Tag Archive for: incontinence

Inner Pelvic Health | A New Approach to the Squat

By Mia Munroe


The Prevalence of Pelvic Floor Dysfunction

Pelvic floor dysfunction is becoming all too prevalent, affecting women in every stage of life, and unfortunately is acknowledged as the norm. Incontinence is not comfortably discussed among women yet the growing number of various adult bladder control products is rising steadily. Mainly following childbirth, varying degrees of prolapse severity (different inner organs falling out of place) is a frightening reality for too many women. The female body was built to handle childbirth and bounce back to full recovery, yet this appears to be no longer the case. It seems apparent that perhaps it is our lifestyle habits that no longer support our pelvic health. By approaching inner pelvic healing from a logical and comprehensive standpoint based on its design and uses, there are alternative answers to healing damage that typically stems from childbirth.

Ineffective Treatments for Pelvic Floor Health

In my exercise teaching experience, I found not only that pelvic floor issues have become the norm following childbirth but the treatments are ineffective and in many cases harmful. Surgically implanting slings and mesh suspension systems, wearing pessary insertions, and injecting bulking agents more commonly used in facial plastic surgery, are some of the current choices offered by traditional medicine. As I began researching and discussing the issue more openly with my clients, I heard Kegel exercises were, if anything, found to be frustrating and seldom reaching beyond a superficial fix of bladder control. The less invasive yet initial option of “X number of Kegels per day” has failed to be effective on it’s own and could even be argued as detrimental to pelvic floor health.

Extensive anatomical research revealed slightly differing graphical interpretations. Its given label of the pelvic floor denotes a complex group of muscles layered and designed to work together in ways that differ depending on the specified function. Where the traditional Kegel exercise is most often learned by isolating the Kegel muscle (pubo-coccygeous), stopping your flow of urine, in truth, that is but one component of a complex family of muscles with differing yet definable actions. Documentation shows Alfred Kegel working with patients primarily using a perineometer (a phallic shaped balloon used to measure and exercise the muscles of the pelvic floor). In actuality, ‘kegeling’ around nothing results in a tight, weak pelvic floor.  Consider the dissatisfaction of chewing with nothing in your mouth. Perhaps if the labeling of these muscles weren’t limited by being called “a floor”, the potential for isolating and emphasizing certain areas along the natural cylindrical shape would be better understood. 

Letting Go of the Kegel and Embracing the Squat

By incorporating movement in one’s legs, pelvis, and spine supported by deep breath work, I teach cylindricization (extending the base downwards and narrowing the top upwards), in either a seated or standing position. With repetitive practice and proper use of breath, one can learn to simultaneously flex at the top and extend at the base. Deep inner pelvic muscles exist to not only to lift but to extend or cylindricize the vaginal canal. However, accessing this level of sophistication led me to what may be the most important component missing from our pelvic health – the opposite of a “Kegel”, which is squatting.

All muscles become stronger when stretched deeply. Unfortunately multiple squatting practices have sociologically disappeared. We no longer harvest our own food and the ones who do, sit on a tractor. Waste cannot be properly eliminated while sitting on a toilet, currently our only social and economic choice (with the exception of many Asian countries). Is it possible that all these near universal changes have contributed to tight, weak pelvic floors? Certain cultures, unlike our own, do embrace squatting as the preferred position during childbirth. Yet this practice is only recognized in a handful of states that accept midwifery.

Our sedentary lifestyle tightens our hips and knees, making squatting difficult for some but not impossible. There are ways to modify a weight-bearing squat by using pillows underneath the sitz bones and positioning ones weight either forward onto ones hands or backward by hanging onto a door jam. Anyone can find their own comfortable squat by adjusting leg width and pointing ones toes either straight front or slightly out. Finding the correct modifications will take pressure off of fragile knees and avoid over-stretching tight hips. As I worked with more and more clients, results have proven that alternating squatting and standing with one’s legs strongly extended will in time result in taking pressure off this central mid-pelvic region. I always insist on completing a squat by standing with the legs as close together as possible if not touching. It is afterwards that one will feel a deep internal lift taking pressure off of the bladder and lower organs.

“Perhaps the best approach to these pelvic disorders could be reversed by letting go of the Kegel and embracing the squat.”


Mia Munroe is a GYROKINESIS® Master Trainer. She will be teaching two GYROKINESIS® for Pelvic Floor Health classes at MOVE Wellness Studios State Street on Monday, June 18 and Wednesday, June 20th from 6:00-7:30pm. They are open to the public and all levels. CLICK HERE to sign up

Gyrokinesis Instructors can take the GYROKINESIS® Applications for Pelvic Floor Health Workshop with Mia Munroe on June 18-20 from 2-6PM. CLICK HERE to sign up.


This article was originally published in “Healing our World” from the Hippocrates Institute


Break Free from Pelvic Floor Disorders

Did you know that 1 in 3 women suffer from or will develop a pelvic floor disorder during their lifetime?

Pelvic floor disorders are problems related to bladder, bowel and sexual function. They include different types of urine leakage (incontinence) or bladder control problems like going frequently, getting up at night to urinate, or getting strong, uncontrollable urges to urinate. Pelvic floor disorders also include problems related to the bowels such as accidental loss of gas or stool. Finally, a condition known as prolapse, which is a feeling that the pelvic organs (bladder, uterus, vagina or rectum) are bulging or falling out, is also a pelvic floor disorder.

The risk for pelvic floor disorders increases with age. While these conditions are often linked to having children, there are other reasons they can develop. There are also many conditions that make pelvic floor disorders worse that can be managed with relative ease. Many women suffer silently from these conditions. They assume that these conditions are a normal part of the aging process. They also assume that because their mother or sister had it, then they are destined to get it too.

Fortunately pelvic floor disorder are not life threatening. They primarily affect a woman’s quality of life. That means that they do not have to be treated right away. Depending on how bothersome the condition is, a watch and wait approach is often acceptable. However, a thorough evaluation is needed first to ensure it is safe to wait.

Once a pelvic floor disorder affects a woman’s quality of life, there are a number of treatment options available. Many of these options are conservative and non-invasive like lifestyle, behavior, or diet changes. Other treatments include medications, physical therapy and surgery in some cases. Each woman is different; therefore each woman’s treatment plan will be different.

Be open with your doctor about your symptoms and ask about treatment options. You can also ask about seeing a specialist and request a referral if needed. There are qualified specialists in your area that are willing to help you break free from pelvic floor disorders.

To learn more about about pelvic health and incontinence, join us for Incontinence Night at MOVE Wellness Studios, on May 4th. Click here for more information.

This article was originally published at www.ihacares.com by Dr. Adam Ziff on October 20, 2014, and was updated on March 30, 2017.

Urinary Incontinence – Are You Among the 1 in 3?

Urinary Incontinence – are you familiar with these words? I am sure you have heard the joke – “laugh until you leak” or seen the commercials for “discrete pads for women”.  Odds are, if you are a woman, then you or someone close to you is dealing with incontinence on a daily basis. Studies have shown that 1 in 3 women suffer from urinary incontinence – which is an uncontrollable loss of urine.  There are two main types of urinary incontinence. Stress urinary incontinence which is when you “leak” when you cough, laugh, sneeze etc, and urge urinary incontinence which is the “gotta go” feeling some women experience and are then unable to hold their urine.  It is also possible to have a little bit of both types of incontinence which is referred to as mixed urinary incontinence. You may have heard from friends or read online that at certain times in your life incontinence is inevitable, like when you are pregnant, if  you have had multiple children, if you are nearing menopause, or if you are a runner. Well, I have great news for you! You are not destined to have “leaky faucets” just because you fall into any of these categories. There are steps you can take to help improve and even resolve incontinence.

Strengthening Your Pelvic Floor

The key to helping to gain your life back from incontinence lies in a few muscles that most people are unaware they have, or unaware of their function…the pelvic floor. Your pelvic floor is a network of muscles that spread across the bottom of your pelvic cavity like a hammock. They have many functions including supporting the pelvic organs such as the uterus, bladder, and rectum. They also help to withstand increases in pressure that occur in the abdomen with activities such as coughing and sneezing, and they help to enhance the sexual response. These are the muscles you are targeting when doing kegels. Many women have probably heard of kegels, but did you know that studies have shown that most women are unable to perform a proper kegel contraction without some education? It takes diligence, awareness, and practice to perform an effective pelvic floor contraction or a kegel.

How Pilates & Gyrotonic Targets the Pelvic Floor

At MOVE Wellness Studios in our Pilates and GYROTONIC sessions, the pelvic floor is a target of our connection to the “core” and we cue and train the contraction of these muscles as regular part of our private sessions and classes.  You learn how to do this in your first session and we work to build tone of the pelvic floor and other related muscles.  As small, local stabilizing muscles, it takes a little bit of time and focus to “feel” this area of our body work but quite often, learning to breathe in a way that supports toning the pelvic floor has other benefits such as releasing stress, relieving low back pain and building core strength.

Kegel Exercise to Strengthen the Pelvic Floor

  • Sit on a flat surface like a chair or bench with a rolled up towel or pillow between your knees.
  • Take a few breaths releasing your shoulders and sitting up tall with your feet flat on the floor.
  • Take a breath in to prepare and on your first exhale gently squeeze the towel.  Notice the area of your pelvis that is in contact with the chair.
  • On your second exhale, try to lift the center of your body off the chair, while gently squeezing the towel.  Do not contract  your large gluteus muscles but keep the focus more to the center and keep it very gentle.
  • Hold the contraction for the length of your breath, relax and inhale and do it again.
  • Repeat 10 breaths, twice per day.

Note: this is just a basic introductory exercise and if you have pain or any other symptoms after practicing it, discontinue it and get help from your physical therapist or doctor.

Physical therapy can be a great option for women who are suffering from incontinence that is more severe and truly impacting their quality of life. A pelvic floor physical therapist has special knowledge in the anatomy and function of the pelvic floor and how dysfunction in this area can lead to issues such as incontinence. Your pelvic floor physical therapist will assess your pelvic and lumbar spine alignment, as well as the strength, endurance, and function of your pelvic floor along with related musculature such as your core and gluteal musculature. They will then identify areas of dysfunction to help formulate a treatment plan geared specifically to your needs to help decrease your incontinence and get you back to living your life without the hassles of urinary incontinence.

For more information, join us on May 4th at 5:30PM for Incontinence Night at MOVE Wellness Studios. Click here for more information.

This post was authored by Stephanie Hemker, PT, DPT and Elaine Economou, PMA-CPT