Why do we ONLY think of KEGELS?
When I say pelvic floor therapy what do you think of? KEGELS! Yes, our culture only talks about strengthening the pelvic floor through kegels.
What if I was to say that very few people should be doing kegels!! That’s right, strength is not usually the issue that is causing leaking, pain, etc. So if you are doing vaginal weights or kegel video games I encourage you to throw them out, unless you are being followed by a pelvic floor therapist, and I will explain why in a minute.
In my practice I strive to help women feel strong, confident and functional in their bodies through a holistic pelvic floor therapy approach. This approach looks at 4 pillars of pelvic floor therapy: Biomechanics, Nervous system regulation, psychological, and emotional/social. I don’t want to just improve your leaking or pain through exercise, I want to improve how you functioning in your life.
So getting back to the kegels…
The pelvic floor has 3 functions: support, elimination and pleasure. To do all these functions well it needs strength, coordination and flexibility. Almost everyone thinks of strength hence the kegels that everyone seems to do for years.
But strength alone doesn’t do much unless you have coordination therefore I start all of my patients with coordinating their pelvic floor to their breath. I have more patients experience improved symptoms with learning breath work and coordinating their pelvic floor vs. just being able to hold a strong contraction.
Let's break this down. I want you to try to do a very strong kegel, what happens to your breath? Do you hold your breath? Could you hold that contraction while doing a functional task? Is your butt griping while you are trying to kegel? Do you feel increased core stability when you do a kegel?
Now I want you to focus on your breath. This sound weird but breathe all the way down into your pelvic floor on your inhale. If you put your hand on your vulva you should feel your pelvic floor drop down into your hand on your inhale. If have never thought about breathing in this way this may be very difficult for you. If you are able to feel your inhale and then notice that your pelvic floor naturally pulls up on your exhale. That is coordinating your pelvic floor with your breathing. Thinking about doing functional tasks or even running, if your pelvic floor naturally responded to your breathing. Do you see how it becomes naturally reactive? And over time will become second nature because it is working with your diaphragm?
A reactive pelvic floor means that it responds to sudden changes of pressure within your abdomen, for example when you sneeze, cough or laugh. I think we all can agree that is the golden ticket!
If you have the coordination piece down then you can add strength if needed. As you are exhaling and your pelvic floor is naturally coming up so then you just pull it up with a little more effort. See how simple that is?? This becomes something that you can do while you are driving, walking, sitting and watching tv. You no longer have to lay on the floor and think about doing kegels. HOORAY!
If you are someone that has a tight pelvic floor or pelvic pain I also want you to think about how breathing like this brings movement into the tissues of the pelvic floor which naturally will relax the pelvic floor and relieve symptoms. Like I said at the beginning of this article, very few people need to be doing strengthening, most people need coordination and then relaxation to get a well functioning pelvic floor.
This is seriously where I start all of my patients. If we don’t have breathing then it is impossible to get the the range of motion, coordination and strength you need to resolve your symptoms.
If you had a difficult time with these breathing exercises or if you are experience any pelvic floor symptoms I would love to be able to help you.
Also remember this is one only pillar of the 4 that makes up a holistic approach to pelvic floor therapy. Breathing doesn’t resolve everything, there is more to learn.
Best,
Kyrsten
