Imagery for Improved Recruitment of the Pelvic Floor

Kegels, also known as a “pelvic floor contraction” are typically used as a means to strengthen the pelvic floor muscles. When performing a kegel it is important to remember how subtle and isolated the movement should feel. Although it may be tempting to use larger, stronger muscles to compensate for the strength of your pelvic floor, it is very important to learn how to properly isolate the muscles prior to any strengthening protocol. When performed correctly, you should not feel engagement from your glutes (butt muscles), inner thighs, or excessive straining from your abdominal muscles.

If you have just started performing kegels, a great position to start in is on your back with both legs bent. Once in this position, consider using visualization to help locate your pelvic floor muscles. It may help to imagine one of the following:

  • Stopping the flow of urine
  • Trying to avoid passing gas in a quiet library
  • Someone holding a needle outside the anus, and you trying to draw the anus in, away from the needle
  • Sitting on a spread of plump blueberries and trying to draw one inside the vagina- without crushing it!
  • You pelvic floor being an elevator resting at the level of your sit bones, now try to raise your elevator up a level above the ground floor
  • One end of a straw placed in the vagina with the other end placed in a thick milkshake, try to slurp milkshake up through the straw and into the vagina
  • Your partner’s finger inside the vagina, and trying to draw them deeper inside you
  • Engaging the muscle that would preventing a tampon from slipping out
  • Lifting the muscles you sit on (between either sit bone) up towards your head
  • Trying to pull the tailbone closer to the pubic bone
  • A flower which has bloomed for the spring, closing its petals for winter and retracting inside you
  • A jellyfish swimming upwards toward the surface of the ocean: creating a dome-like shape with its head, and a narrowing of its legs- this lift symbolizes the “lift” of the pelvic floor
  • Closing an upside-down umbrella
  • Nodding your clitoris down towards the vagina
  • Pulling a tissue out of a tissue box with your vagina
  • Pulling your anus up towards your heart

Once you feel like you have located your pelvic floor muscles, see if you can coordinate it with a breath. Take a nice deep inhale, then see if you can simultaneously perform your contraction with your exhale. Coordinating a kegel with your breath allows you to produce a stronger contraction by utilizing the natural biomechanics of the pelvic floor that occurs with breathing.

Once you have perfected kegels while lying down, a progression would be to perform them in a seated position, and then a standing position. Regardless of what position you perform your kegels in, it is important to not only focus on the contraction, but also the relaxation component. Without properly relaxing the muscles in between repetitions, the muscle isn’t allowed to be strengthened throughout its full range of motion. Consider starting with a ratio of 1:1, for example holding a contraction for 10 seconds, followed by a period of complete relaxation for 10 seconds.

Kegels are not indicated for everyone, especially if you are having pelvic pain. Please consult with a skilled pelvic floor physical therapist prior to incorporating kegels into your strengthening routine to make sure they are useful in achieving your goals.

References for Photos:

  1. TV, (2019). lotus bloom. Retrieved 26 September 2019, from https://framemytv.com/products/lotus-bloom
  2. LAMINATED POSTER Flower Blossom Lotus Blossom Plant Bloom Lotus Poster Print 24 x 36 - Walmart.com. (2019). Retrieved 26 September 2019, from https://www.walmart.com/ip/LAMINATED-POSTER-Flower-Blossom-Lotus-Blossom-Plant-Bloom-Lotus-Poster-Print-24-x-36/855455790
  3. (2019). Retrieved 26 September 2019, from https://en.wikipedia.org/wiki/Jellyfish

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