Continuing Education,  Health

Pelvic Power: The Force is with You

At Other Nature, we run continuing education training sessions for our team, because when it comes to sex, the learning never stops! How it works is that we invite a guest speaker to talk to us about their special area of knowledge, which relates in some way to our day-to-day work in the store.

A few months ago, we asked sex-positive, queer-positive, and über-knowledgeable midwife Imogen Raye Minton to give us a session on the pelvic floor.

While we were aware that we had some gaps in our knowledge, as a team we already felt pretty comfortable talking about the pelvic floor, and more specifically, about Kegel balls, since this is a type of product that we sell in the shop. What none of us expected was the extent to which, by the end of Imogen’s session, we were blown away by how much there was still to learn and discover.

We were so thankful for the opportunity to access this wealth of information, and immediately began incorporating Imogen’s thoughtful tips and advice into our customer consultations. But we wanted to share what we learned with even more people – indeed with as many people as possible…

And then there was blog.

First, if you haven’t already read our new and improved website info page about the pelvic floor, we suggest doing that before you continue reading this post, which is meant as a follow up to the basic info that we’ve already provided there.

 

So, what exactly do we mean when we talk about the “pelvic floor”?

The term “pelvic floor” describes a hammock-shaped group of muscles, ligaments, nerves, blood vessels, and fascia (connective tissue that surrounds and supports our organs) that cradles the pelvic area, extending from the front pubic bone back to the tailbone, and from side to side between the sit bones.

If you imagine the pelvic floor as an actual hammock, hanging between the front pubic bone and tailbone “trees”, you can picture the pelvic organs (bladder, uterus, prostate, and bowel) resting oh-so-lazily inside the hammock. Meanwhile, the grassy ground below the hammock is actually the genitals (vulva or penis/scrotum), which lie outside of the pelvic floor and are externally visible.

Our special pelvic hammock has an important design feature that’s integral to its function. The pelvic floor has holes in it, allowing a passage way for the urethra, vagina, and bowel. These canals or tubes pass through the holes in the pelvic floor, and emerge out the other side of the external body (as the urethral, vaginal, and anal openings, respectively.)

Because these tubes pass through the pelvic floor, it’s the contraction and relaxation of the pelvic floor that allows our anal and urethral sphincters to work properly. In other words, these muscles are integral both to our ability to pee and poop when we want to (and not when we don’t), as well as to our sexual functioning – regardless of what kind of genitals we have.

 

As functional as the sum of its parts

To understand how the pelvic floor works, and why Kegels alone won’t solve all your pelvic floor woes (more on that later!), it’s worth getting a bit nerdy about the composition of the pelvic floor muscles.

Just as the cloth of a hammock is made of interweaving fabric fibers, the pelvic floor is a complex structure of overlapping parts. For our purposes here, we don’t need to get too technical, but it’s helpful to understand that the pelvic floor has three distinct layers:

A. The outermost, “superficial” layer forms a figure-8 around the genitals and anus and includes the external anal sphincter (you might know this as your butt hole!).

B. The second layer, the urogenital diaphragm, is a strong muscular membrane that includes the urethral sphincter (aka the pee hole).

C. the deepest layer, the pelvic diaphragm, is a wide but thin layer of muscles and connective tissue, including the muscles which run from the tailbone to the pubis.

If these various layers aren’t working together to provide the most secure and comfy bracing system for your pelvic organs, then you’re likely to end up with a hammock that won’t properly hold you – be it saggy or too taut… and that can lead can lead to a whole range of unpleasant symptoms.

 

What are these symptoms you speak of?

Given that we can’t actually see our pelvic floor (as it’s inside our body), how can we know if it’s in good shape?

There are some symptoms that are more obviously associated with pelvic floor dysfunction, such as urinary incontinence, pain during penetration, or organ prolapse.

But what was surprising to learn during our training session was that there are a bunch of other symptoms that you might not think of as being connected to your pelvic floor, but that can actually be helped a lot by improving your pelvic floor health.

These symptoms might include quite common things like back, hip, or knee pain, constipation, irritable bowel syndrome (IBS), hemorrhoids, varicose veins, or difficult, unreachable or unsatisfying orgasms.

Some other symptoms that can be linked to pelvic floor dysfunction are:

• 
Not being able to fully empty your bladder
• Feeling like you need to pee, but then getting to the toilet and barely nothing comes out
• Painful urination or a frequent need to urinate
• Vulvodynia (chronic pain or irritation of the vulva)
• Vaginismus (involuntary contraction of vaginal muscles, often painful)
• Lowered libido
• Interstitial cystitis (inflammation of the bladder)
• Rectal spasm and pain
• Erectile dysfunction
• Premature ejaculation

Other conditions often have the same or similar symptoms as pelvic floor dysfunction, so it’s important to consult a medical practitioner who can properly assess your individual situation. But note that pelvic floor health and dysfunction are, unfortunately, still not often talked about in traditional medicine, so you may have to advocate for yourself to get referred to a pelvic floor specialist.

 

A differentiated approach to pelvic floor health

One of the points that Imogen repeatedly stressed was that pelvic floor health can’t be addressed by doing one thing only. In other words, Kegels are not enough.

Instead of exclusively relying on Kegel exercises to maximize pelvic floor health and function, we need to incorporate exercises and techniques that activate the full range of our pelvic floor muscles. This is what Imogen calls a “differentiated approach.”

So in addition to doing Kegel exercises, you can help a weakened pelvic floor in the following ways:

• hold a squishy ball between your knees, slowly squeezing and releasing. You can do this while sitting at your desk!

Deep squats

• Sit on a ball chair instead of a regular office chair.

Specific yoga poses that improve strength and won’t put pressure on the pelvic floor.

• Masturbate. You can even try masturbating while wearing Kegel balls!

 

Kegel dos and don’ts

As ever, you are the boss of your vagina… or rather, your vagina is Boss. And if your vagina-boss wants a Kegel ball, then a Kegel ball it shall have.

That said, ever since Imogen informed us just how bad using Kegel weights can be for folks experiencing pelvic tension, we’ve been actively bringing this awareness into our pelvic floor consultations and, when appropriate, suggesting alternatives to these products.

Basically, if your pelvic floor is tight all the time, you should avoid doing exercises that isolate any particular pelvic floor muscles or that will put excessive downward pressure on the pelvic floor. This includes doing Kegel exercises.

If you think you might have an overly tense pelvic floor, the best thing to do is to get it assessed by a pelvic floor specialist, who can suggest an appropriate course of action for your individual diagnosis.

If that’s not an option right now, try some of the following relaxation techniques:

Deep and dyaphramic breathing

Deep squats

Specific yoga and relaxation stretches  that focus on hip and pelvic floor muscle stretching (avoid exercises that put direct downward pressure on the pelvic floor, including some yoga and pilates poses

• Take regular warm baths

• Focus your attention on your pelvic area, and then visualize warmth and your muscles relaxing.

• Relax your whole body, as this will help to relax your pelvic floor, too. Easier said than done? Try using guided relaxation, or a relaxation guide such as Edie Irwin’s Healing Relaxation.

You might also consider finding a bodyworker who specialises in fascial release (relaxing tension in the pelvic fascia) and trigger points.

Of course, strength is also important for optimal pelvic floor function. So if you’re not suffering from hypertonicity (tightness), then you might want to do some Kegels, and that’s a-okay.

Here are a few of Imogen’s tips to keep in mind when you Kegel:

• Relaxing is just as important as strengthening. So balance any strength training with the same amount of relaxation exercises (for example, follow Kegel exercises with some deep squats).

• In between each Kegel exercise, relax your pelvic floor muscles for at least the same amount of time as you contracted them for.

• Maintain each Kegel contraction for no more than 10 seconds each. When starting out, holding the contraction for only 2-3 seconds is totally fine. Work up to 10 seconds over time.

• Put some power into your pelvic floor exercises. When you squeeze, squeeze fully… followed by a complete release. That goes for when you pee, too – piss with power! If you keep your pelvic floor in a state of partial contraction, you end up putting a lot of strain on it, which will only weaken the muscles. Also, never stop your pee mid-stream!!

• Don’t wear Kegel balls for long periods of time, as this will keep your muscles in a state of partial contraction, not allowing them to fully contract or relax. Wearing Kegel balls for 10 minutes to an hour max is plenty.

• Beware of over-exerting your Kegel muscles either by doing too much exercise or using weights that are too heavy.

An alternative Kegel exercise that doesn’t use Kegel weights and that strengthens a broader cross-section of the pelvic floor is the “elevator Kegel technique.” Here’s how you do it:

1) Picture your pelvic floor muscles.

2) Breathe in deeply. Imagine the muscles between your sit bones as the two elevator doors. As you breath out, draw these muscles together: as if the doors were closing to meet in the middle. Then try to lift the elevator up, before releasing completely on your next inhale.

3) This time, imagine the elevator doors as the pelvic floor muscles between your front pubic bone and tailbone. Start with a deep inhale; on your exhale, draw those muscles together to meet in the middle, lift the elevator, and then release.

4) Now draw all four elevator doors towards each other at the same time, lifting the elevator once they meet in the middle. Again, practice this contraction on your exhale and then relax and release on the inhale.

5) Repeat each 5 times.

Below are links to some more regular Kegel workouts for both vagina-havers and penis-havers:

https://www.pelvicexercises.com.au/kegel-exercises-video-workout/

https://www.pelvicexercises.com.au/how-to-kegel-for-men/

https://www.pelvicexercises.com.au/successful-pelvic-floor-exercises/

 

You’re all set

We know from talking with our customers that lots of people have pelvic floor health on their radar, but aren’t sure where to start or don’t have a lot of information. One of the things that we took from our staff training with Imogen is that there are so many things each of us can do to support our pelvic floors, starting now and without even having to buy anything.