To Kegel or not to Kegel?

There is a big debate about kegels in the world of fitness. Should we be doing them, should we not be doing them, and what are they.

Let’s start with what they are: a kegel is a pelvic floor contraction. Just like you contract your arm to show off / flex your bicep, you can also contract your pelvic floor, which is just a group of muscles at the base of your pelvis. The name “kegel” came from the guy who “invented them” - Dr. Arnold Kegel. There is no way he “invented them” as our pelvic floor automatically contracts and relaxes and works with the rest of our body all day long to keep our insides in and keep us standing upright. He just put a name to it.

So let’s stick with calling them a pelvic floor contraction.

Here is an image of the pelvic floor muscles. They like a sling at the bottom of your pelvis. They’re really awesome. They support your internal organs, have holes in them that allow for the rectum, vagina, and urethra to pass through, contribute to sex and the orgasm, and they help us breathe, stand and move.

So let’s take care of them!

Now onto the next question: should I be doing them or avoiding them?

The short answer is I don’t really recommend just doing isolated pelvic floor contractions for pelvic floor strength unless you have a pelvic physical therapist that tells you it’s what you need.

Let’s start this topic by talking about muscle contractions and muscle strength. If you wanted to get stronger biceps, you would do bicep curls, right? With a bicep curl, your arm is fully extending and then contracting and flexing - in other words you’re moving it through it’s full range of motion under load. What you probably wouldn’t do is flex your arm and hold it there for 30 seconds.

So maybe contacting our pelvic floor for 30 seconds (or even worse for 200 reps, which is what I was recommended after the birth of my first child), isn’t the best strategy for gaining strength.

The best strategy for improving pelvic floor strength is a 3 step process:

1. Learn to feel and coordinate your pelvic floor muscles. Start with diaphragmatic breathing (see This Blog Post for more information on that). During a normal breath cycle, the pelvic floor will work through a contraction on the exhale and a relaxation on the inhale). Get comfortable with what both of these motions feel like.

2. Make sure you are able to contract and relax ALL of your pelvic floor. If you really focus on different areas of your pelvic floor (the back where your anus is vs the middle where your perinium and back of your vaginal opening are, or the front where your urethra is), can you feel all of them contract and relax? You might need the help of a pelvic PT to really understand this!

3. Combine that muscle coordination with strength exercises. Start simple on the floor with things like dead bugs (I’ll share a deadbug progression below), and slowly progress to higher level strength exercises like squatting, sprinting, lunging, etc. By putting your body under load and focusing on coordinated breathing, you will be strengthening your pelvic floor.
   

Go see a pelvic floor physical therapist.

If you have never seen a pelvic floor physical therapist before, this is your sign to go see one. They can help you understand how to *properly* perform a pelvic floor contraction and then coordinate that with movement of the rest of your body. They can determine your pelvic floor strength and help you come up with a plan this is right for you.

Then come find me so I can help you get strong while remaining connected to the super awesome muscles that make up your pelvic floor.

And most importantly of all; let’s please stop pretending we don’t have pelvic floors or avoiding the topic because it feels taboo. Our pelvic floor muscles are WAY TOO IMPORTANT for our overall health and wellness to ignore.

I ran a “Better than Kegels” workshop on May 15, 2024 & it’s available for download now.

You can always message me at @postpartumstrength on instagram or e-mail me at ellen@functionalempowerefitness.com!