Demystifying pelvic floor health for women in all stages of life

By Stephanie Sandleben, FMCHC, Certified Pelvic Floor Yoga™ teacher, Franklin Method™ Pelvic Floor Fascia Trainer

When asked about your pelvic floor health, what usually comes to mind is the kegel. But what exactly is a kegel, and what are its health benefits? Ask a group of people and there would be many answers because there isn’t a clear consensus on what a kegel does, how to do it correctly, and whether it helps.

Most agree that kegels help strengthen your pelvic floor muscles and manage incontinence. We know they’re named after a 1940s American male gynecologist, Dr. Arnold H. Kegel, and were considered a non-surgical method to prevent women from leaking urine. Beyond that, there’s a lack of specificity in what muscles in the pelvic floor kegels actually engage, who should be doing them, and for how long.

To determine those things, first we must understand what the pelvic floor (PF) is and what it does. It’s a multi-tiered, interconnected group of muscles and connective tissue that provide support for the organs of digestion and reproduction along with controlling the sphincters. Imagine a trampoline and how it responds to the pressure along its surface—the PF helps manage pressure both from above and below. This is why we get into trouble when we sneeze or jog: the muscles aren’t reacting properly to the force that’s being exerted. The PF muscles also provide postural support, help stabilize the bones of the pelvis (specifically the heart-shaped bone called the sacrum), and enhance orgasms (by making them stronger and better).

When the PF is doing all these important jobs, we don’t spend too much time thinking about it. Yet when we sneeze and leak urine or find ourselves moments away from the toilet with an uncontrollable urge to go and leak—it gets our attention.

These symptoms are connected to PF dysfunction, which is not just the normal progression of aging or expected after giving birth. Simply put, your PF muscles can have too low of muscle tone (hypotonicity) or too high of muscle tone (hypertonicity), or confusingly, both. We experience symptoms when the PF muscles aren’t able to do their jobs.

If you’re someone with low muscle tone, engaging the PF muscles in a targeted way can be helpful. Identifying and lifting from your perineum (the center of the pelvic floor) strengthens the muscles over time. (Please don’t stop urine mid-stream as this can disrupt the bladder’s signaling!)

However, if you’re someone with too high of muscle tone—meaning your PF muscles are contracted all the time—then a kegel/engaging the PF could worsen your symptoms. In this instance what is needed is more stretching, application of consistent pressure through massage (myofascial release), and guided relaxation of the PF muscles.

Relief is possible and knowledge is power when it comes to our PF health and how kegels can be part of that. If you’re suffering with urinary incontinence, prolapse, or pelvic pain, and want help identifying specific exercises that can alleviate your symptoms, please reach out for a free consultation.

Stephanie Sandleben provides Yoga Therapy and Functional Movement for Pelvic Floor Health and Women’s Health Coaching. She sees clients in-person at The Midwives & Wellness Collective and James Marco Health in downtown Prescott. Learn more at www.thesamamama.com or by emailing [email protected].