Updated: Dec 30, 2021
Kegals have become increasingly common these days; you might hear about them in your yoga class, from someone at pilates, from new or expecting parents.
Kegals are everywhere and everyone seems to be doing them; I’ve even seen a surfer holding a surfboard up with her pelvic floor (don’t ask me why).
And I have the unpopular opinion that there’s more to pelvic floor therapy than the kegal. Before I fall into the trap of disparaging the kegal, I want to explain 3 things:
1) what a kegal is
2) other ways the pelvic floor can be strengthened
3) the other kinds of contractions we can perform with our pelvic floor.
What exactly is a kegal?
A kegal is the term for the coordinated contraction of the pelvic floor muscles. Just as we contract our bicep muscles or our quads, the kegal isolates our pelvic floor muscles and sometimes may need to be a part of a strengthening routine.
To begin, let’s bring awareness to your pelvic floor. I like to have patients put their hands or a towel in between their thighs and over their groin to help provide feedback. Now, I want you to imagine you’re squeezing, as if you’re stopping a flow of urine and preventing gas from coming out. (don’t actually attempt to stop the flow of urine in real life more than 1x a month or so; it confuses your poor bladder). It should feel like drawing “up” and “in” as you squeeze.
It’s okay if it doesn’t make sense immediately; there are muscles there, and you can absolutely bring your conscious awareness to them. Use the tactile input and your own hands to feel when the muscles squeeze.
If you feel like other muscles are kicking on as you try to do this, sit in a wide stance with your knees apart, or in child’s pose. I personally have most clients sit on a towel with back support or lying on their back, as these help most muscles relax.
Now, check in with what your pelvic floor is doing while you breathe.
As you inhale, your diaphragm should drop, your belly and ribs expand; there shouldn’t be much upper chest movement. If there is chest movement, that could be part of the problem as well. Focus on breathing into your belly and lower ribs, and as you breathe in, your pelvic floor should relax and drop down, pushing into whatever tactile input you’ve chosen.
In some cases we may need to work on isolated pelvic floor strength. However it’s important to note that many times people actually have pelvic floor tightness which then translates to weakness. This would be a case where we don’t actually want to work on strengthening because the lengthening and relaxation is more important (hence why getting evaluated is so important)
This brings me to my second point. I want to touch on something that might actually not be that common. You don’t necessarily need to do kegals to get a stronger pelvic floor; coordinated core exercises can do just as much to strengthen the pelvic floor, and are much more functional. A farmer’s carry can promote pelvic floor strength, if your breathing is in sync with your pelvic floor. A side lying plank can help promote the strength of your pelvic floor. A squat, a deadlift, a kettlebell swing can also be used to promote strength of the pelvic floor, if done correctly.
What does “done correctly” mean? It means keeping your pelvic floor in sync with your breath, and having good core engagement so help maintain pressure in the abdomen as you move.
What’s the difference between a deadlift and a kegal? One of them is more functional; I’d rather have you practicing a deadlift, keeping your body functional, and get the benefit of strengthening your pelvic floor when you’re actually using it, rather than isolating it’s training to when you’re lying on your back with no challenge. Kegals absolutely have their place, and if someone has incontinence with a deadlift, an internal assessment will be key to figuring out what’s going on, but I’d much rather train their deadlift and coordinate their pelvic floor rather than have them spend hours on a kegal. Because the deadlift gives us more bang for our buck.
Lastly, and most interestingly, I want to highlight that a kegal is a contraction of all the pelvic floor muscles, all at once. These muscles are uniquely innervated, and don’t actually have to all contract at once. With practice, you can develop unique and distinct conscious control of each set of muscles. For example, you can contract the pelvic floor in an anterior-middle-posterior wave, and the reverse direction. It’s also possible to contract one side, and then the other.
This increased differentiation and fine tuning of muscular control will increase your stability and your awareness of your pelvis, and empower you to better prevent injuries by being consciously aware of what each layer of muscles is doing.
And for those of you thinking ahead, yes, having increased control of your pelvic floor can help with pain during sex, as well as promoting increased pleasure.
That all being said, kegals are not my “go to” exercise. The strength of the pelvic floor muscles matters, but more often than not, it is incoordination with our breath that results in over-pressurizing the abdomen, or tightness and tension in the muscles that’s causing the problem. Being able to coordinate and control them has some added benefits that are useful, can help prevent injury, and maximize pleasure, so use them well, and use them wisely!
Dealing with any issues that require further attention? Contact us today to set up your evaluation!