pelvic floor work - no kegels required.
today i have for you some unsolicited advice about your pelvic floor and why getting right with those mysterious muscles is important. unfortunately, until very recently the good ol' pelvic floor was a taboo subject kept absent from everything from fitness to postnatal care to sex ed - even though at least 50% of postpartum women experience pelvic floor issues, and not for nothing, we ALL originally come from a human pelvis.
and no, you're not off the hook if you're not having babies, having a planned c-section (it's not “just” childbirth that contributes to pfm problems), or don't identify as a woman. we all have pelvic floors and will hopefully reach advanced age someday, when our decades of work, movement, emotions, experiences, habits and stress can accumulate into all kinds of aches & pains, dysfunctions and problems in the pelvic floor and elsewhere.
not to mention, this incredible area is home to our root chakra, our deepest source of self and strength and creative force. it's where all human lives begin, a bony bowl containing womb and guts, eggs and seeds, the junction of the top & bottom of the body.the point is - the pelvic floor shouldn't be a specialty topic, a whispered secret, or an add-on workshop. it IS core strength. it IS a deep full breath. it's key to true fitness and, take it from a pre & postnatal exercise professional and mother of 2, you don't want to wait until there's an issue to get hip to what's happening between your hips.
the internet + pelvic floor
when i was pregnant with my first baby - 5 years ago from the time of writing this, actually - i had to really dig to find information on the pelvic floor, and to learn about what in the name of jumping jacks was about to happen to mine. the pelvic floor seemed to begin and end with kegels, and that's as far it went. now, at least on my instagram feed, there are hundreds of experts and reels and programs and gadgets galore to support pelvic floor health and other pre/postnatal conditions. and this is great - truly, it's a step in the right direction! - but i still see clients who are mystified as to why the “method” they just paid for isn't working for them and why, months and years after childbirth, they are still dealing with issues like leaking, pain, or tightness. people who are doing all the kegels in all the ways and are still suffering.
and it really is suffering.
when such a deep, integral part of you isn't right, it's incredibly disorienting, confusing, and distracting. as i mentioned before, pelvic floor muscles are literally the deepest part of our core and surround our root chakra, which carries with it an integral sense of selfhood and creativity. lack of connection and control, pain, risk of embarrassment, all of these things can very much take their toll on our psyche. coupled with extreme life changes like having a baby (or becoming older and less independent) the psychological effects of pelvic floor issues can be devastating, not least because stress itself is a major contributor to pelvic floor problems.
real talk
i'm speaking from my own experience, as well as from my training, research and what my clients have shared with me. i have never felt so vulnerable as i did after giving birth to my first child. it was as if i'd been opened up and not put back together (and i didn't even tear, prolapse or have a c-section.) i felt shame from some dumb internal monologue i had about being a pilates professional and still being unable to fully prevent these issues or “fix” myself. also, i was deeply frustrated with the postures of early motherhood that result in even more downward and outward pressure on this area (holding, feeding and caring for tiny humans is a flexion-intensive situation for the spine, hips and shoulders.) as much as i had studied, prepared, and pilates-ized myself, i felt unprepared for this particular reality (of being a normal human woman) and, coupled with the terror of being a new parent, i felt uncertain of myself, nervous and afraid, pretty much all the time.
but, after awhile, things got better. partially on their own, because the body just needs time to heal itself and do its thing, and partially because i set about a patient process of healing myself from a full-body perspective. it took a bit of time, but this turned out to be effective so that by the time i had my second baby, 3 years later, i managed to do so with virtually zero postpartum pelvic floor issues, DR or low back pain. since then, i am pleased to report that i still haven’t had any pain or leaking and have resumed all physical activities including trampoline jumping and running (sometimes). also, while this tidbit is probably tmi, i even still use the same size menstrual cup as before babies (!).
and it wasn't kegels that accomplished all this
kegels are the oft-cited go-to exercise for pelvic floor health named for the gynecologist that “discovered” them. they are a squeeze of the superficial pelvic floor muscles (think vagina, perineum, anus), referred to as such because they are superficial in relation to the deeper layers of pelvic floor muscles (there are two deeper levels , in fact). personally i prefer to call them lifts or squeezes because i refuse to credit some dude doctor with finding the strength of my pelvic floor (although - fun fact - he and i have the same birthday.)
but here’s the thing - while it’s a useful life skill to be able to contract and hold pelvic floor muscles, it’s not the only (or even the most effective) way to heal, strengthen and support the pelvic floor. in fact, some teachers even suggest not to cue lifting and squeezing from the pelvic floor because it interrupts the natural recruitment of the deep pelvic floor muscles, which we don’t control with our minds. it’s like placing a paper bag of groceries on a hammock - yes, the hammock must be strong enough to contain the bag, but if the bag isn’t strong, the groceries will still spill.
honestly, i do still cue a pelvic floor lift, especially for pre & postnatal women, because it’s important to connect to our bodies and work towards a sense of calm control. but there’s a little more to it than that.
when kegels fail, there’s a few reasons why:
some pelvic floor issues stem from hypertonic muscles, or too much tightness, which means that the exact opposite of a kegel is needed
like using a bandaid when we really need stitches, strengthening superficial muscles without addressing deeper ones only sort of works - it means our brains have to think fast enough to contract the muscles before any drama, while our deep pelvic floor muscles and organs work without our conscious control, which means that we may be too late in our conscious response
the pelvic floor is part of a whole body system of pressure regulation, structural integrity, and many moving parts working together. if posture, breath, alignment or muscle activation timing is off elsewhere, there can be direct impact on the pelvic floor.
so, what to do?
well, that might be the subject of entire classes, books and master’s degrees, and i will surely write more on this in the future, but for now, here’s some tenets of my approach to pelvic floor health. these are the steps i took for myself and teach my clients, but they are not to be taken as medical advice as i am most definitely not a medical professional.
1) breathe well and deeply. fill your lungs like balloons and expand them in all directions. relax your center as you inhale and allow it to engage on your exhale. a deeper breathing pattern is genuinely life-changing. and if nothing else, deep breathing can calm the nervous system and reduce stress, which has a direct positive impact on the pelvic floor.
2) work your sides. stretch them, strengthen them, and get to know the muscles of your side body. they assist with proper breathing, structural integrity, and posture, which brings me to the next point:
3) practice excellent posture. and i don’t mean trying to sit “at attention” at your desk all day. i mean strengthening your posture muscles to help you stand taller all the time without having to think about it, to make room for fuller deeper breaths, and to free your body of unnecessary pressure, downward pull, and pain-causing patterns.
4) get strong glutes. when the surrounding muscles of the pelvis are strong and functional, the internal contents of the pelvis are better able to do their job. lively, unclenched glutes directly and indirectly contribute to pelvic floor health and have positive effects throughout the body.
as promised, more details coming soon, but i hope this helps you begin to connect to, heal, or care for your own power of the pelvis.
