the kegel debate

Submitted by doubtful on January 2, 2011 - 9:47am
Body: 

I've read a lot of interesting posts on kegels, but wonder if anyone can help me with a hunch I'm developing.

Basically, three months into serious ww stuff i had a very encouraging month with my peeking urethrocele mid nov to mid dec. More brilliant days ( with it up and inside most of the time, even when I was on my feet all day) than not. The peeking days coincided with my the time just before to just after my period. I was ecstatic and thought I was beginning to get there.

In addition, I had been experimenting with what was an anti inflammatory diet for me and ( after a good bit of nausea and vomitting as I overdid it with nuts , brown rice and apples, was starting to feel really well on a vegetarian, non dairy, v low sugar GI diet that still let me eat wholemeal bread, pasta and oats with lots of soya. In fact, I am sure it was this low GI high phytoeostrogen diet that gave me my first 27 day ( not 22 day) cycle in two years with no PMT and a very high cervix throughout and only five days of moderate/light bleeding. I was triumphant.

I'd been diligent about the whole woman workout , with lots of extra firebreathing and nauli sessions. And then - well, I stopped bleeding on Chrstmas Eve and my urethrocele has been peeking and dragging almost every since. Very discouraging, but I think I might know why.
I'd been topping up my exercises with lots of kegels - on all fours with my bum in the air. I was working on the theory that bulking up my of muscles might provide a belt and braces effect to help keep everything in. Eight years ago when I saw a gynaecologist with what I know realise was a peeking urethrocele ( he didn't diagnose it as anything but poor muscle tone) he sent me to to a physio who recommended a kegelmaster and I used it religiously. Lo and behold, bulge disappeared, ( or was braced back in perhaps). I now think that the kegels I have been doing over the last month have just created a squeezing pressure on the urethrocele and my newly toned muscles are just pushing it down and out.

Depresssing, but i hope no lasting damage has been done. I'm now mentally encouraging my pf muscles to atrophy as quickly as possible. I'm not even doing Christine's seated keges, working on the theory that I was making progress without them before, and maybe, because my type of pop is so localised and so near the introitus, kegels are not at all helpful. Anyone else had this sort of experience and put right the damage afterwards?

Christine

January 2, 2011 - 6:32pm

dearie, that the only thing that works is moving the pelvic contents forward. The *amazing* thing about this is, we can do it - perhaps even best - by simply sitting strongly pulled up into WW posture. Kegels are nonsense at any level.

My prolapse was *horrible* a few days ago, and I fixed it completely by sitting up strongly in the posture for 48 hours while playing on the floor with my granddaughter! The fascia will comply, but the key is getting these heavy organs tilted over toward the front.

Christine

louiseds

January 2, 2011 - 10:02pm

Hi Doubtful

I agree with you about kegels having the ability to strengthen pelvic floor muscles to the point where they will keep organs down, rather than allowing them to rise up again.They are not muscles that are built for bulking up. They are meant to open and shut, and allow the organs to move around. There are shallow muscles and deep muscles. If you really crunch down on the deep muscles while your organs are low, of course your organs will be kept low.

I agree with Christine that the main principle is to pull them forwards. If you pull them forwards, they *will* rise. Then an active (not bulked up) pelvic floor will keep them in that forward position, by stabilising from the back, as long as they have that position of 'out of the way' safety in their relaxed little pozzie against the lower abdominal wall, with the pelvis remaining tilted slightly forwards, held in place by a proudly raised chest which maintains a large lumbar curve.

You may be right about the diet, but you won't know unless you do it over several months.

Christine

January 3, 2011 - 9:41am

oops...I try to be very careful of sentences like that. The difference between my surgically-induced uterine prolapse being horrible and fine-enough is very slight, maybe 2-3 centimeters. The posture has been enough to pull it forward so it's not stretching and rubbing my introitus. This has been a true miracle for me and once I understood how female anatomy really works, I believed if I could make this work for me, it could work for the majority of women who had never had surgery.

granolamom

January 5, 2011 - 11:27am

hey doubtful
I have had a similar experience, started to get my cystocele up and forward, thought adding kegels would be icing on the cake and it backfired. literally- I developed a rectocele in addition to worsening my cystocele.
so I stopped kegels and got back to where I was and continued to see positive changes.
dont worry about it, you've learned something valuable about your body. experience isn't free you know!
deep breath and on with it : )
you'll be ok

doubtful

January 6, 2011 - 5:10am

Thanks Christine and Granolamom for the reassurance and tips.

It's hard to get ourselves out of the mindset that more is more ( exercise/ deprivation etc) but I've hardly worked out in the last few days - strictly no kegels- ever - again but lots of busyness and ordinary exercise - walking- housework and the trusty firebreathing and nauli. I've also forced myself to sit in the posture for long stretches at my desk
It is hard work- tires your back out. But, hurrah - big improvement already.

There's something very silly about spending hours squeezing your fanny anyway.

Cheerfully,

Doubtful

Christine

January 6, 2011 - 9:57am

hahahaha, doubtful - I totally agree.

christinabf

January 6, 2011 - 10:36pm

Can anyone explain this to me? I thought they were pretty benign.

granolamom

January 7, 2011 - 1:19pm

I guess it depends on your goal. for me, bulking up those muscles just to bulk 'em up, made my POP symptoms worse. I dont think strong pelvic 'floor' muscles will reverse a prolapse, so in terms of POP management, I think kegels are useless at best. at worst they fatigue the muscle and increase bulk in the area. I also wonder (not that I've got any scientific reasoning behind these statements) if overworked pelvic floor muscle can cause a functional imbalance. similar to what you'd get if you overdid your ab's without also working out your paraspinals.
aside from serious athletes and those recovering from injury, I wonder why we do targeted, isolated exercise reps of any muscle group. it doesnt seem functional to me at all. when used properly and regularly throughout the course of an active day, one's muscles stay pretty strong. strong enough to do the things that one typically does, anyway.
and back to kegels, we have some anecdotal evidence here that they sometimes worsen prolapse. without any proven benefit to prolapse, I say why bother?

Aussie Mum

January 7, 2011 - 6:08pm

I just felt I had to comment on this post as I have most definately found kegels helpful. If I had seen these posts when I was newly diagnosed, scared and very very emotional I may have been discouraged to try something which is potentially helpful.

So to share my experience with kegels - I recall doing them randomly in the past, and during pregnancy. I always thought they felt strange, and this discouraged me doing many. I did them after pop as told by the hospital, but it was only once the womens physiotherapist showed me how to do them that I noticed an improvement. For me - they stopped the slight urine leakage I had, relatively quickly. For my rectocele I was unsure what was exactly helping as I tried many things. More recently I stopped doing them, as just got lazy I guess and am no longer seeing the physio, so not having to 'report back'. When seeing her my pelvic floor strength went from weak to very good. It is only since feeling really awful again in the past couple of weeks that I started doing kegels again, and the other night did a pelvic floor DVD I have, and also went to the gym. Well I am amazed to say that after doing them for 2 days the horrible feeling went away again.

I am convinced for me, that they DO make a difference. The only time I think they make things worse for a rectocele is if you are constipated. I always feel that squeezing this area when consitpated is not helpful. If bowels are functioning ok, kegels make me feel stronger, less bulgy and weighty in the pelvic floor.

They are worth trying and seeing how they go for you, and if no good then give it a miss.

louiseds

January 8, 2011 - 10:17am

Valid Point, AussieMum.

Each woman's POP is different. Granolamom is right. There is zero scientific evidence that Kegels help POP. Bladder continence is often associated/present with POP, ie general stretching and lack of muscle tone and response around the urethra. But I have always thought that Kegels were primarily to sort out bladder continence anyway.

After a woman gives birth her pelvic floor muscles sometimes just don't want to work. It is important for them to move. Kegels will help them to get back to work again and get some tone, but beyond that I agree with Gmom. WW posture and lots of appropriate, whole body exercise will get them moving too, as well as a heap of other muscles. Kegels exercise muscles. WW posture fixes POP *symptoms* by realigning pelvic organs via their fascial supports. I would be doing both, but for these two different reasons.

You will still have POP, even if you do both, but your symptoms of POP and your stretched urethra sphincters will both improve.

...but none of us needs a six pack between our legs! That is just silly and unnecessary.

Louise

Louise