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The Kegel Myth. Could Kegels Be Hurting Your Pelvic Floor?



A woman looking out the window thinking about her medical health concerns.
Bladder leakage is one pelvic floor symptom that can cause stress and embarrassment. Sadly, The Kegel Myth has created confusion on how to holistically heal the pelvic floor.


We are a culture obsessed with strength. Only our perception of what is strong is limited, flawed, and often causes harm to our physical structure.


Let's say a woman has low back pain, this pain could be anywhere from nagging, to moderate, to severe. Upon palpation we could discover that her SI Joint, that beautiful triangular-shaped bone at the end of her spine is off, not centered, pulling on the tissue--the low back muscles and fascia--above. To assist her SI joint we work further down the chain, palpating the attached glut muscles. With no more pressure than the weight of a fingertip, while still just plapating the tissue, she may wince in pain. So we talk, I tell her what muscles we are feeling and she asks why they are so painful. I explain the area is hypertonic or in a chronic state of contraction, tight and tense. I can't tell you how many women in this situation then reply, "Well isn't having a tight butt a good thing?" We laugh together as I explain that isn't necessarily the case.


Muscles need strength. But they also need softness. Buoyancy. Easy slide and glide between structures. An optimal body is free of pain and nagging discomfort and to achieve this optimal body buoyancy and slide and glide should be talked about as much as strength. But is that what you have heard? Have you heard a lot of talk about creating soft muscles? About creating muscles free of restriction, muscles that glide past each other as you move your arm or move your back? Has that ever been the focus of our cultural discussion(s)?


Strength is not the answer. Strength is just one of your many needs and strength must be balanced with relaxation, softness, and ease of movement. Which brings us to The Kegel Myth.


In a culture obsessed with strength, the answer to all things pelvic floor is Kegels. And yes, like all muscles, your pelvic floor needs to be strong. A quick Google search can find us a variety of ways to strengthen the pelvic floor. We can join group fitness classes in person or online that talk about engaging the pelvic floor with smart core strengthening exercises. Pilates, yoga, and barre classes are all fitness choices that create pelvic floor strength.


And yet, most pelvic floor issues result from tension and tightness. Pelvic floor muscles with trigger points (heightened zones of electrical activity) that are pulling on the structures above. A tight pelvic floor pulls on the bladder causing bladder leakage and varied types of pain. Women may describe burning around the bladder, sharp bladder sensations, or feelings of bladder infection without the presence of infection. Or due to a tight pelvic floor stressing the bladder actual infections may come and go (more on this in another post).


Here is the visual I often give in the office: Imagine a tight bicep. Think Popeye, when the bicep is tight and tense the fibers will be pulled together, interlocking and creating some degree of a "hypertonic bulge". The muscle is in that state chronically, unable to release and relax. Your brain knows things are going wrong, it tracks everything related to the bicep, and the brain is sending the pain signals. Because the brain "does not feel safe" in this area of the body your range of motion is decreased. As you go throughout your day, your body starts compensating, now other muscles are being worked incorrectly or overused. More pain awaits your future.


Now what if someone told you the way out of this bicep problem was through strength training? To lift weights. To take a muscle whose fibers are already in a state of tension, a muscle whose fibers are pulled tight together, and crunch them together even more? That seems counterintuitive, doesn't it? And yet, that is the blanket advice we give women experiencing pelvic floor related tension or illness such as bladder leakage. And yes, I am labeling bladder leakage as an illness because well...it is. Bladder leakage is a sign of being unwell and if left unheaded, the symptoms can become worse and start to vary. What started as "just some bladder leakage" can become a lot of bladder leakage, pain with vaginal insertion, or eventually prolapse.


The Kegel myth is not personalized advice. It's a one-size-fits-all approach to pelvic floor health that leaves many many women worse off than when they started. For many women, they will be tightening an area that needs relaxation. Some women have a pelvic floor that is tight on one side but weak on the other. Some women have a pelvic floor that is weak because it is burnt out from chronic tension. Some women may have bladder leakage and a tight pelvic floor and then do Kelgels and increase the tension to the point where the bladder is now held so tight that bladder leakage stops but urine retention begins. Just doing Kegels--without understanding your individual needs or even just broadly understanding what creates holistic neuromuscular health-- can increase tension in a way that causes long-term issues.


Be calm. Dont worry. Stress is not a friend to the pelvic floor ;) Another blog post will soon explain more about what you should be doing to create a healthy pelvic floor structure. In the meantime, just explore what strength means to you. Your mind is not separate from any part of your physical body and having a conversation with tense muscles is a powerful form of healing.


Tell yourself that strength is not found in tension. That you can let go. The act of allowing yourself to become soft is an act of growth and for many women cultivating emotional and spiritual strength is the ultimate act of long-term pelvic floor healing.


All is changeable. All is changing.


Peace & Love,


Tara


*Author Tara Lee Clasen is a manual massage therapist specializing in women's health and pain conditions related to the pelvic floor, neck, jaw & shoulder. She also trained in clinical Ayurveda and has authored a book on Ayurveda called The Elemental Woman.














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