Let’s be Frank about: Kegels during Pregnancy
Kegels are such a hot but confusing topic around pregnancy. Some people say do it or else, and other’s say kegels are bad. Let’s try and clarify WHY they’re good and why it’s so important to focus on relaxation as well as strength. This article will address:
What are kegels and should I be doing them during pregnancy?
Why do some people say not to do kegels?
How should I do kegels during pregnancy?
When should I stop doing kegels?
Frank Tips
What are kegels and should I be doing them during pregnancy?
Kegels is a fancy name (named after Mr. Kegel) for Pelvic Floor Muscle Training (PFMT). Your pelvic floor is an automatic set of muscles that does its job of containing intra-abdominal pressure without your conscious effort. Every moment of the day when you’re upright, being active, sneezing or coughing, your pelvic floor is right there by your side doing it’s thang. HOWEVER — during pregnancy, as your baby grows, your pelvic floor can become challenged by the increasing weight and pressure and may lil extra support. Here’s a quick summary of the evidence supporting PFMT / Kegels.
Prevention: People who do kegels during pregnancy have fewer instances of urinary incontinence and prolapse both during pregnancy and in the postpartum period compared to those who do not.
Labour Preparation: Kegels contribute to better pelvic floor muscle function and support, which is crucial during the labor and delivery process. Learning how to contract vs. relax your pelvic floor while pushing a baby out can be a huge game changer.
Postpartum Recovery: PFMT has been associated with faster postpartum recovery, including improved bladder control and reduced pelvic pain. Stronger in, stronger out. These benefits extend beyond pregnancy, as regular pelvic floor exercises can also help prevent pelvic floor disorders later in life.
Why Do Some People Say Not to do Kegels?
Let’s get one thing straight — Kegels are often misinterpreted to be about contraction/squeeze/being able to lift weights your vagina — thats not it. I often see people who have been working on their kegels and as a result have a lot of pelvic floor muscle tension, which you can imagine is not very helpful for softening, lengthening and accommodating a baby out of the body. So, yes kegels can be super beneficial for supportive strength, but without range of motion and training a long and strong muscle we often run into dysfunction. Check out the visuals and videos below to explore helpful well rounded pelvic floor muscle training ideas.
How Should I Do Kegels During Pregnancy?
So we can agree that PFMT is beneficial during pregnancy but lets lay out some ground rules & priorities:
Quality Control:
Make sure to get feedback on how you’re engaging these muscles. The shocking stat is that 70% of people are doing kegels wrong, and if you’ve never even thought about your pelvic floor, you don’t even know if your pelvic floor is tight, weak, or AOK. Working with a pelvic floor physiotherapist (come see me!) can be an excellent first step to get feedback on your quality before introducing this new workout regimen.
Frequency & Consistency:
Like any exercise, it takes time and consistency to make change in the body. You should be able to do 3 sets of 10 reps and be able to hold for 10seconds without losing the quality of contraction or full relaxation. We’re also looking for consistent like 3 months of work so feel change in the muscle strength and coordination. It can be helpful to pair your PFMT with an activity — either with your workouts or when you’re lying in bed, or brushing your teeth - something that reminds you to do them regularly (like a few times a week).
Incorporate Kegels into your workouts: Hello Frank!
There’s a lot of evidence showing that your PF works even MORE with exercise than it does with kegels alone so take advantage while you’re doing your Frank workouts ◡̈ Honestly, even pair them into your every day movements! Pair your inhales with pelvic floor length, and your exhales with PF contraction to maximize your workouts from the inside out. Your kegels won’t feel the same during movement than they would when you’re just lying down isolating but becoming mindful of lengthening and gentle engaging (even if you dont feel it) is a really great idea and beneficial postpartum.
Always finish your workouts with RELAXATION:
We prioritize a good stretch after a big workout to prevent soreness, excess tension and dysfunction. The same goes for your pelvic floor. Whether you’ve done a regular workout or a PF isolated workout — finish with 5-10 breaths fully releasing your pelvic floor muscles in positions like childpose or happy baby.
Different priorities at different stages of pregnancy:
I created this little graphic to show how the focus around your pelvic floor muscle training should change throughout your pregnancy. It’s as simple as focusing on strength earlier on, as your body is changing and your body wants more stability, vs. focusing on pelvic floor relaxation through your third trimester as you approach birth.
When Should I Stop Doing Kegels?
If you start doing kegels and start noticing any of these signs, this may be a hint that too much tension is building internally. I’d recommend focusing on release work for a while and noticing if that improves things. Working with a PF physio can also be helpful because PF relaxation can feel a lil unerwhelming and hard to tell compared to that contraction work.
If you already have pain with sex — pretty solid sign you should spend your pregnancy learning how to make space in there
If you start having pain with sex
If you start feeling like you need to be all the time
If you start developing urinary urgency i.e running to the bathroom and not making it in time
If you develop pain in or around you pelvis including your tailbone and pubic bone
If you start struggling with more constipation
If kegels give you anxiety or feel uncomfortable
A Few Final Frank Kegel Tips:
As you inhale, allow your belly and pelvic floor to relax and lengthen as if a flower is slowly opening
As you exhale, imagine your trying to lift a tampon back into your body that was slipping out.
The contraction should feel like a firm hug not a clench and should isolate the muscles INSIDE your body.
If you’re using your butt muscles, inner thighs or just sucking in with your belly - you’re doing it too hard or very wrong.
Practice contraction & relaxation in different positions - lying down, sitting, standing.
Try out various types of kegels to challenge yourself and your control — Like these!
In Summary:
The main goals of PFMT during pregnancy is to develop awareness, range of motion, strength and support. Don’t forget that your PF works with you during all physical activity even more so than kegels alone so make the most of your full body strength training (through Frank DUH!) as much as possible so that you feel supported through your PF, glute, core, and full body strength. If you feel unsure about if kegels are right for you, go work with a PF physiotherapist and we’ll make sure you know exactly what work is best for your body. If you want to try on your own, focus on the relaxation as much as the strength and you’ll be good to go.
