In my last post, I discussed my first appointment with a pelvic floor physiotherapist. I noted one interesting moment for me was noticing how good my body is at tensing, and how bad it is at relaxing (you can read about that here). For instance, when asked to do a Kegel, I had no problem; my strength was good. However, when asked to release the Kegel, I couldn’t do it right away. Releasing took a while. Tensing was clearly something my body could perform and was used to doing, but it was clear it had trouble releasing tension. This inevitably contributed to my experiencing painful sex (read about my history with painful sex here). In this post, I discuss some of the strategies employed during Pelvic Floor Physiotherapy to help relax my pelvic and vaginal muscles.
Don't forget to read until the end for this post's #TLLCTuesdayTip!
If you’ve ever been in physiotherapy, you know you usually leave your appointment with homework. For instance, you may have specific strengthening exercises or stretches to do. Similarly, you may be asked to work on your posture and make some adjustments to how you sit or stand.
I don’t know about you, but when I think of pelvic floor physiotherapy, I think about ALL THE KEGELS!!!! As a result, I expected them to be my homework. Instead, I had something called reverse Kegels as my homework.
What on earth is a reverse Kegel you might be asking yourself? And what was the purpose of doing them? I asked myself the same thing.
When asked to release a Kegel during my physiotherapy appointment I couldn’t. I could tense up easily but releasing took a lot of focus and effort; it didn’t come naturally.
A Kegel requires tightening your pelvic floor muscles and holding it for a few seconds. A reverse Kegel is the opposite; It is relaxing and releasing the tension and activation occurring when you perform a Kegel.
How do reverse Kegels help you relax? This resource from Pelvic Health Solutions explains the importance of relaxed pelvic floor muscles:
“Your ability to consciously relax your pelvic floor muscles is a critical part of your recovery program. You must learn to relax these muscles before they can become functional again and pain-free. Relaxing your pelvic floor, or reverse Kegels is also called downtraining the muscles” (Pelvic Health Solutions).
Moreover, if your pelvic floor muscles are tight or in a constant tensed state, vaginal penetration will be less comfortable than if the muscles were relaxed and open. If your pelvic floor and vaginal muscles are stuck in tension mode like mine were, you might experience pain during vaginal penetration. Add Lichen Sclerosus symptoms to the mix, and you are talking about some pretty painful sex.
Performing reverse Kegels involves really tuning into your body and your breath. Specifically, you should practice diaphragmatic breathing (also known as belly breathing) whilst doing reverse Kegels. To do so, breath in slowly through your nose, place one hand on your chest and the other on your low rib cage. Your chest should stay still, while your low belly swloly rises on the inhale. It can take time to master this alone. I used to breath into my chest all the timeand it took a while to break this habit. Diaphragmatic breathing itself is great for relaxing and calming the nervous system.
When you are ready to do the reverse Kegel, on your inhale, practice sending the breath from your nose into your belly and deep into your pelvic floor. Jane, my physiotherapist gave me some really helpful tips
First, work with imagery. She suggested imagining a large rose slowly blooming and opening up on the inhale.
Second, up your relaxation game. Find what works for you. For example, try dimming the lights and lighting some candles. Perhaps use some relaxing spa music to get you into that relaxed headspace.
Finally, experiment with positions. You can perform reverse Kegels standing up, lying down, in child’s pose, or even on the toilet.
In the beginning, I had a hard time performing reverse Kegels. I believe this is due to my body being in chronic hypertension mode for years, and because the concept was hard for me to grasp in the beginning.
Jane suggested practicing on the toilet first, after voiding your bladder. Once you have urinated, practice mimicking the action of urinating/emptying your bladder. Essentially, this movement is the movement of the reverse Kegel. Once I practiced dropping my pelvic floor after voiding on the toilet a few times, I moved on to practicing while standing.
At the time, I was working on my Ph.D. and spent a lot of time writing at my standing desk. I would do my reverse Kegels and diaphragmatic breathing while standing and writing. In time, I became very good at relaxing my pelvic floor muscles.
This was key to working with dilators and getting to a place where I can have pain-free sex again!
Another piece of my initial homework was practicing specific yoga poses to help open up my hip flexors and relieve tension in my glutes and low back. The body really is all connected: Lichen Sclerosus impacts the vulva, but it is also connected to and affected by surrounding anatomy such as our sacrum, low back, hips, glutes, etc.
For me, this involved: child’s pose, various hip flexor and glute stretches, and cat-cows. During these yoga poses, I would practice diaphragmatic breathing to further help my nervous system and body relax.
In sum, practicing diaphragmatic breathing, reverse Kegels, and yoga poses helped me relax my pelvic and vaginal muscles. Further, it helped me tune into my mind-body connection and help relieve some of my general anxiety and stress. In my next post, I will discuss the following steps of pelvic floor physiotherapy, which involved dilators and body scans.
Do you have pelvic pain or pain during sex? Do you think your pelvic muscles are tight? Have you ever practiced reverse Kegels? Let me know in the comments below or feel free to contact me via social media. I would love to hear from you!
Instagram: @thelostlabiachronicles
Facebook: @TheLostLabiaChronicles
#TuesdayTipbyLLC: If you are trying out reverse Kegels, be mindful they can be tricky to get the hang of. Everyone responds to different cues and body positions. If you can’t get the hang of reverse Kegels standing up, try lying down. If a blooming rose image doesn’t resonate with you, find an image that does. Explore and be creative, but most of all, be patient and gentle with yourself.
Bonus tip! If you are new to diaphragmatic breathing, check out this helpful YouTube video here: https://www.youtube.com/watch?v=kgTL5G1ibIo
If any of my readers are in the Toronto area/live in Ontario and experience pelvic pain issues, Jane is available for virtual pelvic floor physiotherapy. Her details are:
Website: https://www.pelvicpro.ca/bio
Instagram: @PelvicPro
Pelvic Floor Meditation Series: https://www.youtube.com/channel/UCfpkNg5XNUKXfFdsItslFqA
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