Beyond Kegels & Pelvic Floor Physical Therapy

April 20, 2023

Okay I have been talking about going beyond kegels, the pelvic floor and advocating for pelvic floor physical therapy for years now. My good friend and colleague Dr. Hannah Strom, DPT  just had to be one of the first guests on the Mavens of Motherhood podcast to talk all about pelvic health and how to go beyond just kegels. We both agree that it is wrong and bad practice to have a generalized approach to pelvic health with “just do kegels”. It is not supportive to all people with a pelvic floor. Not everyone needs kegels and kegels could be the wrong tool for some people.

If you are curious to learn more about going beyond kegels, optimizing your pelvic health and healing your pelvic floor with holistic pelvic floor physical therapy and an at home practice that you can do yourself check out this podcast episode on the Mavens of Motherhood Podcast!

Why Pelvic Floor Physical Therapy? 

If you experience pain in your pelvis or abdomen, constipation, leaking, sexual difficulties, are pregnant/postpartum, or having any bowel/bladder problems I highly recommend seeing a pelvic floor physical therapist. Even if you are feeling like your symptoms are common. Common does not mean that it is normal and you do not need to live with your symptoms. Not having any problems and still curious on how to optimize your pelvic floor or prepare for pregnancy? Schedule a visit and see someone. There is so much we can do to help maintain this muscle group and support our pelvic health sustainability. 

What Can I Expect from Pelvic Floor Physical Therapy?

Pelvic Floor Physical Therapy is a specialized form of physical therapy that treats the pelvic area, pelvic floor dysfunction and can help to support you in pregnancy and postpartum. In other countries it is standard of care to receive pelvic floor physical therapy in pregnancy and postpartum. The US still has a long way to go with normalizing this form of treatment beyond just acute care and treating injuries and dysfunction. Pelvic Floor Physical Therapy can include external manual therapy, internal manual therapy, weight lifting, exercises, yoga, pilates, breathwork, mindfulness and physical therapy for the whole body. 

What is the Pelvic Floor?

If you imagine your pelvis has four corners and there is a hammock of muscles under your pelvis connecting those four corners – That is your pelvic floor! These muscles provide support for your pelvic organs, provide stability for the joints of your pelvis, and pressure management for your core. We usually do not think about our pelvic floor until we have dysfunction. Dysfunction can look like pain with sex, incontinence, bowel dysfunction, pelvic pain and pregnancy or postpartum recovery.

“The pelvic floor is a really awesome area of the body! Of course I am a little biased.” 

– Dr. Hannah Strom, DPT

The first time that I heard about my pelvic floor was in a yoga class when my yoga teacher would say, “Lift and engage your mula bandha” Mula Bandha is your root energy lock in yoga which is the engagement of your pelvic floor muscles or otherwise known as a kegel. Mula Bandha was always discussed as an engagement or a lift and never as a relax. As I’ve come to learn that now we want to have function, both engagement and relaxation to create a functional pelvic floor. 

“We all have a pelvic floor. No matter who you are, you do have a pelvic floor.” 

– Dr. Hannah Strom, DPT

Something I wish I would have learned in Sex Ed or Health Class in high school is about my pelvic floor. Pelvic Health is one of those things that you don’t really think about and tend to until you have to. Which is so unfortunate. It is easy to take things like being able to hold your bladder, run without leaking, orgasim and not experience pelvic pain. I didn’t really learn about my pelvic floor until I was pregnant for the first time which we really need to address pelvic floor dysfunction prior to getting pregnant. 

What is a Kegel?

A kegel is a pelvic floor contraction. Think of it like the action of holding back your urine. Another analogy is the concept of picking up a blueberry with your vaginal opening. A kegel was used as a “solve all” or the one and only exercise prescribed to people to solve pelvic floor issues. Which is just not an appropriate exercise for all bodies experiencing pelvic floor dysfunction. There is so much more you can do for your pelvic floor function than just Kegels! The goal should be a functional pelvic floor vs. only developing strength with kegel exercises. 

Why you NEED a Functional Pelvic Floor

A functional pelvic floor is a pelvic floor that can fully engage and fully relax. The pelvic floor is just like any other muscle group. Think of it like your bicep muscle. If your bicep is “too strong” or has too much muscle tension and your focus is solely on lifting and engagement your arm will look engaged. This can lead to injury, pain and weakness. If your bicep muscle is “too relaxed” or hyper mobile this can lead to instability which can in return lead to injury, pain and weakness. Our goal is to have a balanced muscle group that is functional in both strength and relaxation. Another analogy I love to think about too is if you are hanging from a bar in a pull up position and your muscles are tense and engaged like this is your neutral. If you sneeze or cough… of course you will get tired and lose your grip on the bar. Doing a kegel with a tense or tight pelvic floor is like trying to do a pull up when you’re already hanging at 90 degrees. You are tired and less likely to have a functional pull up.

Can I do this myself?

There are a lot of tools, exercises and stretches that you can do on your own to support a functional pelvic floor. When you work with a skilled physical therapist like Dr. Hannah, they will be able to access your current situation down there and give you specific therapy recommendations like internal therapy, exercises, stretches, breathwork or even energetic therapy. It truly is not a one size fits all when it comes to pelvic floor physical therapy and I highly recommend working with someone to get to know your specific needs. If you are looking for guidance on how to get started with your at home practice and improve your pelvic floor function check out the course I designed with Dr. Hannah Strom, DPT called “Beyond Kegels”. This is a great place to get started and learn more.

About Dr. Hannah Strom, Founder of Awake Pelvic Health & Wellness

Why I love Dr. Hannah Strom, DPT at Awake Pelvic Health & Wellness out of Woodbury Minnesota is because she truly has a holistic and mindful approach to pelvic health. With her private practice she works outside of the parameters of medical insurance which allows her to length and customize your appointments. She integrates yoga, mindfulness, breathwork, pilates, exercise and truly treats your whole body to help your pelvic health symptoms. 

Awake Pelvic Health & Wellness is a specialty Pelvic Physical Therapy practice helping individuals overcome pelvic floor dysfunction. We believe in an active, hands on, “whole-body” approach to treatment. Grounded in both holistic and evidence-informed practice, we’re passionate about providing positive, life-changing experiences for each unique individual. For us, that means full-length, hour-long sessions 1:1 with a true pelvic specialist.  No pawning you off on an aide.  No hooking you up to a machine.  No watching you exercise.  Just expert care from a specialist who has dedicated her entire career to pelvic health. Every person is different.  We don’t just teach everyone Kegels or have a program every single person gets.  Instead we tailor treatment to your situation, your goals and your body.

We uncover the reason your symptoms are there in the first place. It isn’t enough to say that the pelvic floor or core is weak or tight. In order to have lasting relief from symptoms, we need to investigate why the symptoms are there in the first place and address them with functional exercises and treatments. We create our treatments to be meaningful and functional and accurately represent your daily tasks; Pelvic floor training that is targeted at how the pelvic floor actually functions with the rest of the body. It’s not about Kegels. Sessions are with your therapist in our private and comfortable space that is devoted solely to pelvic floor therapy and when you call, you will get a compassionate team member to assist you.

Beyond Kegels – A Functional Pelvic Floor Course for Women

Join Dr. Hannah Strom, PT, DPT and Ella Frances, ERYT-200 for a virtual workshop for women. We’ll do a deep dive into the role the pelvic floor plays in our functional daily lives and move beyond Kegels as a “one size fits all” pelvic floor strengthening solution. You will learn more about how your pelvic floor is connected to your breath and rest of your body and learn about common pelvic floor issues. We will end with a 30 minute movement session, focusing on breath, posture, strengthening, and mobility to connect everything you learned in the course. Plus you will receive downloadable PDFs with takeaway strategies and education!

This Course is for women who:

  • Curious to learn more about their body and pelvic floor
  • Want to learn more about how yoga and exercise can support their pelvic floor
  • Have given birth
  • Are currently pregnant
  • Who experience pelvic discomfort during menstruation or intercourse
  • Are managing urinary leaking or prolapse

Hannah and Ella provide collaborative education to help you walk away feeling more confident and empowered about your body and your pelvic floor. You will walk away with valuable strategies to cultivate a more functional pelvic floor, moving beyond just Kegels!


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