Wednesday, February 9, 2011

No More Kegels!?!? How to REALLY strengthen the pelvic floor...

I had a blog post written in my head about a COMPLETELY different subject, but I will have to save it for another day. Because I just read something that completely ROCKED MY WORLD. When I first started FitMePink nearly three years ago, I gave a little shpeel about incontinence. At the time, I had a 6-month old baby, went on a walk with my husband, started sneezing every few minutes during our walk (due to allergies), and nearly pee'd my pants with every sneeze. I urged all of you to DO YOUR KEGELS!

I have a good friend (who will remain nameless) who is also currently training for a marathon. She ran 12 miles on Saturday, and for the first time in a long time (probably since having 3 kids), ended the run with dry pants. For her (and for lots of women), even running ONE mile (or sneezing, laughing, coughing or jumping) causes major leakage. I'm a big advocate for strengthening the pelvic floor muscles. And I just read something that shook the foundation of pelvic floor strength I've always stood on...namely kegels.

You all HAVE to actually read this post (and it's follow-up). I'll post the links in a second, but first I'll very briefly sum up what I read:

We all do kegels in an attempt to strengthen the pelvic floor, but REALLY what we are doing is just pulling the sacrum inward, which promotes even more weakness! The muscles that actually balance out this pull on the sacrum are the glutes! Having a lack of gluteal strength (AKA no butt) makes us much more susceptible to pelvic floor disorder (PFD) or incontinence. DEEP, REGULAR SQUATS (like the kind I had to do in public restrooms in Japan--there were no toilets, just flushing holes in the ground--betcha women over there don't have PFD!) create the posterior pull on the sacrum. You want your pelvic floor to be less like a hammock, and more like a trampoline!

ALSO mentioned--another reason not to do CRUNCHES! With crunches, you are actually bearing down on the pelvic floor, making it's health worse! It's better to do transverse abdominal stabilizing exercises, like the plank, (or like the seated tupler).

If you're at all intrigued, (which you all should be!), read this post over at Mama Sweat. And then read her follow-up which helps clarify why we were told to do kegels in the first place (and to not completely count them out!) And then check this post out about how to properly squat to strengthen your lower back, pelvic floor, and even improve your digestive health. (And also to prepare your body for child birth by mimicking what women all over the world have done for centuries!)

And then come back here and give me your thoughts! Are you as shocked as I was? Did it make sense to you? Discuss.


Marci said...

Robyn, its okay, I'm pretty much over the embarrassment of peeing my pants (for nearly 5 years!!)...but hey, that is great news about the squats as opposed to kegels, because I for some reason love doing squats more than kegels, so maybe that body pump is doing me some good!! I will go read up on it...


Nameless (he, he)

Bree said...

Haha. Who's ever heard of "pelvic floor" before?? Well, I hadn't until I just read your post. Good thing us ladies have someone like you to keep us in the fitness loop!

Bonnie Wayne said...

The pelvic floor is something I was trained extensively on, along with the Tupler Technique to be licensed as a prenatal/postnatal trainer in the Tupler Technique.

I read both of the articles - found some of the information to be in line and some things described a little inaccurately.

Squatting IS fantastic, and is a great place to kegels, as the 2nd article states. I do this with all my prenatal clients.

One thing not looked into much, but WAS somewhat commented on in the comments section was using the transverse also in conjuction with the pelvic floor. In fact, one of my clients tried for years to strengthen her pelvic floor with the StepFree system (like a tampon but for strengthening) but it would always fall out UNTIL she started doing Seated Tupler exercises. Her story is awesome:

Another thing that is recommended is the GYNOFLEX - which allows you to strengthen and get bio feedback and a good mind-body connection with the muscle:

Goes into the different modalities that can be used.

Bonnie Wayne said...

PART II of comment

One thing I would correct Katy on is her understanding of a lengthened vs. tight muscle. A shortened muscle does not need to be a tight muscle. You CAN tighten a weak muscle. A lengthened muscle has been stretched out - like the recti during pregnancy, as well as the pelvic floor which goes from long and narrow, to short and shallow. The short and shallow factor is why people are prolapsing. If the vaginal canal is long and narrow it holds in the bladder, bowel and the uterus.

Also, when pushing out a baby, if the transverse is used rather than forcefully blowing out the pelvic floor, much of the ligament laxity damage is minimized and the bowel bladder and uterus won't "hang out" in the prolapsed position.

One side note is that the pelvic floor is one of the 5 muscles automatically used when the transverse abdominus is being used. Many people tell me they feel like they are working their pelvic floor while doing the seated tuplers, which is another reason why the client I mention above had great results.

However, when a client is pregnant, we have them relax the pelvic floor while doing transverse work to prepare for labor, where you use the transverse strenghth for pushing and totally relax the pelvic floor so baby pops out. We call this technique PERFECT PUSHING®.

I could go on and on about this - I have also seen Dr. Kegel's original work - including videos full of clients, and small children who had bed wetting problems (although not a good video to watch during a lunch break!) - and these clients who showed marked improvement were not just clients who used his device, but utilized the slow and fast twitch muscles of the pelvic floor. The one GREAt point was that relaxation NEEDS to be a part of the pelvic floor - and that squatters have strong pelvic floors.