To Kegel or not Kegel?

To achieve optimum function of your pelvic floor, it has to have the ability to;

  1. Contract fully
  2. Relax fully
  3. Contract at the correct time
  4. Relax at the correct time

It is pretty difficult to decide whether you’re able to do all of the above, especially if you aren’t fully aware of how those pelvic floor muscles do their thing. It is easiest and best to have your pelvic function assessed by a pelvic floor physiotherapist. It is especially helpful if you are experiencing any pelvic dysfunction symptoms or if you are early postpartum or are peri/post-menopausal. This way you will be sure as to the condition of your muscles and understand the exercises appropriate for you.

Are they tight or relaxed?

Once assessed, we will determine if your pelvic floor is too hypertonic (short and tight) or hypotonic (relaxed/lax). These two presentations do not necessarily relate to strength and you will be surprised to know that most patients present with tight yet weak pelvic floors. Take a look at the first post to check in with what pelvic floor dysfunction entails.

In addition to the impact of how tight or lax your pelvic floor is, when determining appropriate pelvic floor muscle training (PFMT), it is important that you take into consideration all aspects of the abdominopelvic region or ‘functional unit’. This includes; starting from the bottom, the pelvic floor, moving forward and up, the abdominal wall (Transversus Abdominus – TrA), the respiratory diaphragm at the top and the multifidus muscles at the back.

Pelvic floor kegel

IMAGE ADDRESS

You may have noticed that these muscles form a continuous loop, or a’unit’, as seen in the image, which makes it clear that one area would affect another. It is therefore essential that you take care of symptoms such as; lower back pain, sciatica, rectus diastasis, poor breathing patterns or cesarean scar adhesions if you wish to affectively treat the pelvic floor.

 

Balanced Strength

A majority of patients require ‘downtraining’ to relax and release the pelvic floor before strengthening begins.

 

Downtraining/Reverse Kegel

Requires great breathing patterns.

  1. Lying or sitting, place one hand on your ribs and the other on your stomach.
  2. Inhale, allow ribs to expand and belly to rise naturally. Do not push it out!
  3. Exhale and relax.
  4. Inhale, bring your attention to your pelvic floor you may feel a gentle relax or downward movement.
  5. Exhale and relax.
  6. Repeat x10 4-5/day

 

Kegel Strengthening PFMT

(Back, front, lift)

    1. Lying/sidelying/sitting
    2. Inhale, allow belly to rise and relax
    3. Exhale, close the back passage as if you are trying to stop wind (no buttocks clenching)
    4. Inhale (relax), Exhale, Close the back passage, bring that feeling forward as if you are trying to stop urine.
    5. Inhale (relax), Exhale, close back, front and lift as if you are drawing up towards your belly button.
    6. Inhale (relax), Exhale, close back front and lift.
    7. Repeat x 10 with the breath.
    8. Progression:
      1. Inhale (relax), Exhale (back, front, lift), hold that tension and progress to 10 breaths, repeat x10
      2. Add movement. i.e. Bridge: Exhale as you contract your pelvic floor and lift your buttocks (10×3)
      3. Move into standing. i.e. Squat: Exhale as you contract your pelvic floor and stand up from a squat position.
      4. i.e. Gently contract your pelvic floor during stair climbing or walking. NB. maintaining breathing throughout.

LINKS:

You can find Candice Langford on:

Website:          https://www.candicejanephysio.com

Instagram:       https://www.instagram.com/umhlangaphysioforwomen/

Facebook:       https://www.facebook.com/umhlangaphysio/

 

Disclaimer

Although this advice and information is based on sound knowledge it is still followed at your own risk. I cannot take any responsibility for injuries or health conditions that may arise as a result of my advice. Videos and advice are generalised and cannot replace the individualised advice provided after a medical assessment by your local healthcare professional.