TO KEGEL OR NOT TO KEGEL?
Updated: Feb 10, 2022
The number one recommendation pregnant and postpartum women receive is to do their kegels, exercises to strengthen the pelvic floor.
The pelvic floor (PF) is the hammock that supports the body’s internal organs and provide control, sexual function and stability to the pelvis and spine. One in three women will experience some form of PF weakness. Hence learning how and when to properly engage and release those muscles can help avoid any unnecessary discomfort such as leaking, bulging or pain when lifting heavy objects (or your baby), coughing or laughing. For example, you want to exhale and lift your PF when picking up baby, coughing or laughing as demonstrated in the below diagram.
The Pelvic Floor is part of the deeper core system and works in coordination with the other core muscles like the diaphragm and transverse abdominis (see below diagram), our deepest core muscles, to manage abdominal pressure and help you move safely and comfortably whether during exercise or most importantly during day to day activities. Hence why isolating the pelvic floor with Kegel exercises may not solve or prevent the problem. Please refer to our blog post “360 breathing and pelvic floor” for more information on connecting PF to your breath and the different types of exercises to get the most out of your effort.
A strong muscle is one that can fully relax in order to generate a stronger contraction. If you are constantly contracting even subconsciously, which is usually the case, and thus unable to fully relax the muscles, you are decreasing the strength of the contraction when you do try to fire it up. The PF muscles are no exception yet the first thing that comes to mind when someone says you need to strengthen your PF is “kegels!” and just like that we contract and engage, but do we give the release the same attention? Do you focus on one part of the exercise?
What causes tightness in the pelvic floor?
Although there is no one defining cause there are several factors that can lead to a hypertonic PF:
Lack of abdominal control due to stretching out of the abdominal muscles during pregnancy.
Birth trauma. If you have experienced perineal or vaginal tearing the pain or the scarring can cause the PF to tighten protectively.
Lack of glute strength. This can be caused by the modern lifestyle that involves a lot sitting, causing the glutes to shut down.
High levels of stress, fear or anxiety can lead to the PF to reflexively tighten. Our flight or fight hormone actually causes our tailbone to tuck under causing the PF to shorten!
Being overweight or unfit in general.
Constant tension from over exercising ie holding onto core muscles to keep them switched “on”.
History of holding it in, ie if you are not comfortable using a public toilet.
In summary, If you don’t have effectiveness at the top or in the glutes, the bottom ie the PF starts working overtime to compensate for the lack of support from surrounding muscles.
How to release the pelvic floor through breath, massage and movement
Relax the pelvic floor through the breath.
Find yourself in a wide legged child’s pose. With every inhale focus on completely relaxing the PF. If you are quite tight, it may take a few breaths to fully relax.
2. Hold the pelvic floor muscles in a lengthened stretch position
Our favorites include Baby Pose and Deep squat. For the latter, you can support yourself on a block as shown or lean against a wall if you are finding it difficult to relax in this position. Stay here for an extended period of time focusing on stretching the muscles surrounding the PF and further releasing with every inhale.
3. Massage the Pelvic Floor.
Start with a bigger and softer ball if really you are really tight. Find your sit bones and place the ball inside either side of the PF musculature. Roll towards the coccyx, the opposite side and the front. You may notice one side tighter. You can also keep the ball still and focus on relaxing in one position. In the below video we are using the Rad Roller Center. If you feel you need a deeper release you can use a smaller, harder ball, sit on a chair and place it on the perineum between the vagina and anus. Breath.
4. Release the deep rotators of the hip
This includes includes t