To Kegal or Not To Kegel? 5 Tips To Look After Your Pelvic Floor

By Ange

How often do you think about your pelvic floor? Do you always ask yourself  ‘should I be doing more Kegel exercises?’

Unless you are pregnant or postpartum, there is a good chance you have never really given this muscle group much thought or questioned how well it’s functioning.  Many people, especially pregnant women, are misled to believe that they should be doing additional pelvic floor exercises to strengthen this region. After all, isn’t stronger better? Spoiler alert, you may not actually need to be doing specific pelvic floor exercises (even if you’re pregnant). 

In this article we will be unpacking the pelvic floor, exploring some common questions, like how to know you are engaging it properly (and what is a Kegel anyway?) why not everyone needs to do them and how to look after it when you are pregnant. 

First let’s look at your anatomy…

There are three muscular slings of the pelvic floor; the anterior (front) sling, the middle sling, and the posterior (back) sling. Some of these muscles are more superficial and are responsible for continence and some are deeper muscles which provide the lift that supports the pelvic cavity and that acts like a sling that holds the pelvic organs. 

You probably know about the pelvic floors’ role in continence and pelvic wall support, but it also works hand in hand with your deep core muscles to modulate pressure and provide stiffness to the sacroiliac joints, contributing to the control of the lumbar spine, posture, and respiratory function. 

1. What is a Kegel?

A Kegel is the general name given to specific pelvic floor exercises that involve the repeatedly contracting and relaxing the muscles that make up the pelvic floor. The name ‘Kegel’ comes from an American obstetrician by the name of Arnold Kegel, who noted that women’s pelvic floor muscles were weakened during childbirth. 

Doing a proper Kegel involves three steps.

  1. Squeeze the pelvic floor muscles by recruiting both the front and back of the pelvic floor. It should feel like a narrowing of the opening of the vagina.
  2. Lift the pelvic floor muscles to deepen the contraction. This should feel like a gathering and lifting the pelvic floor as a whole. 
  3. Fully relax the pelvic floor muscles where all the muscles return back to baseline.

2. How do I know I am doing them right?

It might feel quite foreign to tune into your pelvic floor at first, but just like bringing your awareness to different areas of the body, it will get easier. Whether you actually need to strengthen or relax this muscle group, everyone needs to be able to consciously generate a squeeze and lift of these muscles and be able to consciously let them go. The tone in your pelvic floor is highly responsive to your breath and movement of your diaphragm. 

Learn some simple techniques to use your breath to engage and release your pelvic floor here. 

3. Should everyone do pelvic floor exercises?

The pelvic floor is an anticipatory muscle that should come on to the level of intensity being expected of it. It works in unison with your core and hip stabilising muscles every time you move and breathe. If you are an active individual with no symptoms of pelvic floor dysfunction, it is highly likely you do not need to do specific pelvic floor exercises, even if you are pregnant. Your pelvic floor is strengthened through daily activities, especially when you are on your feet and during exercise.

However, what we do know is that the pelvic floor does a tremendous amount of work to help carry and deliver your baby. It needs to stretch by around 15 cm during a vaginal delivery and it may sustain some trauma in the process. Even a Caesarean delivery will see the pelvic floor muscles go ‘offline’ as you undergo major abdominal surgery that may affect your ability to control muscles in this lower abdominal region. 

During pregnancy, it is therefore important to be able to know how to perform a Kegel and know what sensations you should feel so that you have better body awareness postpartum. 

 After having the baby, there is a good chance that you need to do pelvic floor exercises to strengthen and regain motor control of this group of muscles. But, in some instances women develop tightness in their pelvic floor (even if it is weak), so doing more pelvic floor exercises is likely to make symptoms worse. See our key indicators of a weak versus tight pelvic floor below. The only way of really knowing about the health of your pelvic floor is by seeing a pelvic floor specialist. We recommend this to all postpartum women around 6 weeks after birth. If you are looking for the best in the business in the Northern suburbs of Melbourne, you can not go past the team at Inner North Physiotherapy. 

Tight Versus Weak Pelvic Floor?

4. How to look after your pelvic floor during pregnancy?

Our first tip is awareness. Make sure you are able to engage and relax your pelvic floor. If you have any concerns about its function, be sure to book an appointment with a specialist. 

  • Stay active and substitute as needed: Continuing to stay active will encourage you to stay strong through your pelvic floor. As the baby grows, be mindful that the types of activities performed may need to be adapted to ensure you are not putting too much force down. This means reducing loads lifted in the gym and substituting out high impact exercises like running, skipping and jumping. Depending on the strength of your pelvic floor, size of your baby and number of pregnancies, you may also find that the pelvic floor becomes overworked during pregnancy to support the uterus. This could mean needing to break up large periods of times spent on your feet or doing additional PF exercises. 
  • Look after your bowels: Drinking plenty of water and maintaining a fibrous diet will help to avoid constipation. Excessive straining on your bowels can lead to a weakened pelvic floor. If you are finding that you are needing to strain to go to the bathroom, chat to your doctor, raise your feet or address any dietary factors that might be contributing to this. 
  • Rest smart and make space for your baby: While you might be tempted to want to slump back with your feet up in the last few weeks of pregnancy, keep in mind the need to make ‘space’ for the baby. You want to avoid creating any imbalances or tightness through your pelvic floor and pelvic ligaments by sitting with your hips higher than your knees, legs uncrossed and belly hanging more forward. This will help to keep your pelvis open, reduce pressure through your back and encourage bubs to sit anterior. 
  • Massage, foam roll and do myofascial release: It is important to remember that parts or your glutes are also muscles that make up the back of your pelvic floor. A tight piriformis and obturator internus  can be causing lower back or sacroiliac (SI) joint pain. This can be relieved by avoiding ‘butt clenching’ or having them released by a profession massage therapist or using a ball or form roller. Sometimes these muscles also become tight as they are overworking to stabilize the spine. When you are pregnant, overstretched abdominals will offer less support, forcing the body to rely on other muscles. You can compensate for this postural change by keeping your glute max and glute medium strong. 
  • Let it go: As you get closer to your due date, it is important to spend more time focusing on letting the pelvic floor go. During a vaginal delivery, the pelvic floor needs to stretch to allow the baby to come through. I find that I am best able to practice this during regular meditation and deep breathing exercises that I do more consistently from 34 weeks. If you are looking for a great app to guide you through some beautiful pregnancy meditations, take a look at Expectful.

Are you almost full term?

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Our founder

Ange Drake is an personal trainer, women’s empowerment coach and fitness blogger in the northern suburbs of Melbourne. She is the director of one of the few womens’ only strength training gyms in Melbourne, 23W. Ange helps women to learn how to use strength based training, nutritional strategies and a positive mindset to transform their bodies, relationship with food and mind.

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