For most women, if you’ve been told anything about the health of your pelvic floor, you’ve probably been told to kegel, or “squeeze like you’re stopping the flow of urine.”
How to Do a Kegel 2.0
This universal prescription of kegeling is problematic for a couple reasons, which is exactly why I teach what I call a “kegel 2.0” instead.
Here’s the basic cueing: Start with deep, relaxed diaphragmatic breathing, feeling your belly fill on the inhale and empty on the exhale. If you can, try to become aware of any movement in the pelvic floor during your diaphragmatic breath. With an exhale, engage the entire pelvic floor by lifting your perineum in and up.
If you’re not quite sure how to lift your perineum, here are a few other visualizations that might help:
- Wiggle around to find the four bony landmarks of the underside of your pelvis: the two sit bones, pubic bone, and tailbone. As you exhale, think of drawing all four together.
- Squeeze your sit bones together like chopsticks.
- Wrap the bones of your pelvis in and up like you’re cinching up a drawstring purse.
- Imagine you’re lifting a blueberry with your vagina.
- Picture your vagina as a smoothie straw and imagine you are sucking smoothie up with it.
On the exhale, gently release the entire pelvic floor back down.
Kegeling with the Whole Pelvic Floor
The first reason the traditional kegel is problematic is because it only refers to cutting off the flow of urine. That would mean engaging your urethral sphincter only. While it may seem like splitting hairs, the urethral sphincter, vagina, and anal sphincter can all be engaged independently. A kegel 2.0 encourages you to use the entire pelvic floor. This is better for your pelvic health and it creates better balance in the pelvic floor, rather than a really strong front pelvic floor without much strength anywhere else.
Releasing Your Kegel
The other big difference between a kegel 2.0 and an old school kegel is that the kegel 2.0 includes in it releasing the pelvic floor. Many women are actually too tight in the pelvic floor, which can create a whole host of other symptoms. One potential symptom is feeling like you aren’t able to kegel (because the pelvic floor is already engaged and can’t engage further). This is exacerbated by more kegeling without actually releasing the pelvic floor. It’s like doing a bicep curl without ever straightening your arm back out.
Which brings me to the last important distinction: Not everyone needs to kegel. Often kegels have been recommended (by actual medical practitioners and the likes of Cosmopolitan) universally without consideration as to whether the woman actually needs to tighten the pelvic floor muscles. If you’re already too tight in the pelvic floor, you might just need to soften, stretch, and relax.
While I certainly can’t take the place of a qualified medical practitioner, I do have experience working hand in hand with pelvic floor PTs. If you need a trainer who can work with your PT or help you deal with recovering from injury, let’s chat!