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Weighing in on The Great Blog Kegel Controversy

November 10, 2010 | by Missy

So, here’s what happened. Waaaay back in May, biomedical scientist Katy Bowman caused quite a ripple in the blogosphere when, during an interview about pelvic fitness on the blog Mama Sweat, she said, “Ditch the kegels.”

Bowman’s actual statement was this: “A kegel attempts to strengthen the PF, but it really only continues to pull the sacrum inward promoting even more weakness, and more PF gripping.”

“The muscles that balance out the anterior pull on the sacrum are the glutes. A lack of glutes (having no butt) is what makes this group so much more susceptible to PFD. Zero lumbar curvature (missing the little curve at the small of the back) is the most telling sign that the PF is beginning to weaken. Deep, regular squats (pictured in hunter-gathering mama) create the posterior pull on the sacrum. Peeing like this in the shower is a great daily practice, as is relaxing the PF muscles to make sure that you’re not squeezing the bathroom muscle closers too tight. Just close them enough… An easier way to say this is: Weak glutes + too many Kegels = PFD.”

It was a hugely popular post, drawing in over a hundred comments and questions and prompted a follow-up question where Bowman went into far more detail on her position. She posted about the story on her own blog and then even faced someone called the Kegel Queen, respectfully interviewing her majesty and sharing her position.

So, here is our own respectful response- if kegels are performed correctly and regularly, medical research shows that they do work!

Proper alignment is important in any exercise program; You’ve heard Diane Lee, world-class Canadian physiotherapist, lament on this blog the related alignment “no no” – “butt clenching”!  Butt clenching sends that tailbone in the wrong direction (i.e. tucked under), which affects not only the pelvic floor, but the low back and entire pelvic alignment.

At WHF, we wish for all women to consider themselves “Kegel queens” (matter of fact, we want a crown too!) and that every woman have, at some point in her life, a “Kegel coach.”  Why not? Why not ask someone to check your alignment, function, exercise routine, breathing – I mean, we do it every day at the gym with our bicep curls or chest presses.  I know, I know, these muscles are tough to check out at the gym, but they AREN’T tough to check.  You just need your coach.

We continue to beat the drum for pelvic floor physical therapists, pelvic floor friendly nurses and even that occasional, amazing doctor who actually works with women of all ages to identify, isolate and maintain the health and function of their pelvic floors. These are the coaches that really put the “personal” in personal training!

Our DVD walks you through a (SFW) pelvic floor workout, then puts this important muscle group together with other muscles in the Pelvic Pyramid – ’cause as we know for everyone in this field, everything needs to work together to keep us pain free, leak free, drop free and SEXY!

Thank you, ladies, for the chatter – as Coco Chanel said, “Even bad publicity is good publicity.”  And our friendly pelvic floor muscles need all the PR they can get.  Don’t forget them; remember it’s truly, “Move It or Lose It!” in our field.

Photo Credit: Like the Grand Canyon

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4 thoughts on “Weighing in on The Great Blog Kegel Controversy

  1. Misty says:

    This is an excellent article. I agree with you about the importance of glute exercises but I also think there is a benefit to kegel exercise in conjunction with them.

  2. sarah emmanuel says:

    I agree with Katy that you want “..the PF to be long, supple, and taut, to generate long-term forces that hold up your organs, as well as have enough motor skill to open and close your bathroom muscles as needed” however I disagree with her in that strengthening the pelvic floor muscles will eventually slacken these muscles. I do not believe the coccyx moves enough for the pelvic floor to be slack. Also this is assuming the person never stops doing the pelvic floor exercises. Plus not all pelvic floor muscles attach to the coccyx and definitely NOT to the sacrum. Plus the coccyx moves separately on the sacrum, it is not a fixed segment as she implies. As she said in the above statement, the pelvic floor should be supple and taut. This assumes that most people contract when needed and relax when not needed. Problems can arise if the pelvic floor muscles are never relaxed but I do not think prolapse is one of those problems. Usually problems from a hypertonic pelvic floor are pain, pain with intercourse, skin irritation, etc.

  3. Sara Passan says:

    I’m as big a “Kegel” fan as they come-I own/use the “Kegel Master” for God’s sake which my 3-year old son found one day and called a “fishing pole!”–but I am also a huge Bikram yoga fan so I can relate to what Katy is trying to say. A short, tense, tight muscle is not useful no matter how strong it may be. I have a hypertonic pelvic floor and yoga has always made me feel better, now I know why. Strength and length are equally important.

  4. Hot topics are fascinating for a number of reasons, one of which is the ability to provoke almost visceral responses. Kegel or pelvic floor muscle exercise is just that sort of topic, perhaps even polarizing. Witness the Katy Says vs Kegel Queen blogs/videos on the subject. I will comment later on the biomechanical ‘evidence’ given in support of not doing Kegels. For now, I think it’s important to keep in mind a few points:
    • At the end of the day, good pelvic floor muscle function is about a combination of variables: strength, endurance, coordination, breathing, not utilizing a gripping strategy, and CONTROL. Control as in the ability to turn it on, turn it off, automatically, without having to think about it all the time.
    • Although Kegel exercises seem like ‘no-brainer’ exercises, they are far from it; they require focused attention.
    • In some cases, individuals need to work with a pelvic floor physical therapist one-on-one to learn how to combine the whole package of strength, endurance, coordination, etc, to perform them correctly. In some cases men and women need to learn how to ‘let go’ first and undo clenching habits. When that is achieved they will have a pelvic floor that is receptive to strength/endurance training if that is their particular requirement for good function.
    • And finally, as is the case with health care in general, evidence-based choices regarding pelvic floor health remain the gold standard.
    So let’s not allow ourselves to ‘throw the baby out with with bathwater.’ To reduce pelvic floor issues to either ‘ good/bad’ or ‘black/white’ is truly being blind to the whole picture.