To Kegel or Not to Kegel? That is the question.
Do you remember a time you could jump on a trampoline and not even think about your bladder?
One common myth for women that is passed through the generations is that leaking urine after having a baby is just par for the course. The little bit of dribbling that happens with a cough, sneeze, vigorous exercise or good hearty laugh, while super common, does not have to be your norm. In fact, it is sign that there are pelvic imbalances that need to be addressed. If you are dealing with this issue, you are not alone. Some studies report (and a uro-gynecologist I recently spoke to confirmed this) that about 50% of women deal with some form of incontinence, whether they’ve had a baby or not.
Or, what about the feeling that after you’ve had a baby that everything is not as it “used to be.” Intense stretching of many parts of the pelvic floor during vaginal deliveries can lead to “over-stretched” and lax pelvic floor muscles. Does a woman avoid pelvic imbalances with a cesarean delivery—not necessarily—through this type of delivery the entire pelvic region is stretched, ligaments are pulled and imbalances of all types can ensue.
So, strengthening the pelvic floor is the answer, right? Well, it may be, but it is more complicated than that. As many women who have relaxed pelvic floors (I don’t like the word “weak”) there are as many women who actually have overactive or tight pelvic floor muscles. The ability of the muscles to work together in a coordinated fashion with the right amount of contraction and relaxation is key to the core strength of these muscles and their optimal functioning. If we are told to keep tightening the pelvic floor as is advised in a Kegel exercise, and an imbalance in the muscles is already present (which I can usually guarantee is the case), then we are just reinforcing this pattern of imbalance.
Your pelvic floor is a interwoven structure similar to a bowl or nest that not only controls sphincter control of the urethra and anus, but is involved in keeping our pelvic organs in proper alignment and in sexual health. This is important for both men and women, but women often see the most obvious imbalances in health problems such as incontinence, pelvic organ prolapses, bladder dysfunction or pain with intercourse.
Are kegels recommended then? Certainly, they have a place in your self-care toolbox and are simple to do. They can even highly enhance your experience of sex! We’ll talk about that another time! I do recommend kegels to some women, but not all. One thing to know is if you begin to develop awareness of both the strengthening and relaxing of your pelvic muscles, no matter where your body is on the spectrum of “tightness” or “overly relaxed”, you can begin to start changing the balance and tipping the scales toward a new optimal functioning.
How do I know if I have a pelvic balance and what do to treat it? I am going to cover this in a series of blogs because, you guessed it, it’s a complex and individualized answer. I haven’t found much in my 17 year career in women’s health that wasn’t complex, but that’s the beauty of it!! We are wonderfully complex, intricate beings with the innate power for self-healing. My philosophy of healing is that your body knows how to self-balance already, but we can learn tools to help facilitate this.
As for beginning the journey of tuning in with your pelvic floor, I first invite you to just start bringing awareness to it. At night, as you lay with your eyes closed before sleep, place your hands on your lower belly, between your hip bones. Invite your awareness to get acquainted with this area of your body in a gentle, loving way. Begin to follow your breath down into the pelvic bowl and start noticing movement internally when your inhale and exhale slowly. And, that is it. That is truly the first step! If you’d like to begin reading more about developing awareness of your pelvic bowl, I cannot recommend a better book than that written by my mentor, Tami Lynn Kent, titled “The Wild Feminine.” She is truly a visionary and a skilled practitioner!
I will guide you through more information and self-care tools in the weeks to come, but truly, this is one initial step to a lifetime of more optimal health as a woman.
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