Episode #28: Should I contract my pelvic floor to 100% with exercise?
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In this episode, Rhonda and Dayna discuss a commonly asked question “do I need to contract my pelvic floor to 100% with exercise?”
The short answer is NO.
Creating too much tension in our body may actually contribute to worsening symptoms like heaviness, leaking, pelvis pain or back pain.
Some tips to keep in mind:
1️⃣ Focus on tension to task (@physiodetective).
Only contract your pelvic floor muscles (or any muscle) enough for the task at hand.
2️⃣ Stop thinking about what your body is doing and just do the exercise.
It’s important to get to a point where consciously thinking about what the pelvic floor is doing is no longer necessary.
3️⃣ The relaxation component is just as important as the contraction component.
We hope you find this discussion helpful!
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Episode #28: Should I contract my pelvic floor to 100% with exercise?
We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.
We also provide helpful education and information on fitness, the pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.
Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!
Hey everyone and welcome back to Pelvic Health and Fitness Podcast. Today, Dayna and I are going to discuss a topic that comes up often with my clients in the fitness space. And the question that I get is, should I contract my pelvic floor to 100 percent with exercise?
So Dayna and I, we've discussed on this podcast, um, a bunch now about Kegels and how Kegels is not the only answer. So I think sometimes there is a bit of confusion. So I know even for myself with my clients, um, when we're first starting to work together in those early postpartum phases, we do spend a little bit of time going over that core connection, breath, and learning to connect our breathing to our pelvic floor.
So learning that Kegel motion, truthfully, I personally don't. Spend long there. I sort of like quickly get people moving. Um, so we'll kind of get into that today. So basically I'll start out by saying the answer to that question. The short answer to that question is no, that you don't need to contract your pelvic floor to a hundred percent with exercise.
And we've also podcast. That creating too much tension in our body and in our pelvic floor might actually lead to worsening symptoms of things like heaviness, leaking, pain, back pain, that kind of thing. If we're always holding that Kegel and we're obsessively contracting with each and every movement, that might actually sort of backfire and kind of work against us.
Yes, absolutely. I think, and we're talking more specifically about the pelvic floor, but I think if you sort of bring it back, I always use my bicep as an example. Like, if you're just lifting a glass of water to your mouth to take a drink, you don't have to Fire that bicep as hard as you can to lift that glass, your bicep and your arm and your nervous system sort of coordinate that movement.
We don't have to think about it. We've practiced it over and over again. So we have the right amount of contraction of that bicep to lift the glass to our mouth. And that ultimately is the goal for our pelvic floor. We want to start, especially if it's new to you, like most of us know how to bend our elbow, right?
We don't have to think about it too much. Um, depending on your situation, maybe a little bit more. But with our pelvic floor, especially if it's not something you've ever practiced, yeah, we're a little bit more mindful of how, what does the Kegel feel like? What does letting it go feel like? What does it feel like for this specific core exercise?
How do we maybe use it as a tool for squats or deadlifts if we feel like we need it or we have symptoms, but then Moving on from there quickly, relatively quickly. And how can you just get back to your exercise life or active life, whatever that looks like for you and not really have to think about it.
Yes, for sure. And I will say my own personal story. I think I've touched on it on the podcast, but I dealt with prolapse symptoms early on still do here and there, but definitely not as often as I did early on. And I found. Me focusing and getting hypervigilant about what my pelvic floor was doing actually made my symptoms worse.
So when I personally focused, took my focus away from, you know, contracting the pelvic floor, focused on relaxation throughout the day. And then when I finally got down to do my workout, I would just stop thinking about my pelvic floor. And that was what led to less symptoms versus thinking about that Kegel with each and every movement.
Yeah, no, for sure. I kind of, again, this sort of idea of the finger in the eye, like if you're constantly, if you have, if you're poking your finger in your eye, and you're thinking about that over time, it's like you have to remove, you have to remove that thought, stop thinking about maybe the finger in the eye is not the right example.
But if you were like holding, you know, poking yourself in the top of the leg, and you're thinking about it, you're thinking about you think about, whereas if you go about your day, eventually, you're going to Forget about that pressure on your leg. For sure. Yep. Yep. So one, um, term I like to use or saying, saying, I guess, is focus on tension to task.
And this is a saying I learned from Anthony Lowe, who we had on a previous podcast. Basically what that means is you only need to generate enough tension in your body to do the task at hand. So if, for example, so, you know, I'm a big fan of using glute bridges as sort of like an early stage exercise for my clients, I always say to them, like a glute bridge doesn't necessarily require a ton of effort in your body.
And so if we sort of like dial up the tension to 10 out of 10, um, we might actually kind of be working against ourselves and again, leading to maybe some symptoms or just feels awkward. If you, you know, lay on your back and you squeeze your body as tight as you can, and you try to do it, uh, Glute bridge, it just feels awkward.
It doesn't feel natural. So same can be said with your pelvic floor. Why would we, again, Anthony Lowe said in that episode, the pelvic floor is not special, it's not any different than any other muscle in our body. So why should we, you know, Only think about contracting to a hundred percent every single time.
And I use a glute bridge example too, because this can also carry over into what your glutes are doing. So this is something I sort of like have to have people unlearn. And this was something I had to unlearn when you're doing a glute bridge. So laying on your back and lifting your bum up in the air, a lot of people also squeeze their bum to a hundred percent.
So they like really squeeze and they kind of like arch their back a little bit. And then they come down. So I've also had to teach clients. Yeah. Pelvic floor and glutes, like maybe a two out of 10 effort is enough to do that movement. And so then as we're progressing back into strength training. So with my clients, I typically don't, you know, go into super heavy weightlifting because typically clients are just doing workouts at home with dumbbells.
But if you're getting back to like a CrossFit gym or weightlifting, and you're starting to get into like heavy deadlifts, that kind of thing. Maybe there's a time and a place. to learn how to generate more attention in your body in general, and perhaps your pelvic floor. So maybe then, you know, like an eight out of 10 contraction is warranted, but maybe not too, right?
So I think it's just body dependent and situation dependent. Um, just finding that amount of tension that your body generates, that's going to help with like keeping symptoms down and also Just help you do that movement. Well, right. So I think if you find that sort of like correct tension to task, the movement just feels better too.
It feels better too. And, and, um, I like how you mentioned symptoms because you know, if you're thinking, well, how do I know if I have the right tension? How does it feel? Do you have, so if you're someone who's experiencing leaking or maybe you get heaviness or maybe, you know, you're, I don't know, those are the main ones sort of for the pelvic floor.
If there's any sort of pain with the movement, then contract your pelvic floor. Start with 10 or 20 percent. See if it helps you. See if it changes anything. If it doesn't, you can then go up or down from there. And so you'll sort of I think it's also important to realize too that these things can change based on what the load on your body is day to day or month to month or what your cycle is doing.
We're dynamic creatures. So sometimes certain exercises just feel a little bit different. And so if you have this as sort of a tool in your toolbox that you can change. How much tension you need in your glutes or your pelvic floor when you're doing a deadlift or something and it's middle of your cycle, maybe you get a little bit heavier or feelings of fullness in the pelvic floor around mid cycle.
Maybe those are the days where we're thinking a little bit more about your pelvic floor. We need a little bit more attention for support and the rest of your cycle, you just play on. You don't just breathe and do your thing. Yeah, that's so important. And I think, um, I would like to hear sort of your take on this too, Dayna.
So again, so early on in the postpartum recovery phase, I will sort of go over that key goal. And then, you know, especially if I'm working with a client that's also working with a pelvic floor physiotherapist, like yourself, an internal therapist, and they've, you know, expressed to that person that they do have some weakness in that pelvic floor, and they do need to work on a little bit of that coordination.
So often with those clients, I'll get them, I'll tell, I'll tell them in their warm up, um, let's work on that, like Kegel connection. So again, if you're doing like a glute bridge, let's kind of focus on a little bit of a contraction, just kind of being mindful of what your pelvic floor is doing. Maybe some squats, just be mindful.
But then when you get into your workout, let's. Again, kind of drop what the pelvic floor is doing. Let's do it. And then cool down. I usually get them to focus on like that relaxation piece. And so again, because I'm not an internal therapist, it is sort of like a trial and error. Um, again, if I, if they're working alongside an internal therapist, then that's even better, a better pairing, um, to get that feedback.
But yeah, what is your take on that in terms of like, Okay. you know, do people continue doing Kegels for a long time? Um, I guess again, it depends on the person. Yeah, I think it depends on the person. I love that use of it as sort of a cool up and a warm down, just
a warm up at a cool down real life. People get verbal diarrhea a lot. Anywho, um, because again, these muscles are not unlike other muscles in our body. So it's not a bad idea as part of sort of your workout routine to wake up that whole neural pathway, that motor. program that the pelvic floor does. So I love that for sure.
Um, and again, sort of speaking to what we were saying with tension to task, I think it depends what's going on in your body. Do we have to think about it in general with my clients, especially if it's someone who is like maybe newly postpartum or is coming in who is symptomatic? Yes. We spend a lot of time initially on that Pairing, breath, contraction, belly.
What does that feel like on its own? What does it feel like during core exercise? But I often right away will tell people and I encourage people not to really think about their pelvic floor with anything else sort of core exercises at that time. So, your squats, your deadlifts, your bicep curls. Um, my cueing to them is just breathe, like make sure you're breathing.
Um, and then I often give the instruction to go play with their movements that way, and then we'll troubleshoot. So then I don't want to get in their heads about like, with a squat, you should be doing a Kegel here. Cause when, you know, there's a level of We want these things to be automatic, including the pelvic floor.
So we'll troubleshoot the movements that they are having symptoms with, and then play from there. Anything cardio wise, I tell people just don't, don't suck your tummy. And in general, just let that belly be nice and soft. So we've got that nice dynamic system. Yeah, that makes sense. Yeah. And I think, you know, like you said, just reminding people to breathe and, you know, I think that's something Anthony sort of talks about too is that there's no right or wrong way to breathe necessarily, there might be an easier way to teach people to breathe initially.
So I sort of talk about that with my clients, but yeah, at the end of the day, and again, not that holding your breath is also going to be, you know, dangerous or cause symptoms, but just being mindful again of your body and your symptoms. Right. So I know for me, I, my habit was to hold my breath often with exercise.
And so that did lead to symptoms for me. So now I'm just very mindful of my breathing. And I, again, I don't get obsessed about how I'm breathing or when I'm breathing. I just try to remember to breathe. And for my body, that usually feels good. And, but again, like if you're someone that's a weightlifter and you're getting into like super heavy squats, super heavy deadlifts, there is a time and a place for like a breath hold technique.
And again, it's, you know, we're not trying to say if you hold your breath, you're going to do damage. But it's your body also has to train for that. Right. And you build a tolerance to do that. And your pelvic floor learns to adapt to that technique, right? It's not, yeah, I think the issue is when, even for me as a, for, you know, a former CrossFitter, I will say I'm not a huge into CrossFit anymore.
That breath hold technique that I learned for heavy lifts, I started to have that carry over into just like a body weight squat. Because it was so ingrained in me, it was that muscle memory that I would hold my breath with every little thing. And for me, it's the repetition of that breath hold that was causing symptoms, not the breath hold itself.
So I want to kind of make that distinction. Yeah. And I think what, and you're saying this as well, just with personal experience, breathing is also attention to task thing. Yeah. At least that's how I view it. So for those higher level things, those one rep maxes, you know, if you are into Olympic lifting, um, we maybe need that bell server, that breath hold to Mac.
give us that max amount of pressure in the system to lift that heavy weight wherever it's going. But we do not need a breath hold for glute bridge in general. Right, right. Exactly. Yeah. I think I kind of think about that breath hold versus breathing as more of that tension to task idea. And again, Play around with it.
If you have been like, I do cue most of my clients with most of their exercise to breathe. I say in general, maybe try and exhale as you lift or on the hardest part of the exercise. However, if you forget about it completely and you don't have any symptoms, it's not really something that we have to think about, or don't get in your head about, oh, shoot, I inhaled with Dayna said to exhale, if you have no symptoms, you're just going to play on.
Yeah. Um, Um, the other thing too, to come back to what we were saying is, should we always be queuing Kegels? Should we always keep doing Kegels? I kind of, again, leave that up to people. I say it's not a bad idea in my personal opinion to take that whole system, that whole coordination muscle, um, activation pattern through a warmup and a cool down, like you said, um, But I also tell people to listen, life is going to happen.
Uh, you will probably leave my room and forget about this at some point, but it is a tool in your toolbox. So should your symptoms reappear? These are one of the things, or, you know, that's one of the things I'm going to have you return to, to see if you can help self settle your own symptoms, go back to the basics and see if that helps.
I love that. Yeah. That's a huge focus of my work with my clients is, you know, I don't want you to rely on me as your coach forever. Right. I want to teach you strategies and techniques that when symptoms arise, you know, I remember Rhonda taught me a B and C I'm going to go back to those tools and see what I can do to manage and sort of regulate those symptoms.
Yeah. So I just wanted to go back. You kind of touched on it in the beginning. Um, but just the fact that yes, again, we want to work on that Kegel contraction. But remembering that the relaxation or the lengthening of those muscles is equally as important. So I think of this, it often comes back to me for like a skipping example, right?
So I think, you know, in our episode with Teresa, we, she sort of went over like skipping and just some strategies you can do to minimize maybe leaking with skipping, for example. But if you think of again, that sort of like flexed arm example. So if I'm, you know, holding my elbow flex all day long, I'm, you know, squeezing that muscle.
You can't see what I'm doing, but you can picture that I'm, you know, flexing that muscle all day long. And then someone tells me to pick something up. So a, that muscle is going to be pretty tired because it's been flexed all day long and B it can't flex any further than it's already flexed because it's already in its shortened position.
So it's going to be really hard to do that task. Right? So again, our pelvic floor muscles are not special. So if we are somebody that, you know, we're doing a workout and there's 300 skips. And, you know, right from rep one, we're clenching and we're squeezing our pelvic floor as tight as we can because we don't want to pee, right?
It seems sort of like intuitive that you would squeeze to hold in that pee, but we're skipping, we're skipping, we're skipping. And then again, those muscles are going to fatigue and reach their threshold pretty quickly because You know, held in contraction. That's tiring. And when you know, um, the bladder starts to get full or there's that sensation of having a pee, there are, the muscles are already flexed as much as they possibly can.
So how are, how are they also going to prevent you from leaking? Right. So yeah, skipping is a good example because it seems intuitive to squeeze and grip and do a Kegel with every rep, but hopefully that can help you understand when you are skipping as hard as it is, you are. Kind of want to just focus on relaxing again, that tension to task.
So you might think like jumping might require a bit more tension, but it's not 100 percent tension to do a jump. You want it to be sort of like soft, absorbing landing with every rep. Yes. It's often a hard sell for me when I have someone who's leaking while skipping and I say, you need to let go of your tummy.
It can be really scary to people. And so if this is some, if that's something that you're sort of hearing and thinking, these girls are crazy, do it in your safe space at home first, build a little bit of confidence with letting go of that belly. Um, but yes, absolutely. And unfortunately for us, one of the easiest loads for our pelvic floor to put down is urine.
Yeah. Yeah. So to take some of the load off of that is any sort of load in the bladder. Right, right. Yep. Um, relaxation is huge. You and I preach this, I feel like we should have merch that talks about relaxing your pelvic floor. Um, nobody leaves my treatment room without Talking about the balance, at least between working and strengthening your pelvic floor and the need, particularly as moms, so whether you're pregnant or postpartum, or maybe you're 10 years down the line, the job is a physical one, you're on your feet a lot, you're lifting littles, maybe you're growing a little inside, that's a lot of extra load on top of what your pelvic floor is already doing for your own personal body in a day.
Holding up your pelvic organs, staying contracted in order to keep in that urine and stool, relaxing to go pee or poop, has a sexual function. It's got a circulation. These muscles are rock stars. Yeah. And then we add this beautiful exercise on it, which has many other wonderful benefits for our skeleton and our mental health and our cardiovascular systems, but it's load.
At the end of the day, it's load. Yeah. And so when we start to get any sort of symptoms, we are in sort of that overdraft of the pelvic floor's bank account. So relaxation is the best way to sort of head that off of the past, make sure that we're putting deposits in that bank account, um, and not overdoing it.
I love it. So good. All right. I'll do a bit of a summary. Anything else to add Dayna, before I kind of wrap up and summarize what we talked about. No, I think that's everything. Yeah. So basically the question that came in, which is a common one is, do I need to contract my pelvic floor to a hundred percent with exercise?
So in summary, the answer is no. Um, a hundred percent contraction is not necessary, not necessary. 99 percent of the time, I would say again, maybe in. Super heavy lifts at some point you might need to do one, but most day to day things, most exercise, um, regimens, you don't need to, the other thing is turn off your brain and just do the exercise.
So you want to get to that point of automaticity where your body just knows what to do. Our bodies are smart, they know what to do. And then also last but not least, our favorite thing to talk about is don't forget to also spend time learning to relax your pelvic floor to find that balance. Happy z-lying.
Thanks for listening to today's podcast. We hope you enjoyed the conversation. If you liked what you heard, we would love if you could share this with a friend, leave us a review or subscribe to anywhere that you listen to your podcasts. Thanks for being here.
