September 2025 . Have you ever hit a button and lost information when you did not mean to? Hmmm, I DID NOT hit a button. Apologies to anyone looking for prior info. It will gradually be added!! In the meantime, if you have questions, ASK!! Always happy to answer and help you get to the bottom of your concerns!
Do Kegels? Don’t do kegels?? What’s a person to do???
Social media. Magazine and online information. Maybe even a sheet of exercises from your doctor with the statement “Do these. You’ll be fine.”
Do Kegels. Don’t do Kegels. What AM I to Do???
Firstly, let’s acknowledge that we are not “one sized fits all.” Holds true to clothing and certainly holds true for pelvic health whether pain, continence, over-activity, back pain….you see where I am going with this? There is generally no one answer!
On top of that, your body changes so what might have worked well previously may not be effective now.
So, what IS a Kegel (and to be clear, when I work with people, I rarely use the term “kegel” as it does not define and describe what the entire pelvic floor does). Kegels were first described by Dr Arnold Kegel in the 1950s as a means to strengthen the pelvic floor. He described a “squeeze” of the muscles and women have been doing this ever since. Sometimes effectively, often times less so.
Part of the issue that we may see with purely doing Kegels (ie, squeezing) is that this may not involve and coordinate with the entire pelvic floor and core. The pelvic floor is several layers of muscles and ligaments that work in coordination with the diaphragm, abdominal and deep spine muscles. The pelvic floor does work with the urethral and anal sphincters to “close and stop” when squeezing, but also work to lift, support and respond to downward pressures as with sneeze and cough and to support in walking, jumping, lifting and life. The pelvic floor muscles are POSTURAL muscles…they help to keep you up, and work at different levels of activity depending on what you are doing.
Just like with your shoulder and arm muscles, quads and hamstrings and other muscle systems, ideally the pelvic floor and core muscles work together without us thinking of them (watch little kids run and jump and hoot and holler and not be out of breath or leak. Their muscles are working together efficiently and beautifully!!). And just like with other muscle systems and groups, if changes occur due to pain, surgery, childbirth and hormonal changes, we often need to assess the muscles, how they are working and retrain. Sometimes that means strengthening, sometimes teaching to do less and teaching them to move in different ways.
The pelvis is the keystone of your body and the pelvic floor muscles are integral to support, movement, intimacy and continence. If you would like to learn more about creating positive changes for your pelvic floor and support system and not being addressed in a “one size fits all” fashion, contact Rebecca Meehan PT at Embody Physiotherapy to learn more.
About me:
I am a PT who loves watching the body move and figuring out how to help you do so efficiently and with more confidence. I was fortunate in my college studies to have a strong anatomy, kinesiology and orthopedic program and to study advanced orthopedic PT in Pitt’s Master Program as well as working in ortho/sports and rheumatology in my earlier career. Using my studies of Bones for Life, Franklin Method and Medical Therapeutic Yoga, I have had the opportunity to explore ways of bringing function and life activities into PT to help my patients and clients resume, maintain and grow. Pelvic health, spine and trunk health, bone and joint health…all are areas that we can bring together to make your system work the way you would like!
REBECCA MEEHAN PT rebecca@embody-pt.com
Putting the system together again
Pelvis, Back and Abs….Why are we not putting them back together??
Today, not for the first time (and likely not for the last) a new client told me about beginning at “Pelvic Floor PT” but then having back pain so they sent her to a “Spine PT” in the same organization. She stopped her pelvic PT, and the 2 therapists did not communicate about findings and potential best practices to help her meet her goals. Fast forward to today. Still with back pain (better but still not able to return to her recreational activities and has daily pain) and has increased urinary leakage. Again. She has confusion about the spine exercises and wonders if the “bracing” that they were instructing is contributing to her pelvic floor problem and increased incontinence. She also wonders how she can return to pickleball and other activities if she is “bracing” as she can’t move her trunk.
Thoughts? Anyone?
I have a few thoughts (and some facts).
Back pain and pelvic floor problems. Up to 95% of women with back pain may have pelvic floor problems. The pelvic floor problems may be related to weakness, prolapse, increased holding and tension (the muscles are trying really really hard to do their job!), pelvic pain and other incoordination and postural patterns.
The relationship between the pelvic floor, abdominals, diaphragm, DEEP spine muscles, hips and shoulder girdle is often overlooked (and ankles and feet!). Or looked at separately instead of as a team. As systems that are a part of the whole. The pelvic floor muscles and diaphragm form the bottom and the top of the abdominal cannister, with the abdominal muscles forming the front of the cannister. They work together to support and to allow movement and upright posture, as well as continence. The cannister also works with the deep spine muscles (multifidi) to support and decompress the spine. Add in the shoulder girdle resting on top and the hips working with the spine and the pelvis and you have a wonderfully complex team and system that allows you to lift, run, jump.
With confidence. Without leakage. With less pressure or pain.
Simple? Sometimes. Sometimes less so. In my perfect world, we would be putting the team back together and getting the system parts to talk sooner rather than later. No one wants to play catch up. But the body is resilient and CAN learn new ways to move and be strong at ANY AGE!
If the notion of moving differently, gaining strength and balance, and being able to do activities while working with one PT versus a bunch speaks to you, ask me about Physical Therapy at Embody.
About me:
I am a PT who loves watching the body move and figuring out how to help you do so efficiently and with more confidence. I was fortunate in my college studies to have a strong anatomy, kinesiology and orthopedic program and to study advanced orthopedic PT in Pitt’s Master Program as well as working in ortho/sports and rheumatology in my earlier career. Using my studies of Bones for Life, Franklin Method and Medical Therapeutic Yoga, I have had the opportunity to explore ways of bringing function and life activities into PT to help my patients and clients resume, maintain and grow. Pelvic health, spine and trunk health, bone and joint health…all are areas that we can bring together to make your system work the way you would like!
REBECCA MEEHAN PT rebecca@embody-pt.com