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.
Menstrual Cups
Why does my menstrual cup fall out? Learn about menstrual cups and pelvic health.
Is Your Menstrual Cup Falling Out? Here’s Why
Your menstrual cup is shaped to create a suction cup around the cervix, however, it keeps it’s seal by resting on the pelvic floor muscles. There are a couple of reasons your pelvic floor muscles may not be supporting the menstrual cup.
The pelvic floor or diaphragm is a group of muscles on the underside of the pelvis responsible for supporting the bony pelvis, the internal organs including the vagina, bladder, and rectum, and support sexual functions. Pelvic floor dysfunction or problems with the muscles of the pelvic floor includes decreased strength, restricted tissues, muscle spasms, or overactive muscles. There are several reasons you could be experiencing pelvic floor dysfunction including vaginal or cesarean birth, trauma, anxiety and stress, constipation, or something as simple as sitting in the car for many hours in the day, to name a few. If you do have pelvic floor dysfunction, some other symptoms you may be experiencing includes pain during sexual intercourse, or pain with insertion of the cup, difficulty reaching orgasm, a feeling of pressure or “falling out” in your vagina or rectum, or leakage of urine, feces or gas.
The good news is that these are similar to other muscles in the body in that they are fairly easy to assess and rehabilitate. The not so good news is that the treatment approach is not as simple as, “just do kegels” or “stop your flow of urine when peeing.” The problem is, if you begin pelvic floor strengthening exercises, but you fall under the “overactive pelvic floor muscles” category, then your exercises will not make a change in your strength leaving your cup to continue to fall out or worse, you may develop pelvic pain.
To learn about your pelvic floor, I recommend seeking professional help from a physical therapist specializing in pelvic health. You can find a physical therapist in your area here http://pt.womenshealthapta.org/
If you do not have access to a pelvic physical therapist, follow my instagram account for additional education.
Content contributed by Dr. Grace Abruzzo PT, DPT, CAPP-OB/Pelvic, CD(DONA), PYT-C
Dr. Grace practices integrative pelvic physical therapy in Los Angeles and is certified in obstetric and pelvic health through the American Physical Therapy Association.