Being active is an essential part of creating long-term, lasting health. But what if participating in exercises classes, running, aerobic activities or heavy weight training results in bladder leakage? Is pushing through the discomfort, feelings of embarrassment or total avoidance of the issue the real lasting solution? Is peeing your pants during exercise ever normal?
You might be surprised to know, that your ‘’wee problem’’ is much larger issue than most people understand. Current statistics clearly show that an alarming 80% of women will suffer with a pelvic floor disorder at some stage in their lives and 1 in 9 woman will have surgery to fix their pelvic issues. 2015 can be a year of change for all of us: before we start to embark on grueling exercise routines, we need to take time to understand and consider the health of our pelvic floors.
Where Does The Problem Come From?
Any exercise that involves a change in intra-abdominal pressure, such as running, jumping, or lifting heavy objects can create a repetitive impact and/or stress on the area of the body known as the pelvic floor. If the pelvic floor is weakened or chronically tight, it cannot provide sufficient support to the bladder and other pelvic organs, resulting in peeing your pants while you try to burn Sunday’s lunch on a treadmill!
What Is The Pelvic Floor?
The pelvic floor is group of muscles that run from the pubic symphysis at the front of the pelvis to the sacrum at the base of the spine. Its main purpose is to provide structural support to our internal organs, specifically the bladder, the uterus and the rectum. It also plays vital role in childbirth and helps maintain optimal intra-abdominal pressure. Healthy pelvic floor musculature supports the hips, lower back and pelvic joints and helps stabilize and support the torso and body. Ideally, a healthy pelvic floor ‘’turns on’’ automatically to help stabilize the pelvis before we begin any movement.
A common thought is that if you are female, over the age of 40, and have had a couple of kids your pelvic floor is guaranteed to be very weak. What I have actually found in many of my clients after years of working in pelvic rehab is that their pelvic floors live in chronic state of contraction and they haven’t been able to relax their tissues for a very long time.
How Can My Pelvic Floor Be Overly Tight And Weak?
Chronic shortening of the pelvic floor muscles, either due to Kegel overtraining, poor postural habits or trauma can lead to an increase in pelvic floor tightness; resulting in myriad of pelvic floor disorders. Too much tightness in your pelvic floor can easily manifest as urge incontinence, irritable bowel syndrome, cystitis or vulvadynia, to name a few.
Where Does The Kegel Fit In?
If you have a pelvic floor disorder and have looked for a solution to your discomfort, it is very likely that you have come across or been suggested to do the Kegel exercise. In fact, most women’s magazines and “fitness authorities” suggest that women do Kegels on a regular basis, and many times daily. But most people are unfamiliar with the mechanics of the Kegel exercise and how to facilitate the “most important exercise down there”.
I have been educating women on the health of their pelvises for a long time and have yet to come across a single patient or student who would know exactly what a Kegel is and how to do it.
Common thought is that Kegels represents “cutting off the urine flow,” but more often than not, when people think they are performing Kegels, they are instead squeezing their buttocks, firming their abdominals and/or clenching their jaws.
In addition, Kegels performed excessively over long periods of time will tighten the pelvic floor and can begin to pull the sacrum inwards. Imagine constantly contracting your biceps without every stretching it – the pelvic floor is no different and excessive contractions in the form of Kegels can result in a shortening of the musculature of pelvic floor. This is the same tightness I referred to previously that contributes to weakness and incontinence when running, jumping, coughing or sneezing.
Come back on Friday for my suggestions for pelvic floor fixes that don’t require Kegels!
Enjoyed this article? Read To Kegel Or Not To Kegel.
I am very glad there seems to be more and more conversation in the fitness and wellness worlds around a balanced pelvic floor. There is so much culturally wrapped up in (particularly women’s) pelvic health as well – there’s so much misinformation around this topic it’s hard to tease out what is best for oneself. Thank you for highlighting that Kegels are not the end all be all for pelvic health.
This all makes sense when trauma such as child birth or over recruiting your PF muscles are the reason for tightness or leakage but what if the woman hasn’t had any children or trauma in her history. How do we assess where the problem is coming from?
For people with a weak pelvic floors would Kegels be useful if done correctly and with appropriate frequency, or are Kegels just not effective regardless of technique?
How does one assess to determine if they have a weak or overly tight pelvic floor?
This is a great article and makes such a valid point- people don’t *know* how to Kegel.
As a young gymnast on a trampoline, bladder control was something the high bouncers struggled with, and the solution provided by our coach was to Kegel…but no one could actually explain what a Kegel was in terms that my adolescent brain could understand…a Kegel free solution would have been a great alternative and something I’ll keep in mind when working with those who are just developing an understanding of the body!
Thank you for sharing. Great information.
This is great information that needs to be more widely available. I am of childbearing years and I don’t think a single one of my girlfriends who have had kids has ever heard of pelvic floor dysfunction. Men out there-you listen up too because you also have a pelvic floor that could be the culprits of your low back pain. The pelvic floor is intimately connected to our breathing and if we have poor breathing mechanics (poor posture, stress, tight torso muscles) it can have negative consequences for the pelvic floor as well as vice versa.
I use the coregeous ball to provide proprioception input when doing my pelvic floor exercises and it makes a world of a difference to bring awareness to the muscles you are actually using.
What an important topic that is so misunderstood. I have always believed, from instinct that kegels were not the answer and in fact we’re actually causing incontinence and other issue such as back pain and SI joint dysfunction.
Unfortunately I think that this training exercise is still prescribed by doctors today to women as the right way to deal with bladder and core issues.
Although well intended, the information seems to do more harm than good and works in the opposite way. A simple understanding of anatomy makes kegels obsolete.
I think that this post reminds us to allow ourselves to listen to what we feel inside our bodies and trust what we know on a visceral level, even when health professionals and others tell us otherwise. Understanding of the body is achieved on multiple levels and can also change from day to day or year to year.
Thank-you Dagmar, awareness and proper information regarding this topic is needed! It seemed like doing ‘Kegles’ became an in-thing to do without people really understanding what they were doing, why to do, or how to do it properly. I will be reading your related article with alternatives to kegels next!
One simple exercise I use is setting up in a quadruped position, keeping the spine neutral and simply shifting back as if to go sit down on heels and then come back to initial position. Few repetitions will do. Quite impressive how movement like this one or a simple squat affects those too-often-neglected muscles.
Thank you for this! I have many students who run for the bathroom when it’s time to jump rope, and I suspect that many of them are doing too many Kegels. Will check your other article to find hints to pass along to these ladies!
Kirsten,
I am so so happy to hear that. It is definitely part of my mission to help women feel fabulous and confident in their bodies- and I loved to help facilitate this journey for you!
Well, I’m over 40 and have never had children. My friends make fun of me because when I laugh or cough too hard or sneeze I have to squeeze my legs and run for the bathroom. Heaven forbid I check out the new trampoline park. I have a friend who will text me to remind me to “Kegel”! Little did I know they don’t help much….I’m off to find your article on the alternatives to Kegels.
Dear Dagmar, thank you for for making a topic like this accessible! I really like the way you see things differently and offer your help to women with pelvic floor issues.
You helped me a lot!
Pelvic floor function is hugely important! Any time we are talking about the intrinsic core, we have to understand the importance as it relates to everything human! I think many take it for granted until they end up having some sort of chronic pain or incontinence issues. Perhaps one of the best ways to work on the pelvic floor functioning better is bring more awareness to it during deep breath work. I’m curious to see your corrective offerings in the next article!
Thanks Dagmar,
I’m looking forward to reading your other articles on developing a healthy pelvic floor. As a guy, I don’t have the exact same motivations as women do for creating & maintaining a healthy pelvic floor, but it is still necessary for men too. Mula Bandha is mentioned in my yoga practice and most of the time I’ll not sure that I’m doing it correctly.
I was always unsure about doing kegels, every time I try “cutting off the urine flow” I never know if I am doing it correctly. I liked how you also made the connection with too much tightness in your pelvic floor can easily manifest as urge incontinence, irritable bowel syndrome! Thanks for this article, very informative.
I’ve read some work from Katy Bowman that seems to make sense in terms of why Kegels may not be the answer to pelvic floor organ prolapse and urinary incontinence. Since the gluteus maximus attaches to the edge of the sacrum, Bowman suggest that squats and similar glute strengthening exercises can help move the sacrum back posteriorly. Due to a posterior pelvic tilt promoted by a “sitting” society, the glute weakness can encourage the the sacrum to shift anteriorly. Meanwhile, more Kegel-ing may promote more of this anterior shift causing the taught trampoline of the pelvic floor to become more of a canopy shape. In turn, sarcomeres are loss, length is loss, and the capacity of the pelvic floor to perform its job is compromised.
As women, we are not usually educated about the pelvic floor until perhaps childbirth or more likely once pelvic floor dysfunction has developed. Not only do we need to have the tools to keep these muscles both strong and flexible but basic understanding of the anatomy so we can be on the side of prevention rather than repairing.
I have worked with the YTU therapy balls to release my own pelvic floor and have successfully improved my bladder control from labor 9 years ago. This was an incredible thing for me as jumping on the trampoline with my daughter is something I enjoy doing and until taking a course with Todd wasn’t sure I would be able to do.Was definitely one of my many ah ha moments.
In a prenatal exercise class at the hospital where my daughter was born, the instructor included Kegel exercises, but there was a lack of clear instruction and feedback from the students due to the sensitivity of discussing sensations “down there”. I hope further discussion of this important part of the body breaks down the social shame and fear of crossing sexually inappropriate lines in legitimate healthcare and fitness environments.
Fascinating topic for sure. I often think people assume their “problem” areas are either an issue of strength OR an issue of mobility (depending on the part of the body) without realizing how interrelated these terms really are when it comes down to functional movement. It is not an easy concept, and I think it is one that exercise science is just now starting to scratch the surface of, and we are lucky for any trickle down research we can gobble up in the fitness/movement industry. When it comes to the pelvic floor, I think the majority of people (certainly women) assume, as you say, that theirs must be very weak. It is eye-opening to consider that for many people the pelvic floor is actually chronically tight (and weak!). I have seen this pattern in abdominal muscles in those who have overworked and chronically contracted abs, which can have a negative effect on posture, breath patterns, and lead to pain in the pelvis or low back. Looking forward to reading your follow up article. Thanks!
Vraiment intéressant article! Nous avons justement parlé du plancher pelvien dans notre formation aujourd’hui de YTU. Comme prof de Pilates, j’ai à enseigner à mes élèves l’importance de le travailler en force et aussi à l’assouplir! Merci
I personally have dealt with a weak pelvic floor and always love to learn more. I have made great improvements, but am always looking for different ways to improve even more.
Very eye-opening. Thank you.
Kegels never worked for me and after three kids born in five years there are certainly changes to my pelvic floor! I had been told sometime ago that it could be tight pelvic muscles cause leakage but these comments were not followed up with ways to release the pelvic floor. I look forward to reading your follow up article to find out!
Not only did I not know that ones pelvic floor could be to tight but that incontinence, IBS could be progressed by this. I’m now wondering if I’ve been doing Kerala the wrong way. Looking forward to reading the follow up article.
As someone who suffered from chronic bladder problems, I never considered a chronically constricted pelvic floor! That totally makes sense! Thank you for another YTU lightbulb moment!
Hi, Dagmar! Interesting post. I was having some confusion over how muscles can be weak and tight and the effect that has on the body, so thank you for explaining that so well. While I am lucky not to experience the issue of incontiinence, I was so surprised to learn a few years ago that several of my friends from college did, after delivering larger babies. (Made me glad mine were more petite!) I can’t wait to learn more about how to help them get strong, supple pelvic floors, since I am quite sure their doctors advice was to do Kegels or wear a pad when exercising. Thank you!
Thank you for giving us some options so that this issue isn’t just a Depends joke! Most women may be dependent on some movements like this to avoid needing Depends!
A yogi named Leslie Howard presents workshops on yoga for the pelvic floor. She has series which are appropriate if your pelvic floor is too tight and weak which can cause pelvic pain. She has other series for a weak and loose pelvic floor which can result in stress incontinence. If you are interested in this topic it is worth checking her out.
Wow! This is eye-opening. I never thought of the possibility of the pelvic floor being too tight and weak!
Wow, those statistics are pretty shocking. Really woke me up to the importance of educating myself further on pelvic floor issues – I’m sure I’ll encounter many clients in the future who can benefit from good advice on how to deal with this widespread problem.
I would point out that all though your article has its main points for woman this is also an important topic for men. I have looked to the pelvic floor as a way to address low back pain and tightness and believe it is one of the many factors in dealing with such an issue. Having a healthy pelvic floor facilitates healthy hips which translates up into the spine. For men that lift, move, carry, and run this is an area of the body not to be ignored.
TDY
As Nancy stated, I will also pass this information on to my clients. I will let you know how this works for them!
Following up from Wednesday, your video and explanation are delightfully simple and easy to follow. I will pass this information on to my pelvic floor knead to know clients . Thank you .Cheers.
Thank you for the interesting topic. I’ve always wondered what truly is a kegel exercise. Because just like you mentioned I’m not familiar with which muscles are supposed to be contracted. Thank you for bringing my awareness to this.
This article is so interesting to me because I have personally dealt with pelvic floor injury caused through yoga (prasarita padahastasana with too much ego involved). I always assumed that kegels would be the answer for me since I tore (or strained) a pelvic floor muscle. But I also haven’t gone through childbirth, so my pelvic floor hasn’t been stretched in that way. In any case, I’m looking forward to the next addition to this blog to see what Dagmar’s other recommendations are to heal this important, and often over-looked, area of the body.
Thanks, Dagmar!
Elise
I’m pleased to see this topic discussed here. When I’ve expressed concern to my doctor about involuntary “leakage” when coughing, sneezing, or lifting weights, she has just told me to do more Kegels. Honestly, they haven’t proven effective in the 30 years I’ve been doing them, so what makes one think they would help now? I would really like an alternative that does the job.
Thank you so much for sharing the information on the pelvic floor. I know many woman that have had surgery because of bladder leakage. I will check back with you on Friday for information on how to correct pelvic floor disorders.
Thank you for this informing article. It’s hard for me personally to distinguish when my pelvic floor is engaged and how to release. I feel I may chronically shorten this muscle. I’m excited to read your next article and further study on my own.
Thank you Dagmar for taking on the topic of, the pelvic floor without Kegel’s ! Are Kegel’s not circa 1900″s? As you have expressed many women are embarrassed to talk about a very important aspect of their anatomy, pelvic floor, even in order to live daily in their bodies. Exposure or shall I say enlightenment on this sensitive topic in such a candid yet professional manor is very much appreciated. It is 2015 and few people really know anything about their own physical anatomy and how it functions at the simple to understand voluntary and involuntary levels, let alone the intricacies of the pelvic floor. Our bodies are often taken for granted. Only when we are faced with a personal issue are we in inquiry. Your discussion of the pelvic floor and practices of preventative mobility and strengthening will surely be appreciated. I look forward to your practices on Friday that do not require Kegel’s. Namaste