Get To Know Your Muscles ‘Way Down There’: The Importance of Kegels

06 Oct Get To Know Your Muscles ‘Way Down There’: The Importance of Kegels

It is a given that in a yoga class we will likely do downward facing dog, warrior two and savasana. But one exercise that is unique to a prenatal or postnatal yoga class is a round or two of pelvic floor exercises, also know as “Kegels”.

I am often surprised how many women do not know about the importance of a healthy pelvic floor. I would think their doctor might have enlightened them about this. Each time we do Kegels in class, I ask the students, “Who is practicing their Kegels at home?” Usually this brings about a few smirks, sheepish looks and a few nods. (These nods often come from the all-knowing second time mothers who know what happens when you don’t do your Kegels! You can read this as “Depends adult diaper anyone??” )

The strength and flexibility of the pelvic floor is especially important to address during and after pregnancy, when the healthy function of the pelvic floor is really tested. Because of the hormones relaxin and progestrone and the weight of the growing fetus, the pelvic floor can become weak and vulnerable. Over time if a woman does not maintain a strong, flexible and healthy pelvic floor she can suffer prolapsed bladder, prolapsed uterus, prolapsed anus, urinary incontinence, back pain and pelvic pain. Even if a woman gives birth by Cesarean section, she will still have carried the weight of her baby for an average of 40 weeks, and the pelvic floor will have experienced some weakening.

Besides the obvious reason to do your Kegels, (not peeing yourself would be that obvious reason), you will gain greater sensitivity and circulation in that area, making sex more enjoyable for both you and your partner. You will lessen your chances of tearing when your baby’s head is crowning, since a toned muscle will stretch more effectively than a weak one, and should you tear, you will likely heal more quickly. You will experience more support for your body, leading to less back pain, you will minimize your chance of getting hemorrhoids and you may experience a shorter second stage of labor – PUSHING!!!

It is a misconception that it is only important to focus on the strengthening aspect of the pelvic floor. It is equally important to remind the students to learn how to relax the pelvic floor. When a woman is in the second stage of labor (the pushing stage) she needs to access the ability to let these muscles relax and let her baby out. If she goes into labor never having familiarized herself with her muscles way down there, how can she expect to know how they work?

One way I like to teach students to relax the pelvic floor is have them focus on the “letting go” of the pelvic floor during Kegel exercises. For example, I ask the students to do an “elevator” Kegel, by imagining there are four floors at the base of the body and that they are to slowly engage and lift the pelvic floor up all four floors, and then slowly release the muscles floor by floor. (Typically, most women say they cannot control the descent of the muscles. They drop from the fourth floor straight down to the bottom.) This type of exercise uses the slow muscle twitch fibers, which make up 70% of the muscles of the pelvic floor, and asks the woman to be more aware of what it is like to consciously relax the pelvic floor muscles. To focus on the fast muscle twitch fibers, I would ask the students to pulse the muscles, quickly engaging and releasing.

If you are brand new to Kegels and are unfamiliar with how to access the pelvic floor muscles, you can practice on the toilet. Try stopping the flow of urine mid-stream – this is a good start. But don’t practice that way too often, since you don’t want to inadvertently give yourself a urinary tract infection. Once you feel comfortable with focusing on the front of the pelvic floor, you can include some of the muscles to the back of the pelvic floor. One of my students, a physical therapist, said you should “engage your rectum as if you were trying not to pass gas in public. But don’t tighten your butt muscles”.

Without getting into a whole anatomy lesson, the muscles that we focus on when practicing Kegels are part of the superficial layer of the pelvic floor, which resembles a figure eight. The bulbospongious muscle is the front loop of the figure eight, which runs from the clitoris to the central tendon (the perineum), and the anal sphincter is the back loop of the figure eight. Here is a link to a picture of the superficial pelvic floor muscles.

Now that you are a little bit more familiar with the workings of your pelvic floor, Kegels will not be such a mystery. Happy Kegeling!

3 Comments
  • Jenny
    Posted at 12:35h, 29 June

    Thank you so much for this straightforward explanation. I have been trying to find out good, simple information on the pelvic floor muscles since I am recently pregnant and have been hearing about the importance of Kegel exercises. It is surprising how difficult it is to find any text that will simply show and explain where these muscles are, what they include, and how to access them for exercise.

  • Adriane
    Posted at 12:24h, 03 January

    Hi, and thank you for the Kegel information. How would you recommend linking the breath to the exercise? Does it matter whether I am inhaling or exhaling as I contract?

  • Deb
    Posted at 10:26h, 08 January

    Hi Adriane

    Thank you for reading my blog and offering a comment.

    You do not necessarily need to coordinate the breath with kegels. For the more basic kegel, you can simply inhale as you engage the vaginal muscles and anal sphincter and exhale as you relax. Since exhaling is often used to relax of surrender tight muscles, this linking of breath and movement might be helpful. But again, it is not completely necessary. You can still pulse the muscles with out match the breath to the movement.

    We also instruct the “elevator kegel” which is engaging the muscles for 4 counts, keeping the muscles toned for 4 counts and then releasing the muscles for 4 counts. Since we do not want to encourage the pregnant mom to hold her breath, the idea of inhaling to activate the muscles and exhale to relax may need some tweeking for this exercise. If you find you work better with breath and movement together, try – engage for 4 while inhaling, keep the muscles toned and exhale for 2 counts, muscles still toned as you inhale for 2 counts and then release the muscles as you exhale for 4 counts. If this is getting you tense and tight while counting and working the pelvic floor, you are better just trying to breath normally while doing your kegels

    I hope this long winded answer helps!!

    Take care
    Deb

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