should I be doing kegels with butt on pillow?

Hi Pat,

You did just fine posting - thanks for writing in. I would say go along with your PT as there may be some value there for you and it sounds like you're already signed up.

In addition you might try this:

Sit on a firm-seat chair (or on the floor cross-legged if you are that limber). Don't sit back against the chair back, but rather sit up straight. Relax your lower belly and sense the lumbar curve at the small of your back. Keep your shoulders down, your upper back flat and broad and your head pulled up at the crown (tuck your chin just slightly). Breathe in through your nose and as you do so allow your lower belly to come forward over the tops of your thighs - keeping spine in this posture. Hold your breath as you contract your pelvic "floor" muscles. You will feel a lot of sensation around your urethra and bladder as these organs move toward their natural positions. Relax and repeat.

This is how kegels ought to be done instead of lying on your back with a pillow under your butt - hopefully PT will get on board one of these days.

:) Christine

I saw your post yesterday and wanted to respond. One way I like to do kegels is while having sex. I also do them sometimes when I am doing an exercise called seperated leg stretch- basically you stand with feet very wide, bend forward from the hips, put hands on the floor, relax the belly and then contract the pelvic floor.

Welcome to the site- ask any questions you think of and use the search function if you want to get tons of posts on kegels.....or anything else you can think of.

I used to do kegels on my back, and yes, with the pillow. as directed by my ob and then later a mw. and it made sense to the PT in me.
but now it makes no sense to me. when I kegel that way I feel the anterior vaginal wall being pulled down. maybe that's just me, maybe I'm not 'normal' due to all the tearing and prolapsing and such, but that's what I feel.
when I kegel the way christine described, I feel a LIFT and a tightening way deep in (make any sense??).
kegels during sex, well, imo those are the best. aside from the obvious, its exercising the muscle functionally and that's a PT gold standard.

I think that you are probably the best expert on your own body. play around with it, do some kegels in any position you think of and pay attention to the sensation. stick with what feels right.

Pat…the second edition (blue book) contains a lot more information and detail…see if your library will order it.

Yes, it took a lot of extreme thinking to untangle the twisted web of misconception surrounding conventional anatomy of the female pelvis. Better to think extremely than be extremely confused – which virtually all of medical science is around this issue.

I will try to address your concerns, but beware – some of the explanations may require extreme thinking! :)

1. There is no pelvic floor.

2. There is only a thin, sinewy wall of muscle at the back of the pelvis serving a primary purpose of regulating intraabdominal pressure – like a barrel of water with round lids at both ends. The top lid is the respiratory diaphragm. Bear in mind, however, that this barrel is L-shaped and the bottom of the barrel is at the back, not the base.

3. Although we inherited our essentially horizontal spine (do you see the horizontal line in the letter L?..that is just how the sacrum is oriented) and pelvic anatomy from mammals, several adaptations have created a system much more protected from prolapse than they are. The three channels that are our pelvic organs – urethra/bladder, vagina/uterus, and anorectum/sigmoid colon also form sharp right angles within the pelvis. Just like this: 777. They all begin a trajectory up and back toward the hollow of the sacrum and then flip sharply toward the front to end up just behind the lower belly.

4. The newborn female spine and pelvic organs do not have this anatomy, rather everything is positioned along a straight axis within one long abdominopelvic cavity.

5. It is the breath under gravity that creates the final shape of the spine and positioning of the organs. With every in-breath the powerful respiratory diaphragm comes all the way down to our last set of ribs. In doing so it pushes all our organs (stomach, liver, intestines, bladder, uterus) down and forward. The natural female body makes room for this movement by developing a rounded lower belly into which the lower organs are pushed with each breath.

6. When we do not allow for this movement by pulling in our stomach and tucking our tailbone, the breath has nowhere to go but up. Natural belly-breathing is replaced by chest breathing, which uses many muscles and ligaments in our chest, neck and face. This not only creates a lot of unnecessary stress and strain, but it removes a primary mechanism of pelvic organ support – intraabdominal pressure pushing the pelvic organs into the hollow of the lower belly and pinning them there breath after breath.

7. When you kegel on your back you are creating this very same anatomically unsound situation. Because the so-called pelvic floor moves in tandem with the abdominal muscles, when you contract it you are also pulling in your belly. PTs will usually reinforce this by asking you to pull “navel to spine”.

8. Under these conditions there is nowhere for the pelvic organs to go but…back. They are actually being pulled away from their natural positions in the hollow of the rounded lower belly. Kegel exercises performed in this way are actually deleterious to pelvic organ support.

9. All the other explanations you say your PT gave you are just jibberish. She does not remotely understand the nature of female pelvic organ support and should not be in the business of helping women with these disorders if she is not willing to learn.

Have a nice day, Pat, and I hope you will copy your PT on this extremely important information.

Christine