24 Jun Demystifying Kegels
Kegels. The magical exercise to cure all pelvic floor dysfunction and have better sex. Ha- if only it were that simple. Kegels, an exercise popularized by gynecologist Dr. Arnold Kegel, (hence the name) are a non-surgical way to strengthen the pelvic floor.
How have you been told to perform a Kegel? To squeeze the muscle that stops the flow of urine while you pee? That seems to be the popular instruction. Have you been told this strengthens your pubococcygeus muscle? Have you been told to do these ALL THE TIME for bladder control and a tight vagina? While driving, working, waiting in the line at the grocery store, etc….
It’s not that these instructions and explanations are completely wrong, but they’re not completely true either. I see the value in keeping it simple for the general populous to understand and these general instructions may work just fine for a small group of people. For most of us though, this over simplification could do more harm than good.
Let me break it down for you…
There is more to the pelvic floor than just the pubococcygeus, also referred to as the PC muscle. This is a mere one muscle in the network of over 11 different pelvic floor muscles and many more supporting muscles of the deep external rotators and adductors.
The pelvic floor is comprised of three layers.
The most external layer makes a figure 8 around the urethra and vaginal opening and the anus.
The middle layer runs side to side, or sit bone to sit bone.
The deepest layer runs front to back, from pubic bone to tail bone. The pubococcygeus lives within this deepest layers.
All of these layers overlap at one place in the pelvic floor, the perineum, or space between the vagina and the anus.
Second: Are Kegels for everyone?
Most pelvic floor dysfunctions can fit into two categories, those that stem from hypotonic (too weak) pelvic floor muscles, and those that stem from hypertonic (too tight) pelvic floor muscles. And to further confuse you, most pelvic floors are a combination of hypotonic and hypertonic muscles. Yikes.
Because of this, squeezing all day long is not beneficial for most people. Before you strengthen a muscle you need to make sure it knows how to first relax.
Why do most of us have tightness in our pelvic floors? Lots of reasons. Everything from posture (especially tail tucking), overtraining in dance, pilates, or yoga, being a generally tense person, and trauma to name a few.
So before you Kegel, first learn to reverse Kegel.
Reverse Kegel: Sit with your weight on your sit bones and spine aligned. As you inhale imagine (then eventually feel) your pelvic floor widening in all directions. As you exhale it returns to neutral. Your pelvic diaphragm matches your thoracic diaphragm. Expanding and lowering on the inhale, returning and lifting on the exhale. Make sure you can feel this action before you move on to Kegels.
Note: Expanding on an inhale is not bearing down like you are pooping. It is much more subtle than that.
Third: How to Kegel.
Knowing what you know now about the anatomy, do you think squeezing the muscle that stops the flow of urine is sufficient to strengthen the entire pelvic floor?
Most women who have mastered this action are squeezing too much in the front of the pelvic floor while ignoring the rest.
Remember when I said that the perineum is where all of the layers of PF muscles overlap? Therefore engaging from this place will give you the most access to all of the PF muscles.
Kegel: On an inhale perform a reverse Kegel. As you exhale imagine (then eventually feel) an engagement of IN (together to the center of the perineum) and UP (towards crown of head) 25% of your full capacity from your perineum. As you inhale again reverse Kegel to relax the engagement.
I don’t prescribe reps and sets. Try some, see how it lands in your body.
Also try reverse Kegels and Kegels in a reclined position watching your PF in a hand mirror. This will help you see and understand what’s happening.
Lastly: What about better sex?
Ah yes, better sex and more intense orgasms from a tighter pelvic floor. Think about that….according to who? The man whose penis is inside you? If your pelvic floor becomes too tight, it will probably cause pain with sex, and that will not lead to better orgasms. Also, sex does not have to be defined as penetration. Let’s put Kegels aside for a moment and discuss another way to experience more pleasure with sex.
Oh yeah, being fully engorged and ready for more.
Women have just as much erectile tissue as men and when we are fully aroused this tissue swells making the vagina both more snug and more expandable. This engorgement also causes vaginal sweat (lubrication) and protects the urethra from friction.
How do you get fully aroused?
That can look different for each woman and even different for the same woman from day to day. It’s a complex interplay between the brain and body, the external and the internal environment, and sense of safety. It can take more time than you want to give it, but for sex to feel more amazing FOR YOU, it’s worth it. Take the time to get your brain and body to say HELL YES to sex and see if that doesn’t feel better and give you better orgasms.