Flexing your pelvic floor, commonly known as “doing Kegels,” has gained huge popularity over the past couple of decades. And for good reason. Gaining better control of your pelvic muscles can enhance your sexual health and enjoyment as well as benefit your digestive and respiratory systems. Kegels can help to improve urinary incontinence and decrease pelvic pain. Plus, this exercise can be done literally anywhere at any time!
But there are two major, common misconceptions about this move that diminish its effectiveness and could actually contribute to pelvic pain. First, pretending to stop urine flow is the best way to do a Kegel
The pelvic floor consists of several muscles that extend from various points along the inside of the pubic and ischial bones to the coccyx. Contracting the muscles that stop urination only engage a portion of that muscular complex. See for yourself by alternating between going through the motions of holding urine and preventing defecation. Feel the difference between contracting the front and the back? While this form of contraction can be beneficial under certain circumstances, a full pelvic floor flex has three major components:
Clitoral nod/penis lift - when the pelvic floor contracts the clitoris will pull downward while the penis will pull upward
Anal squeeze - just as when preventing defecation, a full pelvic contraction will close the anal sphincters
Perineal lift - performing a Kegel will raise the perineum, the tissue between the genitals and the anus, so it pulls upward and into the pelvic bowl
To successfully enact all of these elements, imagine squeezing your entire pelvis, lifting the base from the middle as if picking up a cloth napkin that has been laid flat from the center. The movement should be smooth and controlled - or at least headed in that direction.
Kegels are a panacea to all pelvic problems is the second misconception.
As has been mentioned several times in this post, pelvic contractions are just that: contractions. Similar to flexing other muscles, if that muscle is underused the act of engaging it can help to increase tone. (Of course that only works for so long, and that’s when you start adding more weight!) The key presumption in having someone perform Kegels is that the pelvic floor is weak and therefore the solution is to strengthen it.
However, it is far more likely that the pelvic muscles are already plenty engaged. This part of your body counteracts gravity for the entirety of your upright day, supporting your organs and helping to regulate your intra-abdominal pressure. The pelvic floor is also highly reactive to stress, contracting when under emotional pressure. Think about something that makes you really angry or especially worried and notice the tension increase within your pelvis.
While alternating front and back contractions, you might have noticed that one of those moves was easier than the other. Maybe you noticed that your right or left side was faster to react. Or perhaps you could do all of the contractions just fine, but it took some time for your muscles to “reset” before you could contract again. The reason behind any of these is usually that your pelvic floor muscles are holding too much tone in part or some areas. Doing Kegels under these conditions, when your muscles are unable to fully relax, can exacerbate current symptoms and increase your likelihood of developing a pelvic floor dysfunction.
If you find that this is the case for you, work on perfecting Reverse Kegels before diving into the contracting version.
Work with your breath to reverse your Kegel. As you inhale, the pelvic floor naturally depresses, moving with your diaphragm. If your muscles are tight and contracted, this motion may feel stilted or nonexistent, but using imagery can help to get the ball rolling. A Reverse Kegel should feel like watching the cloth you picked up (refer to visualization above) fall flat and spreading out. You could also think of a weight pushing down on the middle of your pelvic floor from the inside or pulling down from the outside. Some people find that imagining their pelvic bones gently spreading apart helps. Use whatever mental picture allows you to feel the sensations of your clitoris lifting/penis dropping, anus relaxing, and perineum descending in unison. It might take some practice, but keep at it and resist the urge to pull in before letting go. What helped you nail the Reverse Kegel? What benefits have you seen from increasing the adaptability of your pelvic floor? What else would you like to know about pelvic floor exercises? Let me know in the comments below!