Should I do kegels?
Do you leak every time you cough? Are you tired of having to change your pants or cross your legs when you sneeze. Have you been doing your kegels and noticing no change?
Do not give up! You are not alone!
Kegels are typically what most people think of to help any pelvic floor issues. But what if I told you there is so much more to your pelvic floor than just contracting and relaxing! It needs to work with other parts of your body as a system and when that team is working well together you pelvic floor will work optimally and your symptoms will go away!
Your pelvic floor is part of your core canister and all parts of that core canister need to work together. they need to each do their part so the rest of the system does not get strained resulting in pain, leaking, pressure, etc. What makes up this core canister:
diaphragm: this is the top of the canister
pelvic floor: this is the bottom
transversus abdominis: this is the front and sides
Multifidi and lumbo-pelvic fascia: this is the back
The most basic way they work is with breathing. When you inhale you diaphragm flattens, transversus, multifidi expand and pelvic floor descends. On an exhale, the opposite happens. This allows for pressure to move into and out of the abdominal cavity without stressing any of the muscles. When these muscles do not work together and one part does too much or too little. It will lead to more strain on the system as a whole. This can result in low back pain, hip pain, leaking with jumping, leaking with sneezing, heaviness/pressure feelings with activity or even pain with sex.
So why does this basic function matter. What happens if part of that system does not move or is tight, for example your pelvic floor. Let’s say it does not descend when you take a breath in. Well now you have more pressure in a smaller area creating more strain on the system as well as the organs sitting in the bottom of the pelvis which can result in leaking, pressure/heaviness or pain. This tightness of your pelvic floor can also lead to its inability ascend up, or react, on the exhale.
Putting it all together let’s use a sneeze as an example with a pelvic floor that is not moving well. The beginning part of a sneeze is an inhale and without your pelvic floor moving, more pressure will exist within the abdominal cavity stressing the system more. The second part of a sneeze is a forced exhale. At this point your pelvic floor should ascend up to help offer support but because it is already tight and already just staying in its ascended position it will not be able to react to this forced exhale resulting in leaking.
This is one of the most basic reasons there is so much more to your pelvic floor than just doing a kegel. There is nothing wrong with doing kegels, they just simply may not be enough. Our pelvic floor needs to move and needs to be able to work with other muscles. In the example above, if you just continued to try and tighten your pelvic floor, you most likely would continue to end up with the same symptoms because you are just looking at one piece and not your body as a whole. For some people, kegels may be a part of their plan of care however it should be just that, a part of it. Pelvic floor treatment should not be a generic, one size fits all treatment. Each person is different and needs an approach that looks at their bodies needs.
If you are currently experiencing any pelvic floor related issues or are unsure if you are please reach out to us either through social media @empowerptandwellness, email: Hello@WeEmpowerPT.com or give us a call or a text at 678-413-5587. You are not alone in what you are experiencing and we would love to help guide you to achieve everything you want!
Empower Physical Therapy and Wellness
1061 Cambridge Square Suite D
Alpharetta GA 30004
678-413-5587
hello@weempowerpt.com
