At Gold Medal Physiotherapy, we help patients to maintain and regain control of their pelvic floor muscles. Physical therapy for expectant and new mothers must include the proper cueing of a “Kegel,” or the activation and relaxation of the pelvic floor. The pelvic floor muscles work extremely hard to support the pelvic organs, especially during pregnancy when their weight significantly increases. Working with clients to ensure proper pelvic floor activation is essential to avoid needless compensations.
When a client’s pelvic floor is weak or uncontrolled, they may feel worse abdominal separation, lower back pain, or SIJ/pelvic pain. A great way to begin strengthening your pelvic floor is to learn how to engage it properly. The following list includes the top 5 cues for pelvic floor activation. Instructing a client in proper relaxation techniques after they have mastered pelvic floor activation is critical.
Cues for Pelvic Floor Activation:
The cues for Pelvic floor activation are verbal or visual instructions used by the physiotherapists to help those who have weaker pelvic floor due to conditions such as urinary incontinence, pain in pelvic regions, genitals, perineum, or rectum, sexual dysfunction, pelvic organ prolapse and chronic low back pain unexplained by other sources. It helps to engage and strengthen their pelvic floor muscles correctly. Here are some commonly used cues:
1- Imagine stopping the flow of urine midstream”: This cue helps you to visualize the sensation of stopping the flow of urine while urinating. It helps you identify and activate the muscles of pelvic floor in a correct manner.
2- Squeeze and lift your pelvic floor muscles”: This cue prompts you to contract and lift the pelvic floor muscles, as if you are trying to lift them upward inside your pelvis. Imagine the feeling of tightening and lifting the muscles.
3- Imagine pulling a blueberry or marble up into your vagina/anus”: This cue is specifically for women and men respectively. It encourages you to imagine gently pulling an object upward using the muscles around your vagina or anus. This helps to activate the pelvic floor muscles effectively.
4- Draw your belly button towards your spine”: This cue focuses on engaging the deep core muscles, including the pelvic floor. Imagine pulling your belly button inwards towards your spine without holding your breath or tensing other muscles excessively.
5- Imagine an elevator going up”: Visualize an elevator moving upwards, floor by floor, and imagine your pelvic floor muscles lifting in the same way. This cue helps coordinate the muscle activation from the bottom to the top.
6- Cough and feel the muscles you use to stop the cough”: Perform a gentle cough and notice the muscles that tighten to prevent the cough from escaping. These are the pelvic floor muscles you want to activate.
Remember, cues can vary depending on individual needs, and it is important to work with a qualified physiotherapist who can provide personalized guidance and instructions tailored to your specific situation.