So what's the deal with this kegel exercise anyway? What exactly am I doing down there? If you have ever wondered this, you are not alone. Many health care providers talk about the importance of doing kegels during pregnancy and post-partum to tone the vagina. You can read about them all over the Internet. But does anyone really explain to you how to do them?
Most sources will tell you to get in touch with the pelvic floor muscles you stop the flow of urine mid stream. There is a lot of talk about squeezing. But does squeezing really tell you how to do this exercise? How can you know if you are doing it right? How does this tie into good function?
Here is what every woman should do to get in touch down there. The first thing to do is look. Yes, look down there! Don't be shy, she's been with you a long time, there is nothing to be afraid of.
The pelvic floor is a muscle like any other part of the body. When you do strength training for the upper and lower body it's helpful to look in the mirror to make sure you have proper form. The pelvic floor is no different, except the muscles are internal. They attach like a hammock in the pelvic bowl and play a crucial role in bowel and bladder function and supporting your internal organs. Although you cannot see them, what you can see is their attachment at the perineal body. The perineal body is the space between the bottom of your vagina and your anus. When you kegel you should see inward movement at the perineal body.
But it's not enough to just look. You must get hands on and feel for correct movement. There are 2 ways to do this:
1. Externally - Place your fingers at the perineal body. With normal breathing you should feel movement at the perineal body. You should feel this point move inward with a kegel contraction and release downward after. We are talking millimeters of movement so it is subtle. If you don't feel this movement, you can gently press inward with your kegel to give the muscles a physical cue.
2. Internally - Place your finger inside the vagina. You should feel a squeeze around your finger and a lift during a kegel. When the muscle is very strong that lift can pull your finger inside. This is really the best way to assess whether the muscles are working correctly.
In order to have correct function of the pelvic floor muscles, you must coordinate the inward squeeze and lift with correct breathing - diaphragmatic breathing. This involves breathing into the belly and expanding the rib cage to allow movement of the diaphragm down and up within the abdomen. Correct function is also not only about the squeeze. You must be able to relax fully back to the resting baseline of the muscles.
To prepare for a kegel contraction, inhale breathing into the belly and rib cage. You should see the belly rise and feel some movement in the chest. The pelvic floor muscles naturally descend as you inhale and you can feel some downward movement at the perineal body. With your exhale, and the natural flattening of your belly, this is where you contract and squeeze your muscles. By squeezing you are drawing together front to back from pubic bone to tail bone and side to side, sits bones coming together. You are creating closure around the vagina, urethera, and anus and then a lifting up and in. Then gradually release the muscles with the next inhale. The release is equally as important. The muscles have to contract and relax back down to their resting baseline.
To avoid strain on the muscles it is important to avoid holding your breath. This increases intra-abdominal pressure creating a force pushing downwards against the pelvic floor.
Try the following the next time you do your kegels:
Remembering these components and practicing will give you a better understanding of what you are doing down there.
Re-educating the pelvic floor muscles is key before returning to exercise post-partum, especially high impact activities. Even if you had an uncomplicated delivery, 10 months of pregnancy and vaginal stretching during birth is enough to cause pelvic floor weakness. Any kind of tearing into the perineal body will affect the muscles whether you feel it or not.
So who is this kegel? Someone very important. You two should meet and get to know one another.
For more articles to help you connect with your pelvic floor visit our breathing section.
Do you have a question? Ask Solange by email or comment below.