I thought this was a great blog post on why kegels are no good.
I have pelvic floor pain and have done a great deal of writing on the topic, and every health care provider--doctor/PT I've talked to on this topic, and that equates to dozens agrees that kegels are not only ineffective, they are bad for the pelvic floor.
http://www.pelvicpainrehab.com/blog/2012/08/why-kegels-are-bad-for-your-pelvic-floor/
That is interesting, but why would a toned muscle be a bad thing? I get the idea that you can have a too tight pelvic muscle if you over-do it, but that would seem similar to any other muscle fatigue in your body: it gets a rest ofr a bit then life goes on. I doubt most women are doing the kind of exercise it would take to get a tight pelvic muscle. Most people, it seems, recommend a moderate amount of exercising for a mucsle that we tend to neglect, and that sounds good to me. Keep it toned, keep kegeling.
I did a bunch of research on this topic last time I was pregnant (towards the end). I believe in kegels. I did them all through pregnancy and my son was born in one push. While I think it makes theoretically makes sense for first time moms, to me it just doesnt make sense if you have already given birth once. IMO, it's important to maintain a strong pelvic floor.
I cant find anyone other than katy bowman and nicole crawford (and whoever is interviewing them at the time) who regularly suggests not doing them. Until I see some doctors and midwives saying not to do them, Im going to keep to my stoplights, shower, and after peeing kegels.
Our pelvic floor actually is not like any other group of muscles in our bodies in that it can never fully relax b/c if it did that would cause incontinence. So already the muscles are at a bit of a handicap compared to other muscles in our bodies b/c they can never relax. These muscles are also in a unique position in that they are in an area of the body where they play a role in the functioning of adjacent organs, the urethra, the bladder, etc. I addition, they share nerve branches with these organ systems. The result is that a problem with the muscles can cause severe problems and pain to the organs and vice versa!
If the muscles become too tight, and they do for a variety of reasons, such as trauma (childbirth, etc.), overuse (frequent biking, SITTING, etc.) a cycle of pain can be ignited. Let me explain: the muscles become tight, the tissue stops getting the oxygen it needs, pain begins, the muscles guard against the pain becoming tighter, more pain, nerves are impeded, more pain, more tightness, trigger points develop b/c that's what happens when muscle tissue doesn't get enough oxygen and other nutrients (b/c of tightness), and next thing you know you're dealing with a slew of painful symptoms that can include urethral burning, pain with sitting, vestibular burning, urinary urgency/frequency...it's a very long list and unfortunately I have dealt with my share of these symptoms for too long (I'm seeing two great PTs now, so getting better finally, slow but sure.) All this because of initial guarding or TIGHTNESS that began due to a trauma, in my case it was a bartholin's abscess.
So this is why over tight pelvic floor muscles are nothing to fool around with and doing kegels is not a good idea!
I've been writing about the pelvic floor for seven years and any doctor/PT who knows about the pelvic floor, and unfortunately more don't than do will back up what Katy Bowman says. It's bad advice and I'm glad that finally folks are starting to slowly but surely become educated about the pelvic floor. Just trying to do my bit.
I asked my PT your question, which was a very good one! and here's what she had to say:
There are many experts in the pelvic floor field that will strongly agree that doing Kegels are appropriate only when pelvic floor muscles are overstretched and weak. There are many articles in medical journals that support this.
I completely believe in the kegel too (Adaline's mama)... From what I gather ( and I have done alot of reserch too) it is Scientifically proven to help in a number of issues.
It is crucial that you learn how to correctly perform the kegel exercises in order to see some real results. The most important thing is to accurately recognize and learn to control the right muscles and that you perform the exercises regularly. I did it threw the birth of both my sons and it had great results.
I have a lot more information in my blog
[Admin note: Link removed as MDC does not permit promotional posting.]
Amy
So ı only do kegels whıle DTD! And Ive done a lot of the deed ın my lıfe. haha. My doctors told me to do them as a kıd wıth chronıc utıs. but usually just dıd them DURING the deed :) whıch was much apprecıated.
long story short my 10 lbs 2 oz baby was out ın two pushes durıng 1 conctractıon (after my body pushed on ıts own maybe 3 or 4 prevıous tımes). Head, shoulders knees and toes! I dıd get a rıp (dıdnt do the stretchıng down there ı was supposed to). But I defınıtely thınk my strong pelıc muscles helped. I defınıtely dıdnt do kegels everyday though. just a few of them durıng the deed over the past uh... decade-ısh. heh.
Here's another little offering to help women understand that sets of kegels performed on one's back in an attempt to strengthen and protect the pelvic "floor" is simply the wrong concept: http://wholewoman.com/blog/
So since Whole Woman advertises on this site Christine can post a link, but Amy Young can't? Weird.
The To Kegel or Not To Kegel debate is frustrating, because it's very difficult to know whose advice is best, and those of us dealing with prolapse would like to manage symptoms as effectively as possible. I have spent a lot of time on the Whole Woman website, but ultimately have been following the exercise program recommended by Tasha Mulligan (www.hab-it.com - perhaps this link isn't allowed either). I do SOME kegels, but not very many, and only 3 times a week. I feel like I'm hedging my bets this way. I'm just not comfortable not doing any kegels. I have noticed a lot of improvement through changes in my posture and strengthening my lower back. Tasha and Christine actually have a lot of points in common. I appreciate that they are both out there supporting women with prolapse. Knowing that it CAN get better is key!
Hi Vanni,
I will do my best to write something (asap!) that will better explain the difference between exercising the full range of motion of the pelvis vs. the focused movement of kegels.
Please understand that Tasha comes from a perspective of the "neutral pelvis", and in fact has publicly maligned Whole Woman posture - misinterpreting it as the belly flopping out and the back swayed. I like some of Tasha's exercises. What Whole Woman brings to the party, however, is a revolutionary understanding of the position of the pelvis and pelvic organs within the standing body. Everything falls into place, so to speak, when that paradigm shift is made. PT has been informed by gynecology and they are not easily making the transition to the reality that doing sets of kegels is a bit like squeezing your biceps and expecting carpal tunnel syndrome to improve. It's just the wrong concept. The organs are carried in front and the opening is at the back. That Tasha and Katy both malign the posture that results from this reality, I find disappointing - especially when countless women are getting results with the WW work. There really is only one pelvic organ support system, and all we can do is keep describing it until the entire world understands.
Christine
True Kegels are ill effective. However, strengthening the pelvic floor is important for a number of reasons. The pelvic floor is the base of support for all of your reproductive and visceral organs. During pregnancy the weight of the uterus increasingly strains and destabilizes the pelvic floor. There is only a 10-15% difference in pelvic floor trauma when comparing vaginal and c section delivery. However, vaginal delivery stretches the nerves of the pelvic floor up to 35%. Nerves can only stretch 15% before they tear. It is a fact that with each vaginal delivery there is consequential nerve damage, and rehabilitating the pelvic floor is essential. Additionally, the pelvic floor plays an important role in spinal decompression. ie-The pelvic floor helps to support the spine. Kegels are not sufficient or dynamic enough to provide optimal strength and flexibility of the pelvic floor. One would benefit more more from combining strengthening and stretching movements for the pelvis, (ie encouraging sacral stability) with pelvic floor strengthening exercises, and intravaginal/perineal massage/pnf stretching. An excellent program for pelvic floor strengthening is Pfilates. It combines co-recruiter activation with plyometric activation of the pelvic floor. Pfllates was developed by a urogynocologist name Dr Bruce Crawford. He has spent years researching this, 'has operated on thousands of women for various pelvic floor disorders, and sought to find a fitness program that may be used as an alternative to or adjunct to surgery. you can find more about his program at www.pfilates.com For those of you who are pregnant and do not have a protocol for perineal massage, get one. For those of you who are and do, add pnf stretching to your routine. Think of it as power yoga class for your vagina.
I'll just throw this into the mix in hopes of reaching the free thinkers in the crowd. ;) http://wholewoman.com/blog/
Gynecology has had the core anatomy of the female pelvis wrong for as long as it's been an established practice. The true pelvic floor is the pubic bones, which with the help of the multi-layered abdominal wall support all the pelvic and abdominal organs, as you say. The thin, sinewy muscle wall at the back of the body is largely out of the way of intraabdominal pressure. It is much better suited to helping things go out than keeping them in.
This is such an important paradigm shift for women to make. Kegels? Whatever. Just learn about your true anatomy and the rest will follow.
There is only a 10-15% difference in pelvic floor trauma when comparing vaginal and c section delivery.
Can you provide more info on where you found this? I'd like to pass it on to an expecting friend. Thanks!
As far as kegels go, I did them religiously with my first (9lb 9oz) baby and didn't do a single one with my second (7lb 5oz) baby. The second delivery was much easier, though this may be due to the size difference!
I do remember one of the midwives at my first daughter's practice saying that dancers and runners were the worst to catch babies for because their pelvic floors were too tight!
All anecdotal :)
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