A 17-year-old girl I know suddenly gave up trampolining. A 41-year-old woman says she has stopped running because of her knees. They may both be avoiding saying the real thing out loud: they leak.
The usual advice is, “Do your Kegels.” Then social media tells women that Kegels are terrible. No wonder so many of us are confused.
A Kegel is simply a pelvic-floor contraction: a close and lift, followed by a proper release. The exercises were developed largely for women after childbirth, based on the idea that the pelvic floor was underactive or less able to respond when needed. The problem is applying that assumption to everybody.
Think of a frightened puppy. It cowers, pulls its tail underneath itself and braces. Humans respond to fear and threat too. We tense, guard and hold. Over time, we can learn to hold tension through the pelvic floor without even realising it. Fear is only one possible cause. Pain, stress, abdominal problems, posture, exercise habits and constantly holding your tummy in may all contribute. A pelvic floor like this can be tense and weak. It may struggle to relax, move through its full range or respond at the right moment. And here is the confusing bit: a tense pelvic floor can contribute to leaking and urgency that look very similar to the symptoms of an underactive pelvic floor.
The symptoms can look the same. The reasons behind them may be completely different.
Where the chair fits
The High-EMF chair can be a useful strengthening tool for the right person. It helps create repeated pelvic-floor contractions without you having to consciously produce every one yourself.
But for us, the chair is not the whole programme.
We also need to consider what happens off the chair:
- Can you fully release the pelvic floor?
- Can you coordinate it with your breathing?
- Can it respond when you cough, lift, run or suddenly need the toilet?
- Are your hips, abdomen and breathing patterns helping or adding more tension?
- Are everyday habits undoing the work you do during your sessions?
Some women need more activation and strengthening. Others need release, movement and coordination first. Many need a mixture of both.
That is why our programme TLC stands for Tone, Length and Control. The chair helps us work on strength and response. The off-chair work helps those changes become useful in real life. Because the goal is not simply to produce a stronger squeeze. The goal is to help your pelvic floor respond appropriately when you need it — and let go when you do not.
The exercise is not the problem.
Assuming every pelvic floor needs the same thing is the problem.
Experiencing urgency, frequency, leakage or repeated night-time toilet trips? Come along to Talkative Bladders at Lyona, our free and friendly talk about what may be going on and what a sensible next step could look like.
Rachael Fisher
Pelvic Floor Coach, owner Lyona