So you had a baby and everyone told you to do the famous kegel exercises. You nod and say “yes I’ve heard of that”, then go home with your newborn baby and try to pull up your pelvic floor muscles, only to find you can’t feel them and really don’t know where they are anymore, let alone how to lift them up. You’re too embarrassed to say anything, cause everyone knows what kegels are, right? Wrong.
You’re not alone. Many women have no idea what kegels are. In fact, many health professionals don’t even know how to teach them. I’ve seen everything on the internet, from “stop your flow of urine” (bad) to “pick up beans” (good)
Here’s the low down:
In order to understand how to use your pelvic floor muscles (PFM), it helps to know where they are and what they do. PFM are a group of muscles that extend from the back of your pelvis to the front. Some say they form a hammock but really it’s more like a trampoline. They shouldn’t be too slack, nor too tight. There are three openings as they figure eight around the rectum, vagina and urethra. Healthy PFM are integral to core stability, help to keep you from peeing your pants when you cough or jump, make sex more pleasurable, and keep your pelvic organs from prolapsing (falling out of your vagina). As part of the anticipatory core, they work in synergy with the diaphragm, transverses abdominis and multifidis. Their role in this strategy cannot be ignored.
So how do you contract these lovelies?
Let’s start with finding them. Here are cues that I have found to work:
- Pick up blueberries with your anus and your vagina
- Pretend you are sucking a smoothie through a straw in your vagina
- Bring your rectum towards your pubic bone (beware: do not pelvic tilt with this)
- Imagine the flower closing into your vagina as it closes in the evening
A favourite is imagine picking up blueberries with your anus and vagina, bring them up and into your body, do not squish them (you will engage other compensatory muscles). You can also do this with your fingers. Insert your fingers into your vagina, gently squeeze around them and pull them up and into your body.
Now remember, relaxing your pelvic floor after each contraction is essential to proper PFM function. Here are some cues for that:
- Let your PFM melt
- Put the blueberries back down
- Imagine a flower blooming out from your vagina
But, the most important thing is to learn to use it in it’s true function. The PFM are best friends with the diaphragm and TrA, they all work together. So here is how to get the best contraction from your pelvic floor:
- Get into perfect posture, that means your bum should not be flat, get your tail in the air and hollow your low back giving you a neutral curve in your spine
- Take a deep breath into your side ribs (expanding out from the sides as opposed to forward from the chest), as you inhale, let all your muscles relax using one of the PFM relax cues above.
- As you exhale contract your PFM with one of the cues above.
- Inhale repeat steps 2-3 this time as you are pulling your PFM up and in, feel the band of tension that is created in your lower abs, this is TvA.
- Inhale let all your muscles relax, repeat.
This is the core breath. It is the base exercise for restoring pelvic floor function and diastasis recti.
That’s it. It’s that simple. Try it right now. What’s your favourite cue for the pelvic floor? Which one worked for you? If you still aren’t sure if you are doing it right, get checked by a pelvic floor physiotherapist. It’s what we do.