How To Do A Kegel The Right Way

By Jessie Mundell
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“Do your kegels!”

What does that even mean?

If you’re pregnant or have had a baby, you’ve likely been told to do your kegels. But, how are you supposed to actually do your kegels? It can be a bit tough to wrap your brain, and your body, around what a kegel is and what it should feel like when you’re doing one.

A lot of women who try to do kegels, end up "bearing down" on their pelvic floor instead (think: valsalva) or aggressively squeezing of what they think to be the right muscles. In these instances, they don't quite have the correct action and could be doing more harm than good.

What is the Pelvic Floor?

The pelvic floor is a network of muscles and other connective tissues in the base of the pelvis that provides structure and stability for the pelvis itself and for the organs within it.

One of the best explanations I’ve heard to describe the pelvic floor is from Lisa Gimenez-Codd (who wrote this article on the pelvic floor) comparing the pelvic floor to a wicker basket.

pelvic-anatomy-402x340Think about the base and outer structure of the basket as your hip bones (your pelvis) and the all the interlocking strands of the basket as the muscles and connective tissues of the pelvic floor. They provide the extremely important internal support to hold things in your basket, or in your pelvis. The diagram on the right shows a typical female pelvic floor. Everyone, including males, has a pelvic floor.

Lisa goes on to explain how you can imagine carrying your wicker basket while grocery shopping. You know the feeling of putting items in your basket and you feel that weight dropping down and pulling at your arm? This is a brilliant way to describe the cumulative effects of pregnancy with the increasing weight of your baby, the placenta, and, not to mention, the normal weight of your pelvic organs. Kegels can be effective for those who have a pelvic floor that needs strengthening and re-toning, which is typically the case later in pregnancy and early postpartum. Check with your pelvic floor or women’s health physiotherapist to be sure.

Disclaimer: Kegels are not effective for everyone. If you have a tight pelvic floor, focus more on relaxing and releasing the muscles first, not on contracting them.

Ready, Set, Go

Step 1: Ready

To get the body ready for kegels you first need to master your alignment. You can think of alignment as posture, but just know that this goes beyond your mom telling you to “stand up straight” or “pull your shoulders back” when you were a kid.

jessie-posture-posterior-pelvic-tilt-example-314x375I think of alignment as the way the joints and bones stack up to create your posture. I’ve used this analogy before, but this is a tale of Goldilocks and the Three Bears to get the body set up in good alignment. For example, your pelvis should  not be rocked too far forward (anteriorly tilted), or too far backwards (posteriorly tilted). The picture on the right shows what non-optimal alignment looks like with a posterior pelvic tilt. The bum is tucked under and the low back is flattened.

Rather, it should be stacked right in the middle, with your ribcage sitting over top of your pelvis. This is a great article from Julie Wiebe, women’s health physical therapist, speaking about what happens when our ribs are not over our hips, leading to a ‘junkless trunk’.

How to get into good alignment:

  • Have a tall upper body, growing up through the crown of the head (instead of rounding forwards
  • Have a gentle arch in your lower back (instead of a long bum with a flat low back, or REALLY arched lower back)
  • Have your ribcage stacked over your pelvis (instead of shifted backwards or flaring up)

jessie-posture-optimal-alignment-example-314x375In good alignment, with the ribs over the hips, you have the diaphragm stacked over the pelvic floor, which sets you up for Step 2. The picture on the right shows what more optimal alignment looks like (it takes some practice to master).

Step 2: Set

When you're ready with your alignment you are set to breathe properly. You need to really focus on your breathing patterns to ensure you're recruiting the core all together as a team. The core starts from the diaphragm, goes all the way down to the pelvic floor muscles, and is surrounded by the abdominal muscles and spinal muscles. Your alignment from Step 1 sets you up for the breath to flow easily and therefore, helps you gain core stability.

Set up for breathing:

  • Sit on a hard chair or bench and pull the flesh away from your seat
  • Make sure you’re in good alignment = feel yourself seated on top of sitz bones
  • Put one hand on your belly and the other hand on your ribcage
  • On your inhale breath, breathe into your hands and think about inflating your pelvic floor with air
  • On your exhale breath, feel the hands fall down and imagine the pelvic floor deflating.

Recap: Inhale to inflate the trunk and the floor. Exhale to feel a deflation of the trunk and the floor.

Step 3: Go

Now that you’re ready in your alignment and set with the basic breathing pattern, you’re ready to go on to the core and  floor connection.  Here’s how to do your Core and Floor Connection:

  • Same alignment and breathing set up as in Steps 1 and 2
  • On your inhale breath, imagine inflating the pelvic floor
  • On your exhale breath, you’re going to imagine lifting your vagina and anus up and into your body gently (30 percent of your max effort.)
  • You’ll feel a deep tension in your pelvic floor and lower abdominals
  • Flow through your breaths, releasing your vagina and anus down on your inhale breath, and picking them back up on your exhale breath.

*Tip: Practice two sets of 10 breaths daily focusing on both the relaxation and the contraction. If the relaxation bit seems trickier to sense, and it often is, it’s best to forgo the contraction and keep working on the relaxation.

Core and Floor Connection Cues:

  1. Lift up a peanut/bean/berry/marble with your vagina and anus.
  2. Imagine pulling a Kleenex out of a box. Think of this as the opening being the vagina and you’re pulling the pelvic floor muscles up.
  3. Try to draw your clitoris towards your vagina (best when you need to feel more activation through the front half of your floor).
  4. Lying on your back, think of the space between your tailbone and your pubic bone as an accordion. On your inhale breath, imagine your tailbone and pubic bone drawing further away from each other (like an accordion extending). On your exhale breath, imagine your tailbone and pubic bone drawing in together (like an accordion contracting).
  5. For those who don’t have a vagina (because, remember, everyone has a pelvic floor): try to pull the boys up, or pretend like you’re walking into cold water.

*These are cues I’ve learned from various resources, physiotherapist, yoga and pilates instructors, and ones that my client’s and I have come up with together to better help them best connect with their core and floor. There’s no "best" cue—it’s truly just a matter of whatever makes the most sense to you in your brain and body.

How Often Should I Practice My Core and Floor Connection?

Daily is best, especially when starting out. Eventually this will become automatic and you won’t have to think so hard. Train your core and floor connection purposefully so that it becomes automatic and happens on cue when you lift, sneeze, sprint, laugh, etc.

Remember:

  • Ready = Align the body
  • Set = Breathe to feel inflation and deflation on the floor
  • Go = Add the core and floor connection to the breath

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About the author:  Jessie Mundell

Jessie Mundell is a certified kinesiologist and a Precision Nutrition Level 1 coach, as well as an author and mother. She specializes in pre- and postnatal exercise and corrective exercise. Learn more about Jessie on her website and connect with her on Twitter.

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