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Should we Kegel?

Kegels in Pregnancy

Everyone know what the Kegel exercise is? The "squeeze everything down there and hope I'm doing it right" exercise - have you just done it? - commonly given to expectant mothers so that "their pelvic floor will be alright" after birth.

Rightly or wrongly, lets have a think and break it down a bit.

We have four central diaphragms:

  • Diaphragm Sellae: Inside our heads.
  • Cervical Diaphragm: Involves your tongue and the muscles in you neck.
  • Thoracic Diaphragm: The diaphragm we all know, separates thoracic cage and abdomen.
  • Pelvic Diaphragm AKA Pelvic Floor: Stops important bits falling out of our bottom. The hammock.

Through connections of muscle, ligament, tendon, fascia and bone these diaphragms span and attach a full 360 degrees to our insides at their given level.

I hope my hastily made model below helps with your visualisation.

Now, lets get technical: all these diaphragms descend (move down) when you breathe in and ascend (move up) when you breathe out. 

Starting from the top (this all happens at the same time, not in sequence, this is for simplicity you understand): 

You breathe in - diaphragm sellae descends, everything under diaphragm sellae descends onto cervical diaphragm but that's OK because cervical diaphragm descends and everything under cervical diaphragm descends onto the thoracic diaphragm but that's OK (getting the hang of it?) because thoracic diaphragm descends and everything under thoracic diaphragm (A LOT) descends onto pelvic floor but that's OK because YOUR PELVIC FLOOR DESCENDS. Happy harmonious days. Now you breathe back out and everything goes back up and your internal organs get a nice massage and your fascia gets a good work out, all at the same time. And you are still living. Awesome job.

Now you are pregnant. More happy days. But not for your pelvic floor. Where previously she had been minding her own business, getting on with being an awesome pelvic floor - she is now having the life squeezed out of her. Nine months in and now you have an Arnold Schwarzenegger pelvic floor. She is no longer a happy hammock flapping in the breeze, cuddling you to sleep. She is shortened and taut. Sad face.

Now when we breathe in, everything descends from the very top onto pelvic floor and poor pelvic floor has no give left. Everything squashes up against her, and who is bottom of the stack? Squashed flat each time we breathe in - bladder that's who. Anyone need another wee? 

AND, after nine months squeezing tight - YOU'VE GOT TO PUSH A BABY OUT THROUGH THERE. Trust me, when you bear down with a contraction, when you are ready to push, you are going to want your pelvic floor to give (in a good way). Holy Mackerel. Give me a flappy hammock any day.

Moral of this story: If your pelvic floor was in good/normal shape prior to pregnancy - LEAVE IT BE. The wrong exercise in any place could literally become a pain in the butt. 

Quick Pelvic Floor Check

Stand or sit comfortably, put a hand between your legs and cup your vagina (in the vague possibility that any men are reading this - feel for the bit between your scrotum and anus, this is important for your prostate health and fertility). Bring your awareness into your breath. Follow your breath in and out. Can you feel your own pelvic floor rising and falling? 

If you have any concerns regarding your pregnancy and/or pelvic floor. Don't be shy, get it checked out.