That’s right. Your pelvic floor muscles are 30% fast twitch fibers and 70% slow twitch fibers. That means doing traditional kegels is really only getting 30% of function (think: sort of like using sprints to train for a marathon…which seems silly doesn’t it?!). And let’s be real. Many days or weeks in a postpartum mother’s life can feel like a marathon. BUT – you postpartum moms are smart these days. You have bantered back and forth about how your pelvic pain and urinary leakage is limiting your abilities to play with your kiddo(s) and/or participate in exercise…creating growing awareness around the fact that the we need to think beyond kegels for a healthy, fully functioning pelvic floor. Furthermore, many of you out there experiencing pelvic pain and urinary leakage have been told that you need to relax and lengthen your pelvic floor muscles vs strengthen. Sooooo…what’s the deal here?! Don’t we need to learn to engage our muscles too vs just letting them hang out?! If kegels aren’t the answer to your pelvic pain and urinary leakage, then what is the answer? (I’m so glad you asked!)
The key phrase I like to use with the pelvic floor (or really any group of muscles for that matter) is motor control. Because most of the pelvic floor muscle fibers assist in posture, breath, and other things that we use all day/every day, we’re less worried about strength and more concerned about range & quality of motion, timing, sequencing, and general awareness of the area. (**say what?! that seems like a lot!**) Let’s go a little deeper…
Range & quality of motion. The pelvic floor muscles need 3 basic things: the ability to 1) engage when needed, 2) relax into a healthy resting position, and 3) bear down in order to pass gas/have a bowel movement (or a baby!). These three actions (engage, relax, bear down) encompass the ‘range of the motion’ for the pelvic floor. Let’s use the neck to describe the concept of range of motion. If you look all the way over your right shoulder and then swivel your head all the way to look over your left shoulder, that’s range of motion for your neck. So range of motion is the full excursion that a group of muscles or a joint can travel. Hence, again, the pelvic floor’s range of motion: engage (ie, squeeze/lift), relax in the middle zone, and bear down (into the basement). The quality of the range of motion matters. Maybe the muscles can barely squeeze/lift to hold back urine during a sneeze, but they are really good at bearing down for a bowel movement. Maybe the muscles are champion squeezers/lifters but they finish in last place when it comes to bearing down. So women, depending on their anatomy, pregnancy/childbirth history, stress levels, and many other variables, have different abilities to access different positions of their pelvic floor muscles. There’s help for that… Keep reading.
Timing and sequencing. This sound complicated, but don’t worry. It’s not! Timing and sequencing = you controlling your pelvic floor muscles when you want to and how you want to. Can you squeeze/lift when asked? Can you let go when you want? Can you bear down when you need to? Or is there a delay in the letting go phase after you squeeze/lift your muscles? Or maybe it takes you an additional second or two to figure out how to bear down? If you aren’t sure what your pelvic muscles are doing or if your pelvic muscles are experiencing delays in their turning on/off, there’s help for that, too… Keeeeep reading!
General pelvic floor muscle awareness. Honestly, simply knowing goes a long way. Knowing that your pelvic floor muscles exist and knowing how to tap into the muscles can be oh so beneficial over the long term, especially as you transition through phases of life (*eh em* menopause).
SO – that part about needing to ‘keeeep reading because there’s help for that’… If you’re not sure on how to relax or how to engage your pelvic floor muscles, it’s best to work with a pelvic floor PT. Pelvic floor therapists have unique skill sets and training in being able to assess and treat the pelvic floor muscles and surrounding tissues. In order to restore function and range of motion, your pelvic floor PT will use different forms of biofeedback to get you reconnected with your muscles. Read a little more about the use of biofeedback during pelvic floor rehab here! And stay tuned for part 2, where we’ll cover more specifics about using your pelvic floor muscles in different functional positions (ie, when you’re tending to your kiddo(s) on the floor or standing at the kitchen sink), and what it means to consider those 70% marathon muscle fibers using different types of muscle engagements/contractions.
When we see posters and memes about life being a journey, well, that applies to the pelvic floor muscles too. No matter what it takes, we can work as a team to get you postpartum moms leak free and pain free (because you’re worth it!).