by Wayne Still
Once upon a time, not so long ago, in a land not so far away there lived a gynaecologist named Dr Arnold Kegel. Dr Kegel noticed that as some of his patients aged they experienced increasing problems with incontinence. The problems were exacerbated if the patient was overweight, had given birth or had abdominal surgery. Dr Kegel also noticed that the condition was related to the strength of the pelvic floor. Women with a weakened or compromised pelvic floor had more of a problem. He deduced that if a woman exercised her pelvic floor to strengthen it, the problem of incontinence could be alleviated or eliminated. This observation led to subsequent study of the pelvic floor and how it related to a persons general health and wellbeing. A Google search of Dr Kegel will take you to a Wikipedia page with lots of information on the pelvic floor and the exercise Dr Kegel developed to strengthen the pelvic floor and which to this day bears his name. In this column I will give you an overview of the pelvic floor and why it is of such importance.
The pelvic floor is made up of three muscles, the pubococcygeus, usually referred to as the “PC”, the levatorani and the ileococcygeus, (these names will be on the test!!!). The muscles form a sling or hammock at the bottom of the abdominal and pelvic basin to hold the associated organs in place. They are attached to the coccyx and hip bones posteriorly and the pubic bone anteriorly. The pelvic floor is kite shaped, longer and narrower in men, shorter and wider in women. Its integrity is compromised by the rectum and uterus in women and by the rectum in men. The strength of the pelvic floor is important to all movements in the hips and legs, its elastic nature gives spring to walking, running, jumping etc. The extra opening in women’s pelvic floors is one reason why women athletes are not able to compete at the highest levels with men. Besides contributing to incontinence in both men and women a weak pelvic floor is also associated with various sexual dysfunctions in both sexes. Strengthening the pelvic floor will help women to achieve stronger and more frequent orgasms while helping to prevent premature ejaculation in men. A strong pelvic floor will make the birthing process easier and speed post partum recovery.
All of us do the Kegel exercise several times a day in the course of normal elimination of wastes from our bodies. The contraction of the pelvic floor at the end of urination and defecation is a Kegel whether we are aware of it or not. In fact if you want to consciously experience a Kegel, just stop urination mid flow. However do not do this regularly as it will lead to urine retention. Once you have isolated the feeling of voluntarily contracting the muscles of the pelvic floor you are set to incorporate Kegel exercises into your daily routine. There are some things to keep in mind while doing them. The contraction should be confined to the pelvic floor, butt clenching doesn’t count. For women the anal and vaginal sphincters should be relaxed, for men the anal sphincter should be relaxed and the testicles descended. Get into the habit of doing your Kegel exercises at certain cues such as at red lights or while in line. It is an invisible exercise, no one knows you are doing them. I like to tell my clients that you don’t have to go to the gym to do them. Do them in reps of 20-30 and experiment with holding them for 3-4 seconds. The feeling is enjoyable and the benefits enormous.