This episode of Sexplanations is sponsored by adamandeve.com

(Intro)

I'm Lindsey Doe.  This is Kim Mize.  We are at Alpine Physical Therapy in Missoula, Montana to see whether or not I'm doing my Kegel exercises correctly.  

Kim: We have abdominal muscles in the front, we have back muscles in the back.  We have our diaphragm on top and on the bottom is the pelvic floor muscle where we, what we like to call the Kegel muscle.  So it attaches from the pubic bone in the front to the tailbone in the back, so it's often referred to as a hammock of a muscle that supports the base of the pelvis.  So it goes from the pubic bone, it loops around the rectum and back up to the pubic bone and some of the other muscles next to it go from this pubic bone here to the tailbone and back up, so it actually loops like this so the big strong part of it really pulls this way.

Lindsay: These are the muscles, the pelvic floor muscles, that you're testing in my body.

Kim: Yes, we're seeing if you can contract them properly with an ultrasound machine.

Lindsay: Let's do it so I can go to the bathroom.

Kim: So, I have a machine that allows me a non-invasive way to see if the pelvic floor is functioning properly and if a person has a decent enough full bladder, I can usually see it on the ultrasound.  Now, I am not an ultrasound tech by any means, and so we can see that bladder on the screen.  The black is the bladder.  The pelvic floor muscles are down here.  They're a little bit white.  So if she does a Kegel properly, the bottom of the bladder should lift up.  

Lindsay: So.

Kim: So let's lift the pelvic floor, lift, and relax.  Good, see that motion?  That excursion means she's activating her pelvic floor properly.  So when a person does kegels, we don't want the butt cheeks to squeeze, we don't want the inner thigh to squeeze.  We just want that area between the pubic bone and the tailbone to lift, pulling up and in like you're trying to keep in urine or the passage of gas, but I wanna know how long you can hold it, so try to hold it for ten seconds.  Ready?  

Lindsay: Yep.

Kim: Lift.  1, 2, 3, 4, 5, 6, 7, 8, 9, 10.  And relax.  Sometimes I count fast.  Good.  Okay, so there's a good relaxation.  You're having a hard time staying relaxed.  That's possible that your bladder's just really full.  Some people do have issues relaxing, so some people hold tension in their pelvic floor, much like some of us might hold tension in our neck.  Most people can relate to like, knots in our neck or even muscle headaches, tension headaches.  The pelvic floor can, in the same way, carry tension and so people like that, pelvic floor strengthening or kegels can actually make their condition worse.  So it's really important to promote the relaxation of the pelvic floor just as much as the contraction and a pelvic floor that doesn't relax doesn't contract very well and then you're not getting effective strengthening.  This is just showing if you're doing your kegels properly.  The internal exam will actually show the strength of your pelvic floor.  So what I usually do is watch you do a Kegel first and then I'll just have you do a Kegel or squeeze around my finger and then relax it and then I'll have you hold it to see how long you can hold it.  Try to do a ten second Kegel and see how many times you can do that.

Lindsay: Okay.

Kim: But first, do I have your consent to do an internal palpation of your pelvic floor?

Lindsay: Yes.  

Kim: Yes, good.  Okay, so pull up and in, like you're trying to stop the flow of urine or the passage of gas.  And relax.  Good, good.  So now I'm gonna just come down and spread the labia apart and assess your pelvic floor.

Lindsay: Okay.  Okay.

Kim: Now squeeze around my finger and relax.  Good.  And squeeze again.  And relax.  Nice.  Very strong.  You had a good contraction and a good relaxation.  So now I want to see how long you can hold it, so try to hold it for 10 seconds.  Ready?  And squeeze, 2, 3.  Squeeze, 4, 5.  That's good, 6, 7, 8, 9, 10, and relax.  Now, you've been doing kegels and it appears that you've been doing them properly, so you're able to hold it a full 10 seconds 'cause I feel a good contraction and a good relaxation.  If you wanted to strengthen your pelvic floor, I would recommend doing exactly this.  This is an isolation of the pelvic floor muscle or a Kegel exercise.  I like people to know they can isolate it because then they can add it in to the other motions like standing or squatting.  The 10 second hold 10 times is a pretty good strong pelvic floor, so once a person can hold it 10 seconds, 10 times with a good relaxation in between, I would have them sit or stand and do a set in that position and at least three sets a day to strengthen your pelvic floor.

Lindsay: So I have a Kegel exerciser from Adam & Eve.  

Kim: Oh, right.

Lindsay: Can you guide me on the best ways to use it?  

Kim: Sure.

Lindsay: So you were showing me earlier that you have a set of these where, as the colors change, the weight progresses.

Kim: Yes.  

Lindsay: And they sent me ones that have cherry shapes.

Kim: So this goes inside, much like a tampon.

Lindsay: Okay.

Kim: And then this hangs on the outside and then since we're here, I can pull on it and see if you can hold it in and that would strengthen your pelvic floor.  Okay, bend your knees again.  Okay.  You got it.  Now you're holding it in.  So I'll mimic you standing up, right, so this is gravity taking it out.  Hold it in.  Hold it in.  Hold it in.  And I can't get it out.  Perfect.  That's a good pelvic floor strength.

Lindsay: Thank you for teaching me and for doing the exam on me so that I can hopefully relax more and also help guide people verbally in their own kegels and mostly to tell them it's okay to go see a specialist and get feedback so that you're physically doing them well.

This episode is sponsored by adamandeve.com and they happen to have these amazing Kegel exercisers.  You're looking here at the lighter weight object that goes up to a heavier weight and this will help work your pelvic floor muscles.  If you want your own set, adamandeve.com, use promo code 'doe', you'll get 50% off of these or any items that they have on their website and free shipping in the US and Canada.

Kim & Lindsay: Stay curious.  

(Endscreen/Credits)