There are two problems with the pelvic floor:  hypertonic and hypotonic.  There will be an article on #ThatsNotAVagina coming soon explaining in detail the dysfunctions of the pelvic floor.  For purposes of this conversation, just think too relaxed or too tight.  In the world of pelvic floor physical therapy, there are at least thirteen pelvic floor exercises according to my personal DPT (Doctorate, Physical Therapy).  Very rarely is a kegel recommended. The absolute best exercise for men or women for their pelvic floor is an orgasm.  It’s a natural progression through lifting, contracting, and relaxing the pelvic floor that cannot be replicated by exercise or devices.

Arnold Henry Kegel was an American gynecologist who invented the Kegel perineometer.  A Perineometer  is an instrument for measuring the strength of voluntary contractions of the pelvic floor muscles. Today pelvic floor exercises are widely held as first-line treatment for urinary stress incontinence and female genital prolapse. Dr. Kegel first published his ideas in 1948.  At that time, such a condition and treatment were unrecognized for people with a penis. What he did then for pelvic floor dysfunction is antitheses to what’s being done today.

I’m pretty rabid about kegels.  I even said so on Twitter.  What ensued was a conversation that came very hard for me to follow.  That 140 character limit can kill an intelligent conversation.  I decided to write an article about them and my experience with pelvic floor dysfunction.  For me personally, I am totally and 100% against kegel exercises and exercisers.  I can hear readers already shrieking in outrage and I’m only a few paragraphs into this article.  Please don’t give up on me yet.  I’d like to explain why and provide some evidence in support of my opinion.  Refrain from a public lynching for at least a little bit.  You won’t be disappointed. Lynching may not be something you want to consider at the end.

Kegel exercise and exercises attempt to strengthen the pelvic floor.  In reality, these exercises and devices are an abysmal failure. The devices don’t go deep enough into the vagina to even stimulate the pelvic floor.  The major difference between what Dr. Kegel offered to his patients 68 years ago and today is the absence of the meter and a qualified health care practitioner to interpret the findings.  Today, a uro gynecologist will perform an Electromyography of the Pelvic Floor Muscles and interpret the findings before recommending or not recommending kegels.  There is also a lack of education with these devices that I find singularly appalling.  I wish the manufacturer of these items would quit using the promotional slogan that implies doing kegel exercises or using their devices will tighten your vagina.  That is not how it works.  Not even close. As for your pelvic floor, #ThatsNotAVagina.  The vagina is a totally separate muscle but muscle tone will improve when the pelvic floor is exercised properly.  Do you own weighted balls? Please throw them out.  Clinical research published in the British Medical Journal in December, 1998 and confirmed again in  September, 2011, revealed lack of sufficient evidence of efficiency in use.

Using a kegel exerciser or routinely performing kegel exercises should never be done without being under the care and supervision of medical care providers specializing in physical therapy, gynecology or another physician who is very familiar with the pelvic floor.  A person who does routine kegel exercises because their best bud told them to do so can actually harm their pelvic floor.  Seventy percent of the time, they are done incorrectly.  If you are one of the masses that do kegel exercises, if you can’t do them without tightening your abdominal muscles, butt cheeks or thighs, you’re doing them wrong.  You also shouldn’t stop and start a stream of urine as a form of kegel exercise as this can cause damage to your bladder and lead to urinary tract infections because cutting off the flow causes the urine to flow backwards. And for the love of a healthy pelvic floor, to my germiphobe owners of a vagina, DO NOT HOVER over a public toilet.

For readers who are still screaming for my head on platter, I want you to visualize your pelvic floor muscles as a diamond that holds everything inside.  The front is hidden inside the ring mount and the back is the part everyone ogles because your diamond is so bright and shiny and BIG.  That big shiny diamond is full of muscles.  Each shiny spark is its own muscle connecting to other muscles. Kegels done incorrectly make the front of the diamond strong.  This is where the misconception of kegels come into play.  As with any chain, it’s only as strong as it’s weakest link. The back of the pelvic floor needs to be just as strong.  Eventually that weakest link is going to fail.  It may just one day snap, or it could be a gradual thing.  So for a traditional kegel of clenching, holding, and relaxing:  it’s tightening the muscle without providing any strength to the muscle.

There are right ways and wrong ways to do kegels.  I’ve already covered the wrong way.  The wrong way will provide a temporary fix to a long term problem.  Doing them the correct way is like training for a marathon.  It requires dedication and time.  So what’s the right way?  It’s actually very simple.

For those of you who actually praise the kegel, I beg of you to try this so you can feel the difference between what you normally do, and what I’m trying to teach you to do.

Lifting your pelvic floor.  In order to do that, you want to pull your vulva – and only your vulva upwards like you want it to fit inside of your vagina. Start slow until you get the hang of it.

Contracting your pelvic floor:  You’ll need to relax everything except your vulva.  You’ll find the most residual overflow into your abs and your butt.  Simply release them. It may take several practice sessions to learn how to relax the other muscles without relaxing your vulva as well.

Release.  Let everything go.  Nothing is tense.  Take a deep breath, hold it, and try to relax your pelvic floor enough so you feel your vagina push outwards.  This is a feeling similar to straining when voiding your bladder. Remember you’re only using the muscles of the pelvic floor.  This is the most difficult to learn.  You might have to learn this in an upright standing position so you know what it feels like, but don’t make a habit of this.

You can do these three simple exercises leaning against a wall, feet shoulder width apart, knees at a ninety degree angle or you can do this flat on your back.  This strengthens the entire diamond I wrote about earlier in the post. To avoid being eviscerated on Twitter, I want to provide one more example of why these exercises need to be supervised by a health care provider.

Let’s say a person with a vagina sneezes and wets herself for the very first time.  So she Googles “sneeze and pee” and sees a lot of articles related to kegel exercises and exercisers.  She buys one or two. She uses the items she purchases. More than likely, she uses them incorrectly.  What if she didn’t have stress incontinence?  What if she had a prolapsed bladder instead?  A prolapsed bladder cannot heal itself.

 

 

 

Most of my education in the area of pelvic floor dysfunction comes from personal experience.  I’ve had over a year of internal physical therapy, trigger point injections, valium vaginal suppositories, and lidocaine gel in my vagina daily.  I have permanent structural damage to my bladder. I grill my physical therapist and talk to others who suffer.  Statistics indicate that there are a lot of men and women who have this dysfunction yet remain undiagnosed for lack of proper education and knowledgeable health care providers.  So I beg of you, please consult a physician before including any type of pelvic floor exercise or device into your routine.  My care and concern is for you.  You can cause irreparable harm to your organs and your muscles.  I don’t discount that some people have benefited from them or their exercisers.  Those I know who have benefited did so under the supervision of a medical care provider.

This is an opinion piece only.  It’s my opinion.  You don’t have to agree with me.  The goal is to simply educate readers there is a potential for unintended consequences.  I hope my head is safe from someone’s platter and I’m not going to burned at the stake as a witch.  I just feel strongly there needs to be more information on pelvic floor therapy.  People need to know there is more than one option.

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