Why Do We Only
Think of Kegels?

Very few people actually need to strengthen their pelvic floor through kegels. Most people need coordination and then relaxation to get a well functioning pelvic floor.

By Kyrsten Spurrier, OTR/L

When I say pelvic floor therapy what do you think of? KEGELS! Yes, our culture only talks about strengthening the pelvic floor through kegels.


What if I was to say that very few people should be doing kegels!! That’s right, strength is not usually the issue that is causing leaking, pain, etc. So if you are doing vaginal weights or kegel video games I encourage you to throw them out, and I will explain why in a minute.


Over the next year, as a HER Expert Panelist, I am excited to share with you more about what I do as a pelvic floor therapist but more importantly I want you to walk away with the knowledge of what holistic pelvic floor therapy is.

A reactive pelvic floor means that it responds to sudden changes of pressure within your abdomen, for example when you sneeze, cough or laugh.

The more educated you are, the more you can make decisions based on your needs and your body.

Pelvic floor therapy is an area that people don’t have much knowledge of therefore they don’t know what to look for when picking a therapist.


I have so many clients say “I have had pelvic floor therapy in the past but it was nothing like this” or “Why didn’t my other pelvic floor therapist ever say this.” I want you to make informed decisions about pelvic floor therapy and what your body needs.


To do this we are going to look at the 4 pillars of pelvic floor therapy: Biomechanics,  Nervous System regulation, Psychological and Emotional / Social.


So getting back to the kegels…

The pelvic floor has 3 functions: support, elimination and pleasure.

To do all these  functions well it needs strength, coordination and flexibility. Almost everyone thinks of strength  hence the kegels that everyone seems to do for years.


But strength alone doesn’t do much unless you have coordination therefore I start all of my  patients with coordinating their pelvic floor to their breath. I have more patients experience  improved symptoms with learning breath work and coordinating their pelvic floor vs. just being  able to hold a strong contraction.


Let’s break this down. I want you to try to do a very strong kegel, what happens to your  breath? Do you hold your breath? Could you hold that contraction while doing a functional  task? Is your butt gripping while you are trying to kegel? Do you feel increased core stability when you do a kegel?


Now I want you to focus on your breath. This sounds weird but breathe all the way down into your pelvic floor on your inhale. If you put your hand on your vulva you should feel your pelvic floor drop down into your hand on your inhale. If you have never thought about breathing in this way this may be very difficult for you. See if you are able to feel your inhale and then notice that your pelvic floor naturally pulls up on your exhale. That is how you coordinate your pelvic floor with your breathing.


Think about doing functional tasks or even running if your pelvic floor naturally responded to your breathing. Do you see how it becomes naturally reactive? Over time it will become second nature because it is working with your diaphragm.

A reactive pelvic floor...

A reactive pelvic floor means that it responds to sudden changes of pressure within your  abdomen, for example when you sneeze, cough or laugh. I think we all can agree that is the golden ticket!


If you have the coordination piece down then you can add strength if needed. As you are  exhaling and your pelvic floor is naturally coming up so then you just pull it up with a little more  effort. See how simple that is?? This becomes something that you can do while you are  driving, walking, sitting and watching tv. You no longer have to lay on the floor and think about  doing kegels. HOORAY!


If you are someone that has a tight pelvic floor or pelvic pain I also want you to think about how  breathing like this brings movement into the tissues of the pelvic floor which naturally will relax  the pelvic floor and relieve symptoms. Like I said at the beginning of this article, very few people need to be doing strengthening, most people need coordination and then relaxation to get a well functioning pelvic floor.


This is seriously where I start all of my patients. If we don’t have breathing then it is impossible to get the range of motion, coordination and strength you need to resolve your symptoms.


If you have had a difficult time with these breathing exercises or if you are experiencing any pelvic floor symptoms I would love to be able to help you. Call 919-275-2545 to set up a free 15-minute consultation.


Also remember this is one only pillar of the 4 that makes up a holistic approach to pelvic floor  therapy. Breathing doesn’t resolve everything, there is more to learn. Make sure you check out my next article about how emotional and social health impact our pelvic floor function.

Kyrsten believes every mom should feel empowered, supported and strong in their bodies.  She was introduced to pelvic health therapy after the birth trauma of her first son.  She felt isolated, embarrassed and weak in her body and even after going to pelvic floor therapy she felt that there was a great need to be better and to think more holistically.

Kyrsten was working as an Occupational Therapist for 3 years in a hospital based setting at this point and started to research what she needed to do to help women with similar experiences.  That began her 4 year journey of taking continuing education classes that focused on the physical, emotional and mental aspects of pelvic floor dysfunction. Kyrsten opened her own business in Oct 2021, The Perinatal Pelvis.

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