Training the Pelvic Floor with Kegals

Kegals, the exercise that can improve your birth experience and get your abs back faster.

The moment your OB/GYN or midwife confirms your pregnancy, you are told to start doing kegals. You will also be told to start them once you have delivered your baby. They are one of the most talked about exercises for pregnancy and post-partum maternal care programs. Do you actually know how to do them correctly?

Before beginning to exercise after delivery you should always have clearance from your OB/GYN or midwife. Most women have to wait a minimum of 6 weeks after giving birth vaginally without complications, a minimum of 8 weeks following a C-section and possibly longer if there were other complications during delivery. You should treat child birth as a “trauma” to your body; it needs time to heal before return to an exercise program.

The following is a list of exercises to AVOID when starting back with abdominal workouts:
• Crunches
• Sit Ups
• Exercise Ball Roll Outs or Crunches
• Side Bridges
• Twisting movements especially seated
• Leg Lifts
• Ab Machines at the Gym
• Planks
• Medicine Ball Exercises

After carrying a growing fetus for over 9 months, your organs have been pushed out of their normal positions and muscles have been stretched. It is this stretched position that takes away the muscles ability to protect your joints and discs of the spine. The best approach is to re-educate your CORE muscles to begin working. Weakness at this point is not only from lack of strength but also due to a loss of communication between these muscles and the brain. The goal is to introduce the brain to the pelvic floor and core muscles so it remembers to use them.

Kegals: How to Do Them Correctly

Most women are told by their practitioner to start with Kegals, but no one has taken the time to actually explain what they are and how to do them. Kegals will help to re-establish control of the pelvic floor. The pelvic floor is a very important element in the CORE. Pelvic floor issues are often over looked and can be the cause of urinary incontinence, fecal incontinence, pelvic pain (including dyspenuria or painful intercourse), low back pain and even organ prolapse. Acta Obstet Gynecol Scand. 2008:87(3) shows that second stage labor of longer than 1 hour is associated with the development of postpartum urinary incontinence. It goes on to state that pelvic floor dysfunction rarely resolves spontaneously. Another article from J Obstet Gynaecol Can. 2003 Jun;25(6) confirms that there is evidence-based effectiveness of pelvic floor training, during pregnancy, in the prevention of pelvic floor problems including urinary and anal incontinence, and prolapsed both rectal and bladder.

The easiest way to properly perform a kegal is to stop a stream of urine (everyone woman has been told this) or to stop yourself from passing gas (probably a new one). What virtually no one has been told is that while you perform these you MUST keep your stomach, thighs and butt RELAXED! If you feel tension in these muscles you are not performing a kegal properly because these other muscles are taking over when the pelvic floor should be contracting. Once you can stop a stream of urine while keeping these areas relaxed you can perform these anywhere. You should be able to hold these for 3-4 seconds working up to 10 second holds for a set of 5 performing them 3-4 times a day.

Kegals with a Czech Twist

A variation on this exercise comes from the Czech Republic and consists of three levels. Level one is to slowly bring your navel toward your spine, or slowly suck in your stomach over a 5 second period. Once you can perform this smoothly add the second step which is to try the same thing in your anal region. When you can hold both of these for 5 seconds add the third step of plugging your nose and gently trying to breathe in through it. This should intensify the feeling in the abdominal and anal regions. Work up to a 10 second hold with sets of 5 performed 3-4 times a day.

I cannot stress the importance of these simple but integral exercises enough. You may not feel like these exercises are doing much, but most women will experience complications of pelvic floor dysfunction anywhere from 1 to 4 decades after giving birth. They are a simple pro-active, do anywhere way to decrease your chances of complications later on in life.