When we think about pelvic floor, we often think of doing kegels as a way to strengthen it to avoid incontinence.
However, strength is only part of the equation, says Haylie Lashta, owner and operator of Warman Physiotherapy & Wellness. She is a Physical Therapist and Certified Pelvic Floor Therapist who works extensively in women’s health, prenatal and postpartum care, and infant development.
When she sees women with symptoms, she often asks, ‘Who told you to ‘strengthen’ your pelvic floor?’
“Often we hear this from friends, family members and other healthcare providers after discussing for a few minutes some symptoms you’re having,” she says. “But does anyone check to make sure you are doing the exercise correctly? I find often no, this is not the case.”
She says part of the problem is women are expected to know what to do for kegels because of what we read in magazines like Cosmo, where kegels are described as squeezing the pelvic floor.
The problem with that?
When we compare this ‘squeeze’ of the pelvic floor to another area of the body, says Lashta, it’s like squeezing the muscles of the arm without actually moving the elbow.
“Does that impart strength? Sort of, but not really. A functional pelvic floor and the proper contraction is thinking of drawing the pelvic floor muscles up and into the abdomen, which will lift the muscles that are essentially like a sling between your pubic bone and tail bone,” she explains. “But we can’t just contract – no other muscle groups do we go to the gym and just hold for as long as we can, pause then repeat, so why do we do this in the pelvic floor?”
For the pelvic floor to be functional, it must be able to lift up and in, as well as relax down and out. An active relaxation is like taking that sling of muscles and letting them fall down and away and it often feels like work, notes Lashta.
She says a good analogy for comparison is to imagine your elbow is stuck in a bent position. You describe that you are having difficulty reaching and grasping things, particularly as they are falling off a table, and someone tells you to strengthen that muscle by contracting as hard as you can for 10 seconds, pause and then repeat 10 times in a row.
“Over time, the elbow will begin to bend farther as the muscle tightens and doesn’t lengthen, and your ability to catch falling objects will often get worse,” says Lashta. “So what does this muscle actually need? It needs first to lengthen to achieve full range of motion. Then it will need functional strengthening and coordination with the rest of the surrounding muscles to ensure that it can do it’s job all the time.”
If you experience any pelvic floor pain in pregnancy or postpartum, seek help: Lashta says it’s not normal.
“There is no reason for pain during pregnancy or postpartum – that’s like saying a runner ‘signed up for’ knee pain.”
And remember that it’s not just about strength: it’s about the ability to relax your muscles as well.
Haylie Lashta graduated from the University of Saskatchewan with a Bachelors of Science Kinesiology with Great Distinction (2009), and Master of Physical Therapy (2011). She has been practicing in Warman since 2012, and opened Warman Physiotherapy & Wellness in the fall of 2014.