For years, maybe even decades, the best (and maybe only) exercise suggested to ladies dealing with incontinence and pelvic floor weakness has been the kegel. A concentric contraction of the muscles running from the pubic symphysis (front of the pelvis) to the coccyx and sacrum (in the back of the pelvis), a kegel should create a squeeze and lift of the those muscles to, in theory, provide organ support and sphincter control. Collectively, the muscles are known as the pelvic floor. In fact, the medical community used to encourage ladies to “do your kegels” every day by stopping mid-stream during urination. And while doing this may be an effective test to see if you can actually isolate those muscles appropriately, we have learned that actually performing a kegel contraction as an exercise during voiding is more detrimental than beneficial.
So recommendations shifted to something more like “do 10 kegels, holding for 10 seconds, at every stop light.” I don’t know about you, but my pelvic floor is not the first thing that pops into my head when I roll up to a red light. So if I was reliant upon that scenario to get my pelvic floor exercise in, then I would be a mess. Don’t get me wrong, there is value in learning how to activate your pelvic floor and in doing a kegel contraction, I really believe this. But I believe there is more value in learning to activate the pelvic floor during functional tasks that we do every day. And there is value in learning to relax your pelvic floor as well.
One of my favorite functional exercises is a squat…aaahh! Just saying it makes me happy. There is just something about the movement as a whole that embodies strength and health, in my mind. Now don’t panic thinking you need to rack up 150# on a barbell and drop into a deep squat to get your pelvic floor going. That is not the vision I am trying to create. In its most basic form, moving from sitting to standing is a squat. How many times a day do you do that? Lets make that functional transition work for us ladies. Or turn it into a straight up exercise session. Our booty and pelvic floor muscles will thanks us!
OK! Here we go: it is the strength of the glute muscles that can assist our pelvic floor muscles, so with that in mind, lets try a booty-friendly sit to stand, ahem, squat.
Sit forward near the edge of your chair so feet are firmly planted on the floor.
Position ankles under knees, so that your tibia (shin bone) is fairly vertical.
Lean forward, keeping your back flat (no slouchy shoulders), exhale and push up to stand. Much of your pressure will be through your heels.
Finish the stand with a slight glute squeeze.
Inhale and relax your pelvic floor as you return to sit.
As we talked about the core connection to breathing last week, you may remember that when you exhale, the pelvic floor should naturally elevate after elongating downward during your inhale. This makes the exhale a perfect time to add a kegel contraction if you need some additional support across the pelvic floor since it is already moving in the upward direction.
When just beginning this type of “glute driven squat” your depth may need to be shallower than typical or you may even find it useful to hold onto a counter top to allow your hips to drop back a bit, keeping the ankle and knee better aligned. The Smith Machine in your local gym is a great asset here too. As you can tell from the pictures above, I need to work a bit on fine tuning the form. As a squat it isn’t bad, but I could still get my backside more involved with better support. It gives you the idea though.
Take home message? Kegels are not the only exercise available to you if you are looking to improve the health and strength of your pelvic floor. A strong booty is just as important. Taking a little extra time with your daily transition from sit to stand, or adding a few dedicated sets of this a few days a week could really pay off for your overall core health.