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Give a Lift to the Floor of Your Core!

Give a lift to the floor of your core!

Pelvic floor rehabilitation is very different than “doing Kegels and squeezing as hard as you can and holding…” This old approach has roots in the 1940-50’s and by the time it was revived, many other exercise approaches had moved on!  For example, we wouldn’t ask someone with a weak, painful or injured shoulder to see what is the most weight they can lift, hold as hard as possible for 5-10 seconds, and do that 5-30 times for 3 times a day! Why would you want to do that?  Even so, did you know that Dr. Kegel’s original research proved that women had greater symptom changes with supervised training?

The great news is that at Passages PT, there are many ways you can learn how to train your pelvic floor muscles (PFM). Physical therapists now focus on how these vital muscles work best with the deepest abdominal and spine muscles.

You need to fight against the pressures of today’s impact activities, running, lifting, straining and pregnancy. These muscles need special attention, whether or not you have had children. These muscles should wake up and work before you lift your groceries, use weights, squat or carry children. You should be able to gently activate your muscles so they are ready for action.

Do you know that “Vintage” Kegels can actually make many pelvic and bladder symptoms worse? These exercises usually train to isolate the pelvic floor muscles and squeeze hard and repeat 90-300 repetitions per day. These strong contractions are often performed when the rest of the body is supposed to be quiet. We have also traditionally been taught to start and stop urine flow as an exercise. Although this may be helpful to feel where to activate, this is not good to perform as an exercise.

As a matter of fact, many clients are surprised to learn they need to improve the release of their muscles, even when there is bladder and bowel leakage, urgency or prolapse. When muscles are constantly contracted, they tend to become tight and surprisingly, even weaker.

Dr. Kegel researched how to watch muscles work

Dr. Arnold Kegel’s early 20th century research found that women had greatest success for combating leakage, pelvic floor organ prolapse POP, and even pain with sex when they were able to watch their muscles working. He actually invented a simple vaginal pressure gauge to help women with symptoms. His highest success rates for pelvic floor rehabilitation included monitored training. Of course, we have updated how to train and most clients can watch muscle contractions with through surface biofeedback or ultrasound imaging.

Dr. Kegel’s words- excerpts from his research:

“For the past fifteen years I have experimented with various means of exercising the perineal muscles. Any active exercise must be directed primarily toward drawing in the perineum.”

“Only the exceptional woman, however, will continue the exercise long enough to produce results on mere instruction to do this.”

“Many women, in addition, have no awareness of function and, unless provided with some way of knowing whether or not they are being successful, soon become discouraged or are unwilling to make even an initial attempt at exercise.”

Am. J. Obst. & Gynec. Aug 1948. “Progressive Resistance Exercise in the Functional Restoration of the Perineal Muscles.” Dr. Arnold H. Kegel, MD FACS

Pat Huston

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