Did you know that you can train your pelvic floor muscles quietly, discretely, and throughout the day with a few simple exercises?
Many people have heard of the word “kegel” before, and some of you might have even practiced doing these muscle contractions in the past, but are you sure that you are working the proper muscles? Even more importantly, are you helping your pelvic floor or priming yourself for pelvic floor disorder?
Before we investigate a few ways to train the pelvic floor we need to understand these key points that help us determine when you should kegel and how to determine if you are strengthening the correct muscles of your pelvic floor.
Get Assessed by a Pelvic Floor Therapist First!
Before starting a pelvic floor strengthening program, I suggest going to see a pelvic floor therapist for a proper evaluation of the muscles. This is very important because not everyone needs strengthening of the pelvic floor (or at least not right away).
Some people need to work on relaxation of these muscles prior to strengthening and others might not need much strengthening at all. Some people have a dysfunction of the pelvic floor reflexes with forced breath (coughing, blowing out candles, laughing to name a few).
The only way to determine the proper treatment is to be evaluated by someone trained in pelvic floor therapy. This is very important due to the fact that kegels/pelvic floor strengthening can actually make some conditions worse when not used in the proper treatment program.
Assessing The Pelvic Floor Using Breath: The Towel Method
Assuming you are asymptomatic and have been cleared for treatment, we can progress to assessment of the muscles and some cues that will help you strengthen your pelvic floor at home. One of the best external assessments that therapists might perform during an examination includes a simple cough. You can try this now, turn your head to the side and cough or think about blowing out a candle with your lips pursed. What do you feel is going on at your pelvic floor?
A few possible answers might include a strong urge to urinate, a pressure in the pelvic floor, or a lifting sensation. The pelvic floor works with our diaphragm to regulate breath in our body. If our breath is dysfunctional, we can feel it pressing downwards at the pelvic floor. You may be able to feel this for yourself with a simple hand towel. Roll the towel up and place it between your sit bones while seated on the chair. This will create a “lift” to the pelvic floor and when you cough, you may feel your pelvic floor descending. If this is happening, you may have dysfunction at the pelvic floor muscles or at the reflex arc.
How to Cue The Kegel
If the muscles are truly weak, we might integrate kegels into the program to help strengthen and tone this area of the body. Some cues that might help include:
- Squeeze your sit bones together without using your glutes
- Squeeze tailbone to pubic bone
- Hold gas in
- Pick up a pearl or blueberry
Try one of these now, do you feel the pelvic floor lifting or are you using your glutes and inner thighs to squeeze these muscles? If you feel the latter you might want to get into a wide leg squat or bring your legs towards your chest and hug them tightly. Try the kegel again in this position and see if you feel the same sensation or if it changes.
These positions put some muscles (glutes and adductors) in a difficult length to contract and compensate for true pelvic floor strengthening so you might feel something completely different when you use these positions. Once you can isolate the pelvic floor, try holding for 5 seconds at a time. Do you feel the strength stays the same or does it decrease? These are all great variables to discuss with your therapist or healthcare provider as feedback to a pelvic floor strengthening program.
If you are struggling to feel these differences, it might be a good time to see a pelvic floor physical therapist to assess the pelvic floor muscles. They can help you distinguish your pelvic floor from your glutes and leg muscles as well as assign a program for proper strengthening of these muscles. Feel free to contact our office in the Flatiron District of Manhattan for more information regarding pelvic floor therapy and to schedule an assessment with our pelvic floor therapist.
