Pelvic Floor 101

If I were to ask a room full of people ‘what are kegal exercises?’ I’m sure it would be all the women’s hands that would shoot up.

For those of you who don’t know, kegals are pelvic floor exercises that women are advised to do during their pregnancy to help avoid embarrassing ‘leaks’.

Embarrassing leaks are not confined to women who have had children, cosmetic companies spend a lot of money targeting women in general, which sweeps under the table the fact that men can suffer too. So although this is a pregnancy focussed health and fitness blog the below holistic approach could apply to anyone.

The pelvic floor (or pelvic diaphragm) consists of muscle and tissue that covers the area below your hips, keeping lots of your important bits separate. It also has important functions during childbirth helping the fetus navigate through the pelvic girdle i.e. helping contain the baby until the head is ready to engage.

So what right?

Well when I first had my first few mid-wife appointments I was told I should be doing my kegals if I wanted to say fit “down there”. This never seemed right to me and I never bothered doing them. I felt that I would be much better served by performing squats regularly and working on posture and body awareness.

Whilst pregnant I had no problems with those embarrassing leaks I was warned about and have no issues presently so for me,  I am glad I did not waste time with kegals.

I have since read a great article which further confirms my doubts regarding kegals.

According to recent research published by Rehab Management, pelvic floor incontinence has been linked to postural alignment and weak glutes. Interestingly the act of squeezing and releasing the pelvic floor (the simplest way to explain kegals) adds to the tightness of the muscle and neglects the length. Over time you tighten the muscle and by doing this reduce optimal length-tension relationship. When the pelvic floor is not functioning adequately the result is an inability to control your urge to ‘go’ or the frequency with which you need to do so, and at worse cause infection.

From a training perspective a shortened pelvic floor are key factors in stress incontinence (imagine sneezing or laughing and a bit of wee coming out! That’s stress incontinence) and is a worry when added intra-abdominal pressure is increased. I was starting to put together a picture of someone who cannot control their lower back, bad posture and a weak bottom, frantically doing their kegals without success.

The research continued to highlight a holistic approach to pelvic floor health looking closely at posture and core strength rather than isolating the muscle itself. As a CrossFitter this makes perfect sense as to we get strong by working the whole body as one unit.

Where does this leave me with kegals? In a healthy active pregnant lady I wouldn’t prescribe them.

I would look at the bigger picture, addressing posture and body awareness to the developing changes in her body. I would recommend squats regularly both with weighted resistance and without. My response is simply squats over kegals – they provide a much better and more natural way for the pelvic floor to do its job the way nature intended.

Please be aware that past 37 weeks pregnant deep squats are not advised as they can cause an early rupture of the membranes (early sign of labour).

 

Sally Dixey is a Personal Trainer @ Crossfit London in Bethnal Green

 

One thought on “Pelvic Floor 101”

  1. Great article. Agree that Kegel exercises are not the way forward. There is some benefit in FES or biofeedback for the pelvic floor post trauma. However what alot of physios and trainers seem to miss is the biomechanical/neurologcial link between the pelvic floor, the feet, the hip adductors and the gluts. Carrying out a lunge matrix will give you a load-explode mechanism for the pelvic floor in a functional pattern.

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