The Truth About Kegals by Allison Oswald
Kegels are great – if you are doing them right.
Everybody thinks of kegels as just contracting or “squeezing” of your pelvic floor muscles – when really that is just half of the equation.
Often times we can forget the main function of the pelvic floor and how important it is for our everyday life. The pelvic floor is essentially a “hammock” or sling of muscles on the base of the pelvis that function to support your organs, control your sphincters and essential in sexual function.
In order for your pelvic floor to function properly not only should you be able to contract your pelvic floor muscles, but you should also be able to lengthen them. A proper kegel is a lengthening of your pelvic floor as you inhale and a squeeze and lift up and in on the exhale.
Being able to have that connection to your pelvic floor and doing a proper kegel is important because often times when we focus too much of the contraction part we can create tension in our pelvic floor that can lead to painful intercourse, incontinence and anorgasmia to name a few. If you do have a dysfunction, experience pain or leaking you should be properly evaluated by a Women’s Health Physical Therapist for an exam. Often times when someone does experience any of those symptoms, it doesn’t necessarily mean that doing these contractions/kegelswill cure all – it could actually mean that one may not be able lengthen and fully relax their pelvic floor muscles. Just as everyone’s anatomy is different, some may not actually experience any symptoms but could just be interested in understanding how to best use and function their pelvic floor. Either way, a Women’s Health Physical Therapist will be able to help assess and individualize a treatment plan that will work and benefit that particular person.
And because your pelvic floor is just one part of your core system, the other parts of your core system need to be functioning as well. The other parts of your core system include your deepest layer of your abdominal wall (transversusabdominis), your diaphragm and your back (multifidus). In order to function properly, all of these parts need to be in the most ideal alignment. So when you are practicing kegels, you want to ensure that you are in the best position as possible. What does an ideal alignment look like? Everyone is different, but a general rule of thumb is this: achieving your ribcage over your pelvis, which in turn will have your pelvic floor and diaphragm parallel to one another. This position will leave a slight arch in your low back.
Because your diaphragm works together with your pelvic floor, breathing properly during kegels is crucial. This means that your pelvic floor and diaphragm work together. As you inhale the diaphragm contracts down, the ribcage should expand sideways and the pelvic floor lengthens. With an exhale, the diaphragm goes up, the ribcage back in and the pelvic floor recoils. I often hear moms discuss that they do kegels when they are at the stoplight, waiting in line at the store, or whenever they get a split second – they do them. However, to do kegels properly actually takes time, focus and a little patience to be able to truly connect to your core. Below you will find a little tutorial on how to achieve just that.
How to do a kegel and connect to your pelvic floor:
Please note that any person symptomatic or not, should be able to do this exercise pain free – this is not the cure all for pelvic floor dysfunction and if you have symptoms, seek a Women’s Health Physical Therapist.
Sit with your feet on the floor and spread your butt cheeks to the sides so you are more connected to the surface you are sitting on. Stack ribs over pelvis so you have a slight arch on your back. Breathe in through your nose allowing your ribcage to expand to the sides and feel the sensation of the pelvic floor drop down and then exhale through your mouth pulling up and in with your pelvic floor while your ribcage comes back to its starting position. As you do this, the shape of your spine should not change and your shoulders should remain relaxed. Do this for about 5 – 10 contractions.
Allison Oswald (DPT, WCS, CPT) Physical Therapy, Board Certified Women’s Clinical Specialist, Certified Pilates Instructor, and mother. Allison’s work relies heavily on strengthening and healing the pelvis. The maintenance of core strength and mobility impacts mind and body, including anorgasmia, loss of bladder control, prenatal and postpartum preparation, and elements of emotional stability which all needs to be looked at holistically. She has owned and operated her own private clinic, Plumb Line: Pilates and Physical Therapy Studio in Santa Monica, CA.