You laugh. You sneeze. You cough. You…pee your pants?! Every pregnant woman and new mom can relate to the brand-new sensation that is caused by your pelvic floor muscles. So how can you train them so they’re at their functional best?
Imagine a basket of support for your pelvic organs, including your uterus, connecting your pubis bone at the front of your tailbone at the back. Now imagine a baby in the basket. Talk about pressure!
Perfecting the Kegel exercise can improve the peeing-the-pants issue of stress incontinence, pregnancy-induced hemorrhoids and provide overall core strength. To work effectively, pelvic floor function is all about balance. Your pelvic floor should work with your deep-core back multifidus muscles and your transverse abdominals to support your spine, pelvic joints and those pesky and often leaky pelvic organs, the bladder and rectum. A tired and stretched pelvic floor may leave you with organ prolapse, where your pelvic organs fall and bulge into your vagina. Lovely. According to the physiotherapy team at BC Women’s Hospital, the biggest mistake women make when it comes to Kegel exercises for the pelvic floor is “not doing them at all.” So what is a Kegel? How do you do one?
A Kegel is the contraction and relaxation of your pelvic floor muscles. You may have heard of the stopping-the-flow-of-urine method of Kegels. Yes, those are the muscles you are trying to isolate but urine stoppage is not a good way to train them and can lead to a urinary tract infection. Physiotherapist Diane Lee, promotes using a cue that works for you. Maybe it’s “urethral squeeze?” Or, “vaginal lift.” Or, thinking of “drawing your anus to the back of your pubic bone.” Whatever you choose, the perineum should lift. Trickier than it seems! Can you isolate your pelvic floor without squeezing your buns, without tightening your abdominals or tensing your inner thighs? Oh yes, and you have to breathe as well, exhaling as you Kegel. Kegels can be done anywhere and you don’t need any equipment. Kegels are not obvious to any observer. Try the following pelvic floor exercises:
Exercise #1: Hold’ems Contract the muscles around the vagina and your anal and urinary sphincters. Try holding for five seconds to start and then relax. Don’t forget to breathe and make sure your buns, abdominals and inner thighs are relaxed. Build up to holding the contraction for 10 seconds and repeat 10 times in one set.
Exercise #2: Elevators Imagine you are in an elevator on the first floor. Begin contracting your pelvic floor muscles and continue pulling up, up, up to the second and third “floor.” Now, reverse your contraction, slowly releasing the contraction as you come back down to the first floor and relax. Try for five elevator repetitions in one set.
Exercise #3: Speed’ems Contract your pelvic floor quickly and strongly and relax. Try five repetitions in a row and work up to 30 repetitions in one set.
Learning to strengthen the pelvic floor is key but equally important is “surrender” or letting go. Balancing training exercises with relaxation is critical if you want to avoid “pushing your baby through a brick wall” of pelvic floor muscle as the BC Women’s physio team so put it. The uterus and abdominal wall should do the pushing as the pelvic floor relaxes to allow baby’s birth. Who can help? For those giving birth at BC Women’s hospital, the physiotherapy department offers a free postpartum workshop up to six weeks after birth. You can ask any embarrassing question in the comforting company of new moms suffering similar indignities. The class also covers pelvic floor exercises, back-care techniques and breastfeeding, carrying, stroller posture tips. If you are having problems with pelvic organ prolapse, incontinence or just want to know if you are kegeling correctly, seek the help of a physiotherapist who specializes in pelvic floor function. Some even offer ultrasound imaging to show you in real-time which muscles you are actually squeezing.
Having a core of steel does not necessarily mean you have strong pelvic floor muscles. During pregnancy and after giving birth, it may feel like you have zero control over what’s going on ‘down there.’ Your ligaments may be stretched, your pelvic floor taking a holiday and your bladder not quite back where it should be but have faith! The best advice from the experts? Do your Kegels and keep doing them!