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Did you know all those kegels you're doing might actually be doing you more harm than good? It's time to dive deep into the world of pelvic floor health and discover why kegels aren't always the answer. In this comprehensive guide, we'll explore the common misconceptions about pelvic floor exercises, the symptoms of a weak pelvic floor, and the best exercises to strengthen this crucial group of muscles.

Understanding Your Pelvic Floor

Before we jump into exercises, let's understand what the pelvic floor actually is. The pelvic floor is a group of muscles that form a hammock-like structure at the base of your pelvis. These layers of muscle stretch from your pubic bone to your tailbone, supporting your pelvic organs, including the bladder, uterus, and rectum. They play a crucial role in bladder and bowel control, sexual function, and overall core stability.

The pelvic floor works in coordination with your abdominal muscles, back muscles, and diaphragm to maintain proper posture and support your spine. When functioning correctly, these muscles contract and relax as needed, allowing for proper bladder and bowel function, as well as enjoyable sexual intercourse.

Common Signs of a Weak Pelvic Floor

Recognizing the symptoms of a weak pelvic floor is the first step towards addressing the issue. Pelvic floor disorders can affect women of all ages, though they become more common after childbirth and as we age. (Actually, fun fact--pelvic floor dysfunction can happen to men, too! WE ALL HAVE A PELVIC FLOOR!) Here are some common signs to watch out for:

1. Urinary incontinence (loss of bladder control)
2. Frequent urge to urinate or overactive bladder
3. Difficulty emptying your bladder completely
4. Fecal incontinence or difficulty controlling bowel movements
5. Pelvic organ prolapse (a heavy feeling or bulge in the vagina or rectum)
6. Lower back pain
7. Painful sex or decreased sexual sensation
8. Difficulty with physical activity or daily activities
9. Chronic pelvic pain or discomfort
10. Painful urination

If you're experiencing any of these symptoms, it's essential to consult with a healthcare provider or a pelvic health physiotherapist for a proper diagnosis and treatment plan. They may perform a physical exam, including an internal pelvic exam, and take your medical history to determine the best course of action.

The Kegel Conundrum

To kegel or not to kegel?? That is the question...! For years, kegel exercises have been touted as the go-to solution for pelvic floor problems. However, there's more to the story. Here's why kegels might not be the best treatment for everyone:

1. Incorrect technique: Many people perform kegels incorrectly, pushing down rather than lifting up and in. This can actually make your pelvic floor dysfunction worse!
2. Overactive pelvic floor: Some individuals already have tight pelvic floor muscles, and more kegels can exacerbate the problem. This can lead to muscle spasms, pain, and even sexual dysfunction.
3. Neglecting relaxation: Proper muscle function requires both contraction and relaxation. Focusing solely on tightening can lead to muscle imbalances and pelvic floor dysfunction.
4. Not engaging the correct muscles: A lot of people end up squeezing their glutes or inner thighs when they're trying to isolate the pelvic floor.

The good news is that there are various pelvic floor exercises and techniques that can help strengthen and balance your pelvic floor muscles. The key is to focus on both strengthening and relaxing these important muscles.

Effective Pelvic Floor Exercises

1. Diaphragmatic Breathing

Believe it or not, proper breathing is crucial for pelvic floor health. Diaphragmatic breathing helps coordinate your core muscles, including your pelvic floor.

How to do it:

• Sit upright with your shoulders over ribs, ribs over pelvis. You might want to actually lean forward ever so slightly to ensure you're not sticking out your tail.
• As you inhale, envision your diaphragm expanding down into your abdomen, like an umbrella opening upside-down.
• Exhale as the diaphragm recoils back up and in.
• Make sure your belly is not expanding as you breathe. Instead, you should feel expansion across your rib cage in 360º all the way around.
• Practice for 5-10 minutes daily.

2. The Deep Squat (Malasana)

Squats are an excellent exercise for overall pelvic floor strength and function. They help bring attention to your pelvic floor as you breathe deeply.

NOTE: If you're dealing with prolapse symptoms and are new to pelvic floor breathing, do NOT practice the deep squat until you feel comfortable doing so.

How to do it:

• Stand with your feet a little wider than hip-width apart.
• Slowly lower your body all the way down until your hips are just floating off the floor.
• If your heels rise up, roll up a blanket or towel to tuck under them. We want the feet and legs to be as free of tension as possible.
• Now, breathe deeply, imagining the breath going down into your pelvic floor--you might even feel it down there! (That's a good thing, as long as you're not adding pressure.)
• Keep your chest up and your weight in your heels.
• Hold for a few breaths, then slowly rise back up.

3. Bridge Pose

This exercise engages your pelvic floor muscles along with your glutes and core. It's great for improving pelvic stability and strength.

How to do it:

• Lie on your back with your knees bent and feet flat on the floor.
• Lift your hips off the ground, squeezing your glutes.
• Hold for 5-10 seconds, then lower back down.
• Repeat for 10-15 repetitions.

4. Happy Baby Pose

This yoga pose helps stretch and relax tight pelvic floor muscles. It's particularly beneficial if you have an overactive or tense pelvic floor.

How to do it:

• Lie on your back and bring your knees toward your chest.
• Grab the outside of your feet with your hands.
• Gently pull your knees toward your armpits. Think of uncurling your tailbone toward the floor.
• Hold for 30 seconds to 1 minute, breathing deeply.

5. Pelvic Floor Breaths (Modified Kegels)

When done correctly, pelvic floor contractions can be beneficial. The key is to focus on both contraction and relaxation.

How to do it:

• Sit or lie in a comfortable position.
• Imagine you're trying to stop the flow of urine and hold in gas simultaneously.
• Inhale deeply, allowing the ribcage (not belly!) to expand.
• Exhale as you gently lift and squeeze these muscles for 3-5 seconds.
• Inhale as you fully relax for 5-10 seconds.
• Repeat 5 times, 2 times a day.

Remember, it's crucial to fully relax between contractions. If you feel any pain or discomfort, stop the exercise and consult a healthcare provider.

Lifestyle Factors for Pelvic Floor Health

In addition to exercises, certain lifestyle changes can support pelvic floor health:

1. Maintain a healthy weight: Excess weight can put additional pressure on your pelvic floor muscles.
2. Stay hydrated: Proper hydration helps prevent constipation, which can strain your pelvic floor.
3. Practice good posture: Proper alignment helps you take the deep breaths you need in order to get your core and pelvic floor functioning optimally!
4. Learn the right way to lift heavy: If you're lifting heavy objects or children (!), use proper technique and engage your core muscles. Exhale as you exert force!
5. Manage chronic constipation: Straining during bowel movements can weaken your pelvic floor over time.
6. Quit smoking: Smoking can lead to chronic coughing, which puts stress on the pelvic floor.
7. Avoid high-impact exercises if you have pelvic floor issues: Instead, opt for low-impact activities like swimming or cycling until you've learned to manage your core pressure and pelvic floor symptoms.

When to Seek Professional Help

While these exercises can be beneficial, it's important to consult a healthcare provider or pelvic health physiotherapist if you're pregnant, and especially if you're experiencing pelvic floor issues. They can perform a thorough assessment, including a physical exam to determine the best treatment plan for your specific needs.

A pelvic floor specialist can also ensure you're performing exercises correctly and can give you personalized techniques and feedback based on your unique situation. If you're on the lookout for a pelvic health physical therapist online or near you, check out my free resource list where I have a bunch of PTs listed.

And let me be clear: I think ALL women in pregnancy and postpartum should attend pelvic floor physical therapy. This specialized form of treatment can help prevent, identify, and address a wide range of pelvic floor disorders and provide significant improvement in symptoms.

Conclusion

A healthy pelvic floor is crucial for women of all ages, impacting everything from bladder and bowel control to sexual function and overall quality of life. By understanding the complexities of pelvic floor health and incorporating appropriate exercises and lifestyle changes, you can take significant steps towards improving or maintaining your pelvic floor strength.

Remember, every woman's journey is unique. What works for one person may not work for another. Be patient with your body, listen to its signals, and don't hesitate to seek professional help when needed. Pelvic floor disorders are common, but they're not a normal or inevitable part of aging or motherhood.

With the right approach, which may include a combination of exercises, lifestyle modifications, and professional treatment, you can achieve a strong, balanced pelvic floor. This can lead to improved bladder and bowel control, enhanced sexual function, reduced pain, and an overall better quality of life.

Here's to strong, balanced pelvic floors and a life free from the constraints of pelvic floor dysfunction!

If you'd like to learn more about how the core and pelvic floor works in pregnancy / postpartum and practice proper pelvic floor exercises with me, check out my Mama Core Workshop.