“How to do a Kegel” articles often recycle the same advice: Use the muscles that stop and start your urine flow. Wash. Rinse. Repeat. (Okay, it was just repeat). The web, self-help books and women’s health magazines are filled with the same articles encouraging this routine. Same advice, with the same result. It doesn’t work. Women faithfully follow this advice but they still leak, others try but can’t feel anything, and most get so frustrated they just give up. For years this has been the story for women, because this has been the only information available.

Time for a change

In the last decade, research has given us new insight into how the pelvic floor (our Kegel muscles) works. We can finally give women new tools to enhance pelvic floor function. Want to see real change “down there”? Follow these three steps.

First step: Figure out where the heck your muscles are

Your pelvic floor is a hammock of muscles that run from your pubic bone in the front to your tailbone in the back. All the muscles of the pelvic floor work together and you can use them in different ways. The parts of the pelvic floor towards your backside will close and lift your anus up and in, which helps to support and control your bowel. The parts of the pelvic floor towards the front will close and lift up and in your urethra and vaginal opening.Thus providing support and control for your bladder and uterus.

Second step: Try to activate your pelvic floor

Stand up and try a Kegel as best you can, using your current strategy for a pelvic floor lift. Where do you feel the contraction? Around your anus? More toward the front of your pelvic floor? Do you hold your breath? Contract your bum? Contract your abdominals? If performed properly, you should feel a balanced contraction between the front and back parts of your pelvic floor and they should lift up and in. It is very common for women who are struggling to stop urine leaks to only feel the contraction around the anus when they try to perform a Kegel. If this is what you experience than this means that the parts of your pelvic floor towards the front that support and control the bladder aren’t responding to the call to lift. A squeeze only around the anus will not stop a urine leak.

If you hold your breath, squeeze your bum, or brace your abdomen, these are substitutions your body has made for a weakened pelvic floor (happens after pregnancy for some, but some women experience weakness and leaks even if they have not had children). These muscular compensations will not help you control a leak. In the case of breath holding or an abdominal contraction, this will actually make leaking worse because of the significant pressure that is created from above pushing against a weakened pelvic floor.

Third Step: Take it to the next level: Kegel 2.0

Let me teach you a trick to get the front of the pelvic floor going again. While you are standing take a mental note of where you feel your body weight goes into the floor, is it through your heels, mid-foot or toes? Look at your profile in a mirror, take note of where your upper body is in relation to your lower. Is your upper body slanting or slouching behind your bum, if yes, then your natural standing position likely puts your weight in your heels.

Now if you are in your heels already, stay there, but if you feel your weight elsewhere, then shift back into heels (nothing extreme, don’t lift your toes, just shift at the ankles). While your weight is in your heels, perform a Kegel and take note of where you feel the contraction.

Now shift your weight forward as if you were going off of a ski jump. Look at your profile again, your upper body and lower body should be aligned in a diagonal angled forward with the shift occurring at the ankle. In this position perform a Kegel and take note of where you feel the contraction.

Shift back and forth, heels to ski jump diagonal. What did you feel? While in your heels you likely felt the pelvic floor work only around your anus. While in the ski jump with weight shifted forward, you likely felt the work of the front of your pelvic floor. The contractions toward the front of your pelvic floor are the elusive muscles you have been searching for, these are the muscles that help stop the leaks. *

This trick is based on current research that has shown that the pelvic floor responds to our postural alignment. The position of our rib cage in relation to our pelvis will determine how well we can connect and utilize the pelvic floor. If in your natural standing posture your rib cage sits behind your pelvis, upper body slanted or slouched behind your bum, then your weight is in your heels throughout the day. So when a sneeze, cough or gut busting joke comes your way then you will squeeze primarily around your anus and not be able to catch a leak. If however, you are in the midst of leaning forward to wash dishes or change a diaper, the same scenario may not cause a leak (Ever wondered why sometimes you leak and sometimes you don’t? Now you know).

This new insight into how to enhance pelvic floor function is also the explanation of why Kegels can be so frustrating and have poor results. If you are practicing them while standing slouched with your weight in your heels or while slouched in sitting, the front part of the pelvic floor will not respond, nor will it be trained.

Now that you feel the right muscles, practice using them in a balanced way (front and back) where ever you are! You will find that your posture will determine how well you can connect to the front of your pelvic floor and help you control leaks.

Stay tuned for learning more tricks to get that pelvic floor really rocking!

Please contact me julie@interiorfitness.com with questions or comments

{*If shifting forward and back brought no change for you, check your profile again and watch your rib cage. As you shift forward into the ski jump, watch to see if your rib cage continues to lag behind your pelvis. If it does then you will continue to experience squeezing around the anus. Try again to create a diagonal alignment with a shift at your ankles as you come forward.}