We have all heard about Kegels. It is what women do so they don’t dribble after having a baby, right? Yes, this is correct, but there is a lot more to it than that and when you break it down and really look at what is going on with a kegel, it has an impact not just on staying dry (yellow hanky) but also for staying clean (brown hanky) as well as sexual function.
The purpose of kegels is to strengthen the pelvic floor muscles. “But what are pelvic floor muscles?” They are a group of muscles at the bottom of the body/torso that create a sling (not that kind of sling … .naughty!) called the levator ani muscles which help keep our insides … inside! They also have two or three openings, depending on your expressed gender. These muscles start at the pubic symphysis and run to the coccyx (tail bone). To find your pubic symphysis I like to use the expression that “men” have furniture, “women” have houses. If you have a uterus then go with the later analogy. Go to the roof of the house or just above your furniture and find the hard bone. You may get some odd looks if you are doing this whilst in a cafe but may be offered a hand if at Leon’s or the Eagle! Now that you have found this bone you now know where your pelvic floor muscles start. The coccyx is at the base of the spine, nestled between your butt cheeks, and this is where they end. This is just part of the picture. While these muscles make up the sling that keeps everything inside, the hip muscles come along from the sides and create the walls. Our “sling” of support is now a “basket” of support.
Where do kegels come into this? Remember those two or three openings I mentioned earlier? Pelvic floor muscles wrap around those openings and create valves for us to control what goes out (or in) those openings. Urethra, vagina, and rectum are in part controlled by the pelvic floor muscles. Excess body weight creates more downward pressure on the pelvic floor muscles causing them to stretch out over time. We also tend to forget that these muscles exist and forget to exercise them as we get older allowing them to get lazy, weak, and stretched out. Kegels are the daily gym exercises for the pelvic floor muscles and yes, you can add weights.
How do you do a kegel? A lot of times I find that people are too vigorous and try to fire all of their muscles at the same time, especially the gluteals and abdominals. It’s not that complicated. Sit quietly in a chair with good back support. This will allow you to focus on the correct muscles. Place your hands on your pubic symphysis (Be mindful of your environment, don’t want you getting arrested!) Think about your anus. Gently try to lift the anus up toward your pubic symphysis, using your hands as a cue for where you are going. Glutes should be relaxed as well as your abdominals. Congratulations! You just did a kegel! Repeat in standing after you get good at doing them sitting down. Half of people who are doing kegels are doing them wrong and to their surprise getting no results.
Sex. The good stuff! There are other muscles that work with the pelvic floor muscles. Bulbocavernosus and ischiocavernosus are two of them, and whether you have a house or furniture, you have these muscles which will be key in getting and maintaining an erection, as well as the labia and clitoris.
The next question: Should you do a kegel? If you are like me, no. My pelvic floor stays elevated and tight due to my quirky neurology. In these cases down training and relaxation is the key. This is a common problem in cross fit.
If you have any questions about kegels and if they are right for you, please feel free to reach out to me. This is where a pelvic physical therapist’s Kung Fu is strong! t
Charles can be found at Dudley Physical Therapy inside Spunk Fitness (8502 Kelso Drive in Essex). Call or text 443-742-0019 or email firstname.lastname@example.org.