Steven Lavender
reference https://theptpractice.nyc

By now many of you would have heard the word Kegel.  Arnold Kegel was an American gynecologist who developed exercises to strengthen “relaxed genitals” in females.  The exercises have been well studied and are now taught to both men and women as the first line of defense against incontinence both urinary and fecal.  In more recent times the role and importance of the pelvic floor in the pursuit of “core stability” has also been well established. Core stability, as you may know, is the concept that efficiency of movement and prevention of injury comes from an internal bracing of the pelvis and trunk and all movement especially movement that involves force or repetition, revolves around this internally braced and stable base.  The stable base and the moving parts need control through a range of strength and endurance. As it turns out, proper activation of the pelvic floor muscles will also engage the deep essential muscles strongly related to core stability.  So done correctly you get a lot of bang for your buck if you learn how to do this well.

One of the things that drive me crazy is at the mere mention of the word Kegel, a patient will immediately stop breathing, suck in their gut as forcefully as possible, possibly contract the pelvic floor or not, and hold this ‘till they turn blue.  The energy cost is too great and no one could possibly sustain this level of muscle activation or oxygen deprivation for long.  You need to be able to use these muscles all day, not for two minutes and forget them. The ability to perform ten perfect examples of a Kegel exercise while lying down in isolation will not help you unless you integrate that ability and use the knowledge and control of those muscles while living your life and doing the things you want to do.

If you remember nothing else from this article remember this.  Activation of the pelvic floor and core stability muscles is like turning on a light with a dimmer switch, not a toggle switch.  It is not an on or off proposition. Rather is a graded body bracing that is able to increase and decrease as required to perform a certain function safely and efficiently.   For example, the amount of gentle pelvic floor and core muscle activation required to stand up from sitting without peeing your pants is not the same as the amount needed while carrying home two heavy shopping bags from the market and that is not the same as the amount required to kayak upstream.  Most of us can function well on just a normal amount of control of endurance and strength. If you wanted to perform at an Olympic level you would have to train especially for that event.

Instead of thinking about the word Kegel think of the concept of pelvic floor control.  It gives the impression of a more dynamic remedy rather than a static one.