05/20/16

written by Kejal Macdonald

Body Banter

Ex-squeeze Me?

This is the third post in our ongoing series, written with the help of our resident Pelvic Protector, Lindsey Vestal. Lindsey runs the Functional Pelvis here in New York, and makes house calls to work with women in the comfort of their own homes.

Lindsey has taught us so much about the pelvic floor, but this week's convo had us (quite literally) floored. It turns out, there's more to Kegels than meets the thigh. 

When it comes to actual pelvic floor exercise, I feel like the only thing most women to do is a Kegel. Are Kegels all they're cracked up to be and should we all be doing them every day?

That’s a great question and I find most people’s general understanding of a Kegel is not exactly accurate. A Kegel is a pelvic floor muscle contraction and it should have two steps - the first should feel like closing or drawing the hip bones together. The second part should feel like lifting or drawing up and in. This is a description of a muscle in its flexed state. There are two other places these muscles should be able to access -- resting and elongation.

 

(Imagine two elevator doors closing then the elevator rising. With a cat inside, duh.)

When you’re not using these muscles, they should be at rest. The final place is elongation or relaxation. So a Kegel is one position (flexed) but you need to be able to access the full range of all three stages throughout your day, depending on what you need. You need the contraction for continence, and you need to access the elongation position for complete elimination. The rest position is vitally important so that you can go between the two positions anytime.

The answer to your second question is no, not every woman should be doing Kegels. You could be leaking if your muscles are stuck in elongation, or if your muscles are stuck in flexion. The idea is, you’re not able to access that full breadth and width of our muscles, regardless of which position you’re stuck in. So a Kegel is not a one-size-fits all. In fact, in therapy, I rarely talk about doing Kegels until several sessions in. There are so many other important things to talk about and address before you even get to Kegels.

Also, Kegels are not for everyone. Especially if you’re experiencing things like pelvic pain, or a sense of tightness down there. You need to rehab your floor like any other muscle in your body, which requires a full range of motion.

When I was pregnant the app that gave me weekly updates on the size of my fetus ala fruits and veggies also told that I should be doing Kegels every day. But based on what you’re telling me I’m questioning everything! Are Kegels even something women should be doing while pregnant?

A Kegel is something that’s great for women to do before they get pregnant. But when a woman is pregnant, we really want to think about what we can do to relax the pelvic floor, so that we can have an easier, less traumatic birth. When your pelvic floor is tight, you’re not accessing the full elasticity and potential of those muscles.

Ok, so you can do a Kegel for that contraction, but what are some ways women can focus on elongating and opening up those muscles as opposed to tightening them?

Elongation can be addressed many ways, but an easy way that women can begin is starting to relax some of the external muscles that are coming into our pelvic floor. Our inner thighs, outer thighs, hips and glutes are all muscular connection points to the pelvic floor, and you can start by releasing some of those external attachments. A really easy way to do this is with a foam roller, which you can do while you’re on the floor, watching TV or playing with your kids. It comes back to those 23 hours I mentioned earlier. What are you doing throughout your day (and not just in 1 hours of exercise) that can help you  connect you back to that pelvic floor? Those little moments we can sneak in are gold.

Next up: Exercises you can do at home to help restore your floor! (And yes, you can squeeze them in while watching Game of Thrones.)