As someone who’s had a baby I think a lot about my pelvic floor. And obviously as a pregnancy and postnatal yoga teacher, it’s one of the things that is concerning students in classes the most, too.
Throughout my practice, training and teaching, I’ve developed 3 golden rules for working with the pelvic floor, and I’ll explain a little more about these below.
- No bum
- No holding
You’re probably not surprised to hear a yoga teacher saying that breathing is the most important thing. Soz to be such a cliché!
But seriously, there’s a reason why it’s so important to breathe while exercising the pelvic floor, and it’s also the reason why one of the first things I teach postnatally is returning breath to normal after pregnancy.
Your diaphragm (which goes up and down as you breathe to draw air into and out of the lungs), core and pelvic floor all work together and are a pressure system. Diaphragm goes down as you breathe in, core muscles expand, pelvic floor goes down (relaxes). Diaphragm goes up, breathe goes out, core comes in, pelvic floor lifts. (* a little note about pregnancy below).
If you’re holding the breath, squeezing the belly button in, or doing anything else to stop this totally natural synchronised movement, it makes things more difficult. So BREATHE. The pelvic floor needs to be able to move to support all kinds of movement and stress on the body.
2. No bum
There are lots of muscles around the torso, pelvis and legs that support the pelvic floor, and a lack of strength in these muscles can cause the pelvic floor to kick in and take the strain. So seriously – when I suffered some stress incontinence after having my son, glute exercises sorted it out (not kegels by themselves…ha).
But if you’re squeezing your bum as you do a kegel exercises, you’re probably missing the muscles you want to be catching. So when exercising, only lift up in the pelvic floor as far as you can without bum clenching (same goes for sucking in the belly button – don’t!).
Everything I teach in pregnancy and postnatal yoga is designed to create strength that supports the pelvic floor, so we do a lot of bum work, and work into the lower abs and other smaller supporting muscles too. But leaving the bum out of kegels is a good idea, so you can be sure that you’re getting into the right places.
3. No holding
Ok, this should probably read ‘no excessive holding or tension’ but that’s not as catchy is it 😂
A few shorter holds while you’re practicing kegels is OK…but what we want to avoid is doing something ridiculous like holding a kegel for 15 minutes while you go for a walk. (This is a genuine horror story that I heard on my postnatal training – a doctor actually told a patient to do this to help with her pelvic floor. I mean, the shocking state of support for women’s health is a story for another time, but…this is what people are being told).
We’re led to believe that tightness is the thing we want – we wanna be toned, we wanna ‘bounce back’, that if our vaginas aren’t tight we won’t have good sex ever again?! All wrong. All bullshit. Tightness in the pelvic floor can cause as many issues as having weakness in the pelvic floor, and a lot of people don’t realise that tightness (or a hypertonic pelvic floor if you want the proper words) can also cause stress urinary incontinence.
So working with your breath, working with the natural rhythm of the lift and lower, and making sure that you do relax as you breathe in, is waaaaaay better than holding, gripping and hoping for the best.
And why I don’t really teach kegels on their own…
I made a decision not to teach kegels by themselves as part of postnatal yoga classes, and that’s for a few reasons. There’s a bit of a misconception that kegels alone will cure all kinds of issues that happen – that if you ‘do your kegels 3 times a day’ everything will magically bounce back, and the first reason I don’t teach them alone is that I don’t want to add to that misunderstanding.
I think that creating strength into the areas that support the pelvic floor – glutes, lower abs, around the pelvis and core – is a far more holistic approach (I hate that phrase…sorry) to postnatal recovery, as well as one which will create far better results than just sitting down and doing some kegels. I also don’t teach kegels on their own in shorter classes (which postnatal usually are) because – let’s be honest – sitting there and doing 10 rounds of kegels is pretty dull, and if exercises are dull, you’re probably not going to stick with them for long.
*A little note on pregnancy…
So it’s often taught, especially in pregnancy yoga, to exercise the pelvic floor to the reverse of the normal rhythm – ie you relax on exhale and lift on inhale. This is partially because during pregnancy, especially towards, the end, the diaphragm is pushed out of the way by baby, which can make getting the connection between pelvic floor and diaphragm really really hard.
I personally teach it this way (inhale to lift, exhale to lower – sometimes I’ve heard it being called a reverse kegel), and that’s not because I’m using the exercise to gain strength in the pelvic floor (I teach lots of other exercises to build strength), but because I want people to be able to properly relax their pelvic floor in preparation for birth. Imagine a tight, tense pelvic floor and a baby trying to come out – doesn’t work does it? The beauty of starting to relax the pelvic floor on an out breath is being able to use the breath during birth – breathing the baby out.
However, I always say that people need to listen in to their bodies and take a movement that feels right. So if the reversed version of the kegel feels wrong, which it could do in early pregnancy especially as the diaphragm isn’t being pushed yet, then always take a movement that feels OK. The main thing is being able to relax the pelvic floor – whichever part of the breath it moves with.
What I aim to do in my pregnancy yoga classes is cultivate that ability to relax the pelvic floor – which can be really hard when we’re told to squeeze and hold and be tight all the time. It’s an undoing of habits to enable breath to lead the relaxation of the muscles. I use the pelvic floor part of the class as more of a coming inwards – a relaxation meditation. We work with the breath and other parts of the body to enable this, and other exercises to build strength. Ask me more about this if you want to!