A new pelvic floor product is getting lots of press called the KGoal. I have to say I am not that excited about yet another product that sells isolated pelvic floor strengthening. I am sure the KGoal and all products of its kind do a great job at what they are sold to do…teach you to find and isolate the pelvic floor…over and over and over again (Now bigger, now smaller, now longer). But there is so much more. Sexual dysfunction, incontinence, and prolapse are ALL multifactorial, multifaceted issues (how bout that for making sex sound boring). Treating them as a one muscle problem misses the boat. I feel the same way about regular old low-tech Kegels. I will not promote them, retweet or post anything about them. There I said it. Anybody else ready to move beyond Kegels. Please?!!
I agree women need help locating and reconnecting with the PF, products, like KGoal, can do that (and I acknowledge, for some, so can a standard Kegel). But the long held premise promoted by these types of products, programs, and Kegels, etc. is that pelvic floor health starts and ends with pelvic floor isolated contractions.That’s it. They are offered as THE final solution, the alpha and omega.
Muscles do not have an optimized output or function when asked to contract in isolation. Try this: Everyone straighten your arm at your side. Now without clenching your fist, moving your wrist, elbow or shoulder, contract your bicep. Harder than you thought right?? Did you get a maximal output? Would you grade it as very weak?? But your bicep is good, right? Healthy, capable? Why did it score so low? That is what we ask when we ask a woman to do a Kegel. We are familiar with our bicep, we can see it, yet we could hardly make it contract. We have learned that women don’t have a brain map for their pelvic floor, in part because they can’t see it, adding to the difficulty of finding it and isolating it. According to this...many haven’t even looked at their lady parts. Does an isolated contraction actually give us an accurate idea of the health and capacity of a pelvic floor? Now…visualize that you are lifting something with your straightened arm, but don’t move. A little more bicep action, right?? So visually imagery can really help women connect. But it is still not gangbusters, right? Now clench your fist. Ah ha…now we are getting somewhere! Muscles work better together. The pelvic floor is no exception.
The word Kegel has certain meanings in our culture like: clench, hold, 3 sets of 10, 3x/day…forever!! The word also carries emotion (frustration, failure, disappointment) and history (they don’t work, never have worked, none of my friends can do them either, neither could my mom). In my humble opinion, Kegel communicates isolated muscle strengthening (all or nothing holds). We need to change the language if we are to change the culture and perception. My current go to phrase is to call it ‘pelvic floor engagement’. And we shouldn’t sell that as the end of the road. Once you get it, you need to integrate it…immediately. Think about your fist-to-bicep connection. You changed from ‘weak and hard to engage’ to ‘ready for action’ in an instant.
Well-meaning colleagues have said to me “When I say Kegel, I don’t mean the old version of Kegel…I mean with breath” or “with TA” or “with alignment”. I simply disagree. A word means what the person hearing it brings to the table. If you say ‘This is a Rose’ the listener immediately conjures images, smells, experiences associated with a Rose. But if you meant a Gerber Daisy…then you are not communicating what you meant to communicate. I have also heard some redefine Kegel saying it actually means an integrative way of doing things (breath, TA, alignment…etc). I suggest that this word, this exercise has been around so long (since 1948, people) that it is generationally embeded in our pop culture, health culture, etc. Using the same word to mean something new…doesn’t mean something new, as hard as you try. A Rose is not a Gerber Daisy.
Solving issues like incontinence, prolapse or sexual dysfunction must be multifaceted, because the problems that create them are multifaceted. The poor pelvic floor has taken the heat for these issues for years…but it can share the blame with many others. And supporting its function doesn’t or shouldn’t only involve a focus on simply strengthening it, and it alone. You improved your bicep contraction because you used other muscles and your brain to make it happen. The pelvic floor needs that kind of support.
My colleague Sandy Hilton suggested a flyer should come with products like these that helps women understand the role of this product in a comprehensive program and to see a Pelvic Health physical therapist if there is no improvement (real, measurable change) in 2 weeks. That would be awesome!
Folks ask me ‘What do you suggest?? What else is there? Waiting for some direction!’ I have lots of helpful suggestions on my blog, videos, follow the #pelvicmafia on twitter and I have a comprehensive, integrative program for incontinence offered as an online course/DVD. And I would make the same suggestion on my own program. If you don’t see improvement quickly, go see someone* and demand more than Kegels from them!
Change the language, change the culture. Change your expectations folks, isolated contractions is not the beginning and the end of what we can do to help you with these issues.
*Find a pelvic health pro here:
USA Physical Therapists
New Zealand Physiotherapists
4 thoughts on “KGoal: What’s the Big Deal?”
Hi Julie, love the blog about KGoal and kegels. I understand your frustration, and we share it too – the press just don’t seem to want to highlight anything ‘below the belt’ unless it is in a sexual way. I once had a UK journalist say to me ‘We don’t write about pissy old women’ . My reply? ‘Even if it’s your wife or daughter?’ So you will see the challenge that we face, when all the ‘press’ want to report is about sex & orgasms.
So, to get away from our Kegel centric culture – I think the flyer idea is great – women are desperate for information and they want to help themselves. So if you and Sandy would like to come up with some ideas for the leaflet – we’d love to promote it, and we will send it out with all of our purchases. How about making this the first official #pelvicmafia leaflet – downloadable fom the site?
I appreciate treatment patterns are different in the US/CAN and UK, but a weak pelvic floor is the same the world over, and at least a Kegel is a start.
Let’s take this a step further to acknowledge that the pelvic floor does so much more than the classic PF issues: sex, continence and prolapse. It is a part of central stability, postural control, hip, pelvic and low back joint support, and movement support. When we keep the topics on the standard women’s health type issues, we honestly miss such a huge bigger picture.
A flyer is a great idea, and I will see what we can come up with. Stay tuned! But I would cautiously submit though that none of us individually speak for the #pelvicmafia, it is such a diverse group.
What I tell my patients that have been doing Kegels (for years in most cases) is that the time they have spent trying to connect with their pelvic floors has value, and has not been wasted. But I let them know we are on a new learning curve that has helped us learn why Kegels are so difficult, and often unsuccessful and it is based in our growing understanding of how the pelvic floor actually functions. It is a team mate, not a solo act. Let me introduce you to the team…..now let’s get them working together. Not only do they work the same in the US, UK, Canada…etc. The team works the same in men, children and teens.
We need to change the message! Thanks for weighing in. Julie
Thank you so much for writing about kGoal. As you know, I am a consultant on the project and I believe a pelvic floor examination by a specialist is very important in teaching women how to use their entire core and I would never suggest a tool could replace the education that we provide or do even as close to as good of a job. My hopes with this device and those like it, is that it might be one more tool in our tool boxes to help women connect with themselves and that they will integrate it into functional programs that help women gain improved motor planning and motor control. Like other products/DVD’s on the market, I feel it will be empowering for those women who don’t have easy access to a pelvic specialist. I will absolutely talk to the team about adding educational information with the product, great idea Sandy! Luckily, we have not yet completed app development so there is lots of room for ideas on how we can use the product. If anyone else reading this has suggestions please feel free to e-mail me personally at email@example.com. Thank you!
Thanks so much for weighing in! I am so glad to hear that as the product moves through development they are open to practitioner and potential customer feedback to prep the product for market. Educational info would truly make the KGoal stand out. I am very much a fan of creating options for women who do not have access to care and appreciate that the KGoal can help meet that need. Thanks again Liz! Julie
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