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Kegels - The Broken Promise - iAM Physical Therapy - Bentonville, AR

Pelvic health these days is as common as going to the dentist.  There are constantly new advances in fertility treatments, birth control and even STD prevention.  And yet, we get the same, tired advice that we’ve been receiving for over 60 years about what to do when we become incontinent – do some Kegels!

The original idea behind Kegels was that a woman would leak because she had a weak pelvic floor.  So, according to Dr. Kegel (yes, I’m serious), if she were to just tone up her pelvic floor all problems would be solved.  It makes sense and seems plausible.  The only problem is, we now know this simply isn’t true and doesn’t work.

Kegels don’t work for at least three reasons: 1) we do them wrong 2) The pelvic floor doesn’t work in isolation 3) Leaks do not happen because of weakness they happen because our brains do a bad job of communicating with the pelvic floor muscles.

We Do Them Wrong

Kegels are easy –  all we have to do is squeeze like we are holding in a fart in an elevator, right?  Wrong!  Let’s do an experiment.  Stand up and put weight through your heels.  Now do your Kegel.  Do you feel your Anus getting tighter or do you feel your vaginal muscles contracting?  My guess is, you felt your Anus getting tighter.  While this is certainly a part of the pelvic floor, it’s not the part most people are trying to address. This little experiment proves it.

The Pelvic Floor Doesn’t Work in Isolation

If you have ever been in a gym, dated a meat head or watched a movie about high school love chances are you have heard the phrase, “isolating the muscle” in your lifetime.  The idea is that if you do a movement in a certain manner, that solitary muscle will get all the attention you are throwing at it.  In return that “isolated muscle” will get bigger and stronger while the other neglected muscles watch jealously from the sidelines.  This way of working out is all well and good except for the fact that it is a complete and utter lie.  It is nearly impossible to get JUST ONE muscle to contract at a time.  Our body has hundreds of muscles and joints for a reason – they all work together.  Your pelvic floor is no different.  The pelvic floor is not an island, it is an interconnected group of muscles that functions best when used in concert with the Diaphragm, Multifidus and Transversus Abdominis. This is why Kegel’s fail.  A Kegel neglects the other three pieces of the puzzle which in turn prevents the pelvic floor from working optimally.  This leads us to are third and final point…

Leaks do not happen because of weakness…

As I mentioned before, Kegels were thought to work because of an inherent weakness found in the pelvic floor.  Pelvic floor exercises for women are much more complicated than that.  What we now understand is that urinary incontinence occurs because the pelvic floor isn’t functioning the way it should or the way it used to.  Why?  Well, for those of you who have had babies, think about the incredible changes your body underwent.  Your ribs flared out, your backs arched, your innards were compressed like a recycled aluminum can and on and on.  And, guess what?  What happens when we do the same thing for long periods of time?  It becomes a habit.  And that is EXACTLY what your brain is doing right now – practicing a bad habit.  Because your breathing patterns change, your pelvic alignment changes and your abdominals get stretched to the max, your brain has developed and adapted a totally new way of keeping you functional.  The good news is, you are functional.  The bad news is, you aren’t functioning the way you should be…yet.

Remember those three muscle groups that I mentioned earlier?  Well, when you get them functioning properly and harmoniously with the pelvic floor something wonderful happens – you stop leaking.  Not because you made the pelvic floor stronger but because you got the pelvic floor’s support group up and running again the way it used to. This in turn helps the brain remember the way things used to be, including how it should operate your pelvic floor during an unexpected sneeze or a cough.

I think this is a powerful message for women to hear.  I believe too many have tried and failed at stopping leaks because they weren’t being given the proper tools needed to address their needs.  Now that we better understand that leaks are due to poor communication from the brain and not just a lazy pelvic floor we can start to address the problem differently and, best of all, more effectively.  If this sounds like something you would like to know more about, check out my FREE e-book “The six things I wish my OB/GYN had told me about incontinence” or contact me personally at 479-268-6040.

Dr. Christian Robertozzi

Author Dr. Christian Robertozzi

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