Top Ten Mistakes of a Pelvic Power Strengthening Program.
By Isa Herrera, MSPT, CSCS
So many of our patients come to us with bits and pieces of a pelvic program that have come from their personal trainers, bodyworkers, Pilates trainers, or internet research. It is important to understand that your pelvic program needs a solid foundation for you to succeed, in order to have long-term benefits of pain free sex, restored pelvic sphincteric strength, and good coordination between the abdominals and the pelvic floor. As physical therapists, we can check your pelvic floor muscles, or PFMs, internally, for imbalances, triggerpoints, hyper/hypo mobility, adhesions, and a host of other symptoms of which you might not even be aware. All of these can impede your long-term progress and set you up for future issues. So below, we have compiled our Top 10 list of mistakes you can avoid,so you can get you started on the right track to a solid PFM foundation.
Mistake-1: Incorrect breathing: there are two parts to a Kegel. The contraction/squeezing part and the letting go/ relaxing part. Incorrect breathing or breath-holding can decrease the effectiveness of the Kegel exercise.
Solution: 1) Exhale as you contract. 2) Breathe naturally as you hold the kegel. 3) Inhale as you release the Kegel. You may also have fascial restrictions within the diaphragm, poor rib mobility and upper body malalignment issues. A Renew Physical Therapist can not only help restore proper mechanics so you are breathing correctly, but can also evaluate the pelvic floor muscles internally and provide you with excellent feedback on your kegel.
Mistake-2: Overworking the abdominal muscles with your Kegels. The abdominal muscles have a synergistic relationship with the pelvic floor muscles (PFMs). When the PFMs contract, the transverse abdominal muscle also contracts and this is a good thing. The problem arises when you over-activate (contract) the larger abdominal muscles. This over-contraction of the rectus and oblique abdominal muscles creates a piston effect, creating downward pressure on the organs and improper activation of the PFMs when performing a kegel.
Solution: There is a fine art to doing Kegels correctly. Only with correct execution of the Kegel exercise will symptoms of pressure, leaking, and/or sexual dysfunction go away. While performing the Kegel, keep the exercise pure without over-recruiting the rectus and oblique abdominal muscles.
Mistake-3: Inconsistency. Be consistent with your Kegel program. You have to keep a set schedule when performing the Kegel exercises and working to regain your pelvic power. The love muscles like to be worked out everyday. Sprinkling the Kegel exercises throughout the day or doing them when you remember is not an effective way to get your love muscles back into shape.
Solution: Do your pelvic strengthening exercises at the same time each day and keep the sets and reps consistent.
Mistake-4: Overworking the PFM. Performing too many reps and sets of Kegel exercises does not give these muscles enough time to recover and causes them to fatigue. PFMs are postural and stability muscles and they work all day long, contracting and relaxing with every movement that you make.
Solution: More is not better. Determine the correct number of reps, sets and endurance (seconds) that you should be doing. This is most effectively measured either intra-vaginally or intra-rectally.
Mistake-5: Not overloading these muscles to make them stronger. Just like regular muscles respond to weight training, so do your pelvic floor muscles.
Solution: Pelvic floor muscle training with weights will work great here. You must provide resistance to PFMs to get them as strong as possible.
Mistake-6: Giving up on your exercise program. It can take anywhere from 6 to 12 weeks to see changes in your symptoms, especially if you have never exercised or are not exercising your love muscles on a regular basis.
Solution: Keep consistent and keep doing your Kegels. Most importantly, make sure that you are doing them correctly. For maximum success, come and see us at Renew Physical Therapy. We can help you develop a holistic and effective PFM Training program.
Mistake-7: High Impact Exercise. High impact exercises, such as running and kickboxing can weaken and stress-out already compromised pelvic floor muscles.
Solution: Avoid high impact exercises in the early stages of your pelvic floor muscle strengthening program.
Mistake-8: Lifting incorrectly at the gym and holding your breathe while exercising. This weakens and puts excessive stress on the PFMs.
Solution: Coordinate your gym exercises with your PFMs strengthening exercises so that they complement each other.
Mistake-9: Variety is the spice of life. Doing the same old Kegel exercise in the same position, with the same number of reps and sets, will only take you so far in your pelvic power program.
Solution: To train your PFM effectively, you need exercise them using many different Kegel exercises, not just squeeze and release.
Mistake-10: Not Seeking Professional Help from a Trained Pelvic Floor Physical Therapist.
Solution: So many times I hear from men and women who come to my healing center, “I am working on these muscles with my personal trainer”. Others say, “My Pilates instructor is teaching me how to do them” or “My body worker is instructing me on my pelvic program.” I can tell you with all honesty that there is no substitute for a physical therapist when it comes to training the PFMs. Pelvic floor physical therapists are trained to rehabilitate the PFMs by testing their strength and endurance internally. A detailed evaluation of the PFMs can reveal other imbalances, such as muscle spasms, trigger points, myofascial restrictions and scar adhesions.
You need to address the whole picture because theses types of imbalances impede proper pelvic floor muscle coordination, endurance and strength, contributing to symptoms such as leaking, pelvic pressure, sexual pain, erectile dysfunction and anorgasmia (the medical term for regular difficulty reaching orgasm after ample sexual stimulation).
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