pelvicfloorfirst.org.au) - An incredible website dedicated to women’s health and they provide a wealth of information on the pelvic floor, signs of issues, who’s at risk, and how it relates to exercise.