Updated: Apr 5
You may have heard of Kegels before – whether it was from your mother, a Cosmo magazine or a friend who just had a baby. Women have shared stories with one another about how this ‘life-changing’ exercise has helped restore balance to their lady bits. However, most of us are left thinking – what on Earth is a Kegel and why do I need to do them?
The truth is, most people don’t actually know what a Kegel is, what it does, or even how to do one properly. In the simplest explanation, Kegels are an exercise for your pelvic floor muscles – and yes, that’s right, I mean an exercise for your vagina (although men can do them too)! In fact, Kegels are the bread and butter of pelvic floor physiotherapy. In reality, Kegels are only half of the story when it comes to pelvic health – like Thelma without Louise or Monica without Rachel. 1 in 3 women have a pelvic health dysfunction, some of which require Kegel exercises and some of which do not1. So let’s talk about the other areas of pelvic floor dysfunction that physiotherapists can work on aside from those that require Kegels:
1. Pelvic Pain
Although we may experience the odd moment of discomfort in certain positions during sex, severe or frequent pain can indicate a pelvic floor dysfunction. The muscles of the pelvic floor play a key role in sexual function and orgasm so if they aren’t working properly, this can cause physical and emotional stress in the bedroom. Pain during sex, while inserting a tampon or even discomfort around your tailbone can be an indication of increased tightness within the pelvic floor. So what does this mean? That you are doomed to a life of painful sex? No. It means that rather than strengthening with Kegels, it’s important to relax the muscles so they aren’t over contracting. Sensitive skin and lubrication dysfunction can also cause a lot of pain with intercourse, which can be addressed while working with a pelvic floor physiotherapist.
2. Pregnancy (Prenatal and Postpartum Recovery)
During pregnancy, the body goes through a lot of changes and the pelvic floor muscles are susceptible to weakness from overstretching. Kegels and pelvic floor strengthening are important for optimizing delivery and increasing the likelihood of vaginal birth, reducing the risk of trauma or tearing, and helping prevent incontinence postpartum. So yes, go Kegels! Outside of weakness, pregnancy can increase the risk of other pelvic floor dysfunctions including Mummy Tummy or Diastasis Recti, C-section scarring, and postpartum perineal pain. In these cases, scar mobility and manual techniques are used as well as specific core strengthening exercises.
3. Pelvic Organ Prolapse (POP)
Think of your pelvic floor muscles as hammock that support the bladder, uterus, and rectum. Weakness from pregnancy, childbirth and other factors can result in these organs falling out of place, even through the opening of the vagina. Strengthening the pelvic floor can help restore support in addition to the use of pessaries and anti-gravity positions. Research has shown the pelvic floor physiotherapy, can help improve symptoms of pelvic pressure, decrease the degree of prolapse and reduce other comorbidities including urinary incontinence and constipation1.
4. Getting Control of Your Bladder
One of the key roles of our pelvic floor muscles is to keep us continent- in other words, be able to control when we pee and poo. That’s right, I’m talking about those moments when you cough, laugh, sneeze, or exercise and feel a little dribble. Although these moments are common, especially in women who have had children, that doesn’t mean that they are normal. Your body is telling you have a pelvic floor dysfunction! It’s important to remember that it’s not just women who are having babies that need pelvic floor physiotherapy. Exercise and resistance training (yes, my CrossFit ladies), constipation, straining on the toilet, respiratory infections and chronic cough can all weaken the pelvic floor muscles because of the increased pressure in the abdominal cavity. In addition to strengthening, education on vulva care, proper positioning for toileting, and breathing techniques can all help regain control of your bowel and bladder.
5. Low back, SI joint, hip and pelvic girdle pain
The pelvic floor muscles run from the pubic bone all the way to the sacrum, sharing a lot of attachments to bony structures within the pelvis. It’s no surprise that the pelvic floor muscles are one of the key stabilizers for the spine and help us strengthen our core. Research has shown that there is a strong association between women who experience low back pain and those who have urinary incontinence. Individuals who experience SI joint discomfort, lower back pain and sciatica, hip discomfort or pelvic girdle pain can all benefit from pelvic floor physiotherapy.
Whether you’re dribbling in places other than the basketball court, experiencing painful sex, or tightness in your hip, pelvic floor physiotherapy can help you. Book an appointment or consultation with our physiotherapist today to find out more information. Remember, it’s not taboo to talk about these things!
Faghani, Nelly, and Carolyn Vandyken. Level 1: The Physical Therapy Approach to Female and Male Urinary Incontinence. Pelvic Health Solutions, 2018.
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