by guest blogger, Michelle Herbst, MPT, DPT
What is a Kegel? Do women know how to do Kegels to make a positive impact on their overall health? Yes and No. But, first a brief history lesson.
In 1956 Dr. Arnold Kegel described physiological therapy (later named the Kegel) in a landmark journal article entitled Early Genital Relaxation – New Technique of Diagnosis and Non-surgical Treatment. The Kegel exercise described by Dr. Kegel was a contraction that was not excessive and isolated to just the pubococcygeus muscle while avoiding the use of gluteals, abdominals, or muscles in the mid-back region. Dr. Kegel recommended his physiological therapy to women of child-bearing age through menopause to prevent, improve, cure incontinence, prolapse and pelvic pain and be an adjunct to surgical interventions.
Sixty years has passed since the Kegel was first prescribed to positively affect genital and pelvic muscle relaxation. By now women around the world should know and consistently use this effective and efficient non-surgical treatment method. However, real barriers exist with respect to the perception, education and regular application of the Kegel. Barrier one: Most women question the effectiveness of Kegels and therefore may choose not to practice them. Barrier two: American women typically first encounter the Kegel exercise in a pre-natal course. Typically, a picture of the pelvic floor muscles or pelvic basket are presented and a nurse describes how to contract the muscles and for how long. The attendees of these prenatal courses are also learning about delivery options, how to breast and/or bottle feed, initial stages of labor, who to call when labor starts, etc. The list of new information and challenges are almost endless. Get my point? The education on Kegels is likely lost or forgotten. Barrier three: The exercise prescriptions for the Kegel is typically are not clear and have been over simplified. These barriers often leave women confused, frustrated and anxious and result in most women making the decision that Kegels are too hard and not worth the time or effort.
How do we overcome these barriers? One way is to use the principles of motor learning to take advantage of the mind-body connection to teach, learn, and master a contemporary approach to Kegels. Using motor learning techniques to learn a new exercise, skill or task addresses the perception and understanding of what the activity is and how to put the activity or skill into action. In a nutshell, motor learning is a process in which the mind and body are engaged in active learning of a new skill or task.
The Hab-It program offers a contemporary approach to learning a Kegel and takes full advantage of motor learning principles. Rather than teaching the Kegel in isolation, the Hab-It program’s 2-step Kegel incorporates natural movement patterns of the pelvic basket working together. The audio-visual presentation of the 2-step Kegel uses motor learning principles by creatively and effectively addressing the perception of what a Kegel is and then educating the client on how to fully engage the pelvic basket. Lastly, Tasha’s exercise prescription for the 2-step Kegel is appropriate for many individual users and can be changed, modified and progressed through as described in the Ask Tasha section of our website.
Knowledge is power. Dr. Kegel gave us a good foundation and a place to start. Sixty years of research have pushed us forward to our current understanding that our bodies do not work in isolation but in functional movement patterns. When barriers are adequately comprehended and addressed, success will come with consistent work and effort. Use of the 2-step Kegel is today’s version of how to prevent, improve, cure incontinence, prolapse and pelvic pain and is a great adjunct to surgical interventions.
References: Shumway-Cook A, Woollacott M. Physiology of Motor Control. In: Motor Control. Translating Research into Clinical Practice. Fourth ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010: 46.
The pelvic basket is an intricate weaving of muscles, tendons, and ligaments that support our pelvic and abdominal organs and assists in bowel and bladder control. As discussed in Tasha’s blog post, The Positive Side Effects of Pelvic Floor Muscle Weakness, “the pelvic basket incorporates the front, back, sides, and floor of your pelvis and lower spine that provide the deepest layer of stability to your body.” Muscle tissue is normally pliable but poor postural habits, trauma to the pelvic basket or chronic tension