Kegels.
Let’s talk about “kegels.”
Arnold Kegel, born 1894, was an American Gynecologist and just one of the MANY CIS White Male Gynecologists experimenting and learning on many female bodies, especially Black, enslaved female bodies.
The term, “kegel,” is one of many terms and names used on the vulvovaginal and uterine/ovarian bodies that are named after White Men. To reclaim our bodies in name and with language, I prefer to no longer use the term, “kegel.”
When people refer to a kegel exercise they are describing the concentric contraction of the pelvic floor diaphragm muscles (it is not a floor.) The problem with this is that the vast network of muscles moves both concentrically (shortens) and eccentrically (lengthens) and both movements are important for pelvic health.
We often find these muscles activated concentrically (shortened) when in a state of stress. If your body is guarding or bracing, it may contract certain muscles around VITAL organs to keep us alive. You can imagine what your neck muscles would do if you saw a car heading towards the back of your car at full speed. They tense up in an effort to protect your brain and neck! That is a reflexive reaction that is developed over thousands of years of evolution towards our survival.
So now, if we bring that same intelligence to the pelvis— it is easy to imagine what those muscles are tensing up for! If we ignore this, and then send a repeated message to contract and shorten with the KEGEL exercise in order to treat ANY pelvic condition then we are MISDIAGNOSING and MISTREATING the pelvis.
It wil important to attune to the pelvis and to our bodies as a whole. To ourselves as whole. Do the pelvis muscles have mobility? Do they move up (in) and down (out)? Do you know where they are right now in the moment? Can you concentrically contract them? Eccentrically contract them? Can you hold that contraction while you breathe deeply? Can you contract them quickly? Can you release them quickly?
>> After all that, do you still feel comfortable talking about them as kegels? I would think not!
Kegels don’t solve pelvic issues. Pelvic Awareness, Movement, breath, coordination, endurance, power, speed, mobility, and strength will feel most supportive… and that is why I call them Pelvic Exercises. <3
Is It Your Hip or Ovary?
Hip or Ovary pain? Let’s talk about how the two relate!
Are you experiencing pain in your hip or lower abdomen? How do we know if it is pain coming from your ovary or hip?
Hip Dysfunction often refers to the lower abdomen, leg, low back, groin and even the ovary.
Ovarian Dysfunction often refers to the same areas— so which needs the attention?
Here are some thoughts:
Your ovary may be the “source” of pain if your symptoms are worsened around ovulation and bleeding times in your cycle.
If you have a history of ovarian cysts, PCOS, endometriosis, anovulation, then you may want an ultrasound screening of your ovary.
If your hip has limited, or painful movements, then you may have more of a hip issue to work with.
Often, back pain is caused by hip mobility issues! If your hip is unable to move or stabilize your pelvis, then your back will take on the compensations and strain.
Hip issues often lead to over active hip flexors, which is the muscle that inserts on the front of the hip near the groin crease. Hip Flexors are a powerful muscle group of the illiacus and psoas, combining to illiopsoas. These muscles run along your spine, starting from the base of the respiratory diaphragm, and inserting at the top of the hip. These muscles will support you in a fight, flight and freeze response. So if your body is experiencing a stress response, these muscles may be the first to engage in protection.
In an evaluation— we first will screen your hip movement, then we will screen your ovary movements. This will inform our course of treatment.
On your own— try massaging your ovary, and your hip to start to self-exam the two. Notice if you consistently cross one leg over the other or carry your kiddos on one side. Notice if your symptoms are constant or cyclical. Offer your body some hip mobility and breath exercises as demonstrated below.
Pelvic Healing After Cancer
Pelvic healing after cancer— Your pelvis may need care after common cancer treatments and pelvic physical therapy can help.
Too many patients are not referred to pelvic health following cancer treatments. Unfortunately, radiation, surgery, and chemotherapies can have a profound impact on pelvic health and sexual health. Some treatments include removal of pelvic organs including the colon, bladder, uterus, ovaries, testicles, and prostate. In addition, the pelvis may go through transitions such a early menopause.
Cancer is hard enough— navigating pelvic health during and after treatment deserves support from a professional. Here are some common complaints:
Bladder changes may occur either due to a neobladder , urostomy, prolonged catheterization, prostatectomy, or radiation to the pelvis. Common complaints are difficulty releasing a stream of urine, urgency (rushing to pee), increased frequency of peeing, pain with peeing, leakage of urine.
Vaginal Pain may occur with radiation, or early onset menopause from hysterectomies. The vaginal tissues may become dry, hypertrophied, sensitive to touch and prone to tearing. Sex play including both vulva focused and vaginal focused touch may become painful. I often see trauma from fighting and surviving invasive surgeries impacting sexual relations between partners.
Testicular and penile pain, pain with erection or difficulty with erection/ejaculation may be experienced after treatments.
Bowel changes may occur as the colon adapts to changes within the pelvis. Common complaints are slowed motility, difficulty emptying, soiling or leakage, urgency, or changes in frequency.
Here’s how physical therapy interventions support pelvic healing:
Treatments may include scar tissue management, fascial mobility with manual therapies, pain management, bladder or bowel retraining, pelvic muscle training, trauma response integration, sex-ed, movements/exercises to support whole body mobility, balance, and regulation, etc. To read more about the specific interventions I offer or on my advanced training, read here.
Mostly, I want you to know, your pelvic health is important. Healing is available to you. There are resources for you and your love ones as you navigate the hardships that often come with cancer treatments.
You are so precious and loved and you deserve to feel peace and pleasure in your pelvis.
Bladder Hygiene
Or should the title be “HOW TO PEE 101” ?
Here is the PEE info you never got—
Don’t Pee “Just in Case” If you teach your family, and yourself to pee before you go, then your bladder will learn this behavior and potentially hold you to it! Your bladder is meant to tolerate holding urine comfortably for 2-4 hours.
Typically we want to see 6-8 pees per day, and 1 per night. If you are peeing 1x/hour or less than that— it is time to book an appointment! That would be considered increased bladder frequency. Things that can affect this, include diuretics (medicine or caffeine that make you pee), irritants (some citrus/juice/coffee/alcohol/sugar/carbonation), or behaviors (see #1).
SLOW DOWN to pee. If you are rushing to the bathroom, and trying to push down to “pee faster,” then you in general are moving too fast. Take some deep breaths. You should be able to slowly walk to the bathroom, slowly remove your undergarments, slowly release your pee until completion.
Feeling like you can never empty your bladder? Well perhaps get tested for urine health, and if the feeling persists— time to see a PT. The feeling of a UTI can linger as tissue memory from the nerves, muscles, fascia and feeling fully empty might be a struggle. If you are in fact needing to empty again shortly after peeing, you may also be experiencing symptoms of prolapse— WAIT! Don’t freak out just yet. This is a possibility- not a Dr. Google Diagnosis time… so be sure to take a deep breath, and see a PT!
Does a full bladder or peeing hurt? OK time to see a PT again. Holding urine, releasing urine, should never hurt. This can be do to a number of things… best to get checked out.
“I was told to practice my kegels while peeing to see if I can stop the flow of urine.” DON’T DO THAT. That was BAD Rubbish advice that was spread during my Mama’s generation.
“I was told holding my urine in would give me a kidney infection.” A Catheter increases risk of infection. Wearing a penis-clamp (if you don’t know what it is— it’s what it sounds like) for too long could increase a risk of harm. But holding a full bladder for 2-4 hours… now that is harmless. Imagine being on the window seat during a plane, or in a long movie, or SLEEPING… holding in urine is okay. Side note— I would still encourage peeing after a sexual play session involving vaginal penetration, or bacterial exchange around the urethra (aka touch without a dental dam or condom).
LEAKAGE IS NOT NORMAL. Ever. Not at any age ( above 4ish years old). Not during or after pregnancy. If you pee you pants (even a little) when coughing, sneezing, washing dishes, running, jumping, hiking, during sexual play (different from golden showers and squirting), then seek pelvic PT.
Odds are— you’re dehydrated. MOST people I see are dehydrated. Try to drink half your body weight in ounces of water. Since I weigh 180 pounds currently, that means I should have a goal of 90 ounces of water intake. If you exercise, make milk (with your chest/breast), talk a lot (like a teacher), then you might even need a little more. Can I drink too much water? YES. Yes actually. There is a sweet spot for hydration. And no, coffee, beer and soda do not count for hydration.
Blood in your urine? Call your Medical Care Provider immediately… that isn’t normal.
