Kegels have long been touted as the go-to exercise for pelvic floor health, especially for people dealing with issues like incontinence or postpartum recovery. While they can help isolate and strengthen the pelvic floor muscles, Kegels alone often fall short of delivering true functional benefits.
Why? Because our bodies don’t operate in isolation. For your pelvic floor to function optimally, it needs to work in harmony with your entire core and adapt to the dynamic movements of daily life. Without this integration, Kegels can become an exercise in futility.
The Problem with Kegels
Lack of Functional Application: Kegels focus on contracting and releasing the pelvic floor muscles, but this movement rarely mirrors real-life demands. Your pelvic floor isn’t just called upon when you’re sitting still; it’s working when you lift, squat, walk, and breathe.
Over-Isolation of Muscles: By isolating the pelvic floor without addressing its relationship with surrounding muscles (like the diaphragm, deep core, and glutes), you risk creating imbalances. Overly tight or weak pelvic floor muscles can lead to dysfunction, just like any other muscle in the body.
Failure to Address Coordination: The pelvic floor works as part of a team. It should naturally contract and relax in response to movement and changes in intra-abdominal pressure (like when you sneeze or lift something heavy). Kegels don’t train this coordination, which is essential for functional pelvic health.
The Functional Alternative
To truly improve pelvic floor function, exercises must integrate the pelvic floor into whole-body movements. Here’s how:
Link the Pelvic Floor to Breathing: Your pelvic floor and diaphragm are closely connected. Practicing diaphragmatic breathing can help you engage the pelvic floor naturally during inhalation and exhalation, training it to respond to pressure changes.
Incorporate Functional Movements: Exercises like squats, lunges, and deadlifts—when performed with proper alignment and core engagement—naturally involve the pelvic floor. These moves train the pelvic floor to support your body during the activities you perform daily.
Focus on Stability and Coordination: Exercises like bird dogs, bridges, and planks can help integrate the pelvic floor into larger movement patterns, ensuring it works cohesively with other muscles.
Final Thoughts
Kegels aren’t inherently bad—they’re just not the whole story. Isolating the pelvic floor can be a useful first step for some, especially in early stages of rehab. But if you want lasting results and improved function, you need to think bigger.
Train your pelvic floor to move and respond as part of a coordinated system, and you’ll not only strengthen this critical muscle group but also improve your overall movement and quality of life.
Say goodbye to endless Kegels and hello to functional movement for true pelvic floor health!
What is Desire Discrepancy, and What Can I Do About It?
Desire discrepancy is a common challenge many couples face—it happens when partners have different levels of sexual desire. More often than not, my female patients complain that they feel as if they are broken because they do not want to have sex with their partners. They often describe that they feel as though they “should” be more into sex and feel tremendous amounts of shame for their lack of interest.
News flash for all of y’all: we may assume that this is a female-specific problem. This is not true. Desire discrepancy can occur in any relationship by any particular person. Same-sex and queer couples can present this issue. Likewise, there are plenty of men with lower libidos than their female partner.
Desires naturally ebb and flow. Many factors feed into our sex life even though we associate most of sex with our genitals. Our stressors, lifestyle, hormonal changes, children, sleep cycles and general health can all tremendously impact how we relate to our sexuality.
The bottom line here that we all really need to understand a couple of things:
What value does sex bring into our lives? Is it a release? Physical touch? Intimacy? Reflecting on what sex means to you and being vulnerable enough to have that conversation with your partner is the first step in conquering this issue. The real challenge here is that SHAME wants to fault your desires and needs.
Good, giving, game of Dan Savage rules when it comes to our sexuality. We have to be willing to at least entertain or explore our partner’s needs in regards to our sexuality in a judgement free space.
SEX WILL CHANGE! This is inevitable. Our hormones change, our bodies change, we age. There are facts. Understanding 1 & 2 will keep these conversations open and make sexuality something that can be adaptable through the lifespan.
At its core, desire discrepancy isn’t about “fixing” anyone. Instead, it’s about understanding the unique factors that influence desire, such as stress, emotional connection, and physical well-being. One powerful tool to navigate this difference is mindfulness.
How Mindfulness Can Help
Mindfulness, the practice of being present and fully engaged in the moment, can shift the way couples approach desire and intimacy. Here’s how:
Managing Stress: Stress is a major libido killer. Mindfulness exercises like deep breathing or guided meditation help calm the nervous system, creating space for desire to re-emerge naturally. Arousal needs us to be in a parasympathetic state. By managing our stressors through mindfulness, we can actually be in a state to be present.
Improves Emotional Connection: Mindfulness fosters nonjudgmental awareness, allowing partners to listen and empathize with each other’s feelings about intimacy without defensiveness or shame.
Enhances Body Awareness: Practices like body scans or mindful touch can help individuals reconnect with their own sensations and desires, paving the way for deeper intimacy. I agree that disembodiment is a beautiful coping mechanism from time to time but we need to be inside of our bodies to experience pleasure.
Builds Communication Skills: When couples approach conversations about their desires and their shame with mindfulness, they can express needs and even boundaries with more ease which fosters mutual understanding.
Mindfulness Exercise to Try
The 5-Minute Connection Practice:
Sit facing your partner.
Spend one minute making eye contact without speaking. Notice your breath and your partner’s presence. Do not feel bad if this is awkward. Notice the feelings or thoughts and let them come and go.
Take turns sharing one sentence about how you’re feeling in the moment. Listen fully without interrupting or problem-solving. You are allowed to feel great, terrible or anywhere in between.
End by thanking each other for the connection.
This simple practice (even if you laugh the entire time) can help you feel more attuned to your partner and create a foundation for open dialogue about your pleasures, desires or just feelings in general. .
Desire discrepancy doesn’t have to create lasting distance between partners. Oftentimes, it can become a point to connect and evolve as a couple. With mindfulness exercises that are self-guided or partnered, you can turn it into an opportunity for growth, understanding, and deeper intimacy.
The Importance of Physically Getting Out of Fight or Flight
In today’s fast-paced world, many people spend a significant portion of their lives under stress, often stuck in a state of fight or flight. This physiological response, rooted in the body’s survival mechanisms, was originally designed to protect us in dangerous situations. However, when the fight-or-flight response is constantly triggered by daily stressors—like work pressures, financial worries, or interpersonal conflicts—it can have detrimental effects on physical health. Understanding the importance of getting out of this state is key to preserving long-term well-being.
What is Fight or Flight?
The fight or flight response is controlled by the sympathetic nervous system (SNS). When faced with a perceived threat, the body reacts by releasing stress hormones like adrenaline and cortisol. These hormones increase heart rate, blood pressure, and glucose levels, preparing the body for immediate action—whether that be to fight or flee.
While this response can be lifesaving in moments of acute danger, chronic activation due to ongoing stress can overwhelm the body and mind, leading to numerous health issues.
The Physical Consequences of Chronic Fight or Flight on your Nervous System
When fight or flight is activated frequently, the body’s parasympathetic nervous system (PNS), which helps bring the body back to a relaxed state, is often underutilized. This imbalance can have serious long-term effects:
Cardiovascular Health Chronic activation of the fight or flight response can lead to increased blood pressure, heart rate, and a heightened risk of cardiovascular disease. Studies show that sustained stress may increase the risk of hypertension and heart disease, as elevated levels of cortisol can contribute to inflammation in blood vessels and the heart.
Source: A review published in The Lancet (2020) found that chronic stress is linked to an increased risk of heart disease and stroke due to persistent elevated blood pressure and inflammation.
Immune System Suppression Prolonged stress can suppress the immune system, making the body more vulnerable to infections and diseases. Elevated cortisol levels can reduce the production of white blood cells, which are essential for immune defense. This compromises the body’s ability to fight off illnesses, leaving it more susceptible to viral and bacterial infections.
Source: Research in the Journal of Neuroimmunology (2015) shows that long-term stress impairs immune function by reducing the body’s ability to mount a proper immune response.
Digestive Problems Stress can lead to digestive disturbances, such as irritable bowel syndrome (IBS), acid reflux, and indigestion. The fight-or-flight response prioritizes blood flow to muscles and away from the digestive system, which can impair digestion and nutrient absorption. Additionally, cortisol can impact gut health by disrupting the balance of good bacteria, leading to gastrointestinal issues.
Source: A study in Gastroenterology (2017) found a direct correlation between chronic stress and the development of gastrointestinal disorders like IBS.
Muscle Tension and Pain When the body is in a constant state of stress, muscles remain contracted, which can lead to chronic pain, particularly in the neck, shoulders, and back. This muscle tension, when prolonged, can also contribute to headaches and joint issues.
Source: According to research in Frontiers in Neurology (2018), chronic muscle tension due to prolonged stress is a leading cause of tension-type headaches and musculoskeletal pain.
Hormonal Imbalance and Reproductive Health Prolonged stress and the release of cortisol can disrupt the body’s hormone levels. This disruption can affect menstrual cycles, fertility, and sexual health in both men and women. Stress can lead to decreased libido, irregular periods, and even early menopause.
Source: A study published in Fertility and Sterility (2010) highlights the link between stress-induced hormonal imbalance and reduced fertility in both men and women.
How Acupuncture Helps Regulate the Nervous System
Acupuncture works by stimulating specific points on the body to influence the flow of Qi (vital energy) and balance the body’s systems. Here’s how acupuncture can help shift the body out of fight or flight:
Activates the Parasympathetic Nervous System (PNS) Acupuncture is known to stimulate the parasympathetic nervous system, which is responsible for the “rest and digest” response. By activating the PNS, acupuncture helps reduce the activity of the sympathetic nervous system (SNS), bringing the body into a more relaxed state. This shift encourages lower heart rates, normalized blood pressure, and a reduction in stress hormones like cortisol.
Source: A study in The Journal of Alternative and Complementary Medicine (2013) showed that acupuncture significantly reduces cortisol levels and improves the body’s stress response.
Reduces Muscle Tension One of the most common physical symptoms of stress is muscle tension. Acupuncture needles are used to target areas where tension accumulates, such as the neck, shoulders, and lower back. By stimulating these points, acupuncture helps to relax the muscles and improve circulation, reducing pain and discomfort.
Source: Research published in Pain Medicine (2017) found that acupuncture significantly decreases muscle pain and tension associated with chronic stress.
Balances the Body’s Energy (Qi) In TCM, health is defined by the free and balanced flow of Qi. Stress causes blockages and imbalances in Qi, leading to physical and emotional symptoms. Acupuncture restores the smooth flow of Qi throughout the body, which helps reduce the negative effects of stress.
Source: A study in Evidence-Based Complementary and Alternative Medicine (2012) found that acupuncture effectively regulates Qi, improving emotional well-being and reducing stress-related symptoms.
Promotes Relaxation and Reduces Anxiety Acupuncture can directly affect brain chemistry, promoting the release of endorphins, the body’s natural painkillers and mood elevators. This effect can help alleviate feelings of anxiety and help individuals feel more calm and centered.
Source: According to research in The Journal of Clinical Psychology (2016), acupuncture is effective in reducing symptoms of anxiety and promoting a sense of calm.
Other ways to Physically Get Out of Fight or Flight
Understanding how to break free from the fight-or-flight response is critical to preventing the harmful physical effects of chronic stress. Here are some practical ways to shift the body from the sympathetic nervous system to the parasympathetic nervous system, allowing for relaxation and recovery:
Deep Breathing and Meditation Deep breathing exercises, such as diaphragmatic breathing, activate the parasympathetic nervous system and help counter the physical effects of stress. Meditation and mindfulness practices are also highly effective in reducing cortisol levels and promoting relaxation.
Physical Exercise Regular physical activity helps the body release endorphins, which counteract the stress response and reduce pain. It also helps lower cortisol levels and improve cardiovascular health, promoting overall well-being.
Adequate Sleep Chronic stress often disrupts sleep, which in turn exacerbates stress. Ensuring adequate, restful sleep is vital for restoring the body’s balance. The body repairs and regenerates itself during deep sleep, making it a crucial component in recovery from stress.
Massage and Bodywork Massage therapy and other bodywork techniques, like acupressure or yoga, can help release built-up muscle tension, stimulate the parasympathetic nervous system, and promote relaxation.
Connection with Nature Spending time outdoors or engaging in activities like forest bathing can help reduce stress levels and encourage a sense of calm, allowing the body to shift out of fight or flight mode.
Conclusion
Getting out of the fight-or-flight state is not just a mental or emotional necessity; it is a physical one. Chronic stress and prolonged activation of the sympathetic nervous system can lead to numerous health issues, from cardiovascular problems to immune suppression. By employing techniques such as deep breathing, exercise, adequate sleep, and bodywork, you can help your body restore balance, alleviate stress, and prevent long-term health problems. Taking action to move out of fight or flight is essential for both physical recovery and overall well-being.
The rise in popularity of acupuncture and trigger point needling (often referred to as dry needling) reflects their effectiveness in treating chronic pain and musculoskeletal issues. However, the debate over who should perform these procedures is a crucial consideration for safety, efficacy, and patient outcomes. While both methods involve inserting needles into the body, there is a compelling case that only licensed acupuncturists should perform needling techniques.
Understanding Acupuncture and Trigger Point Needling
Acupuncture: Rooted in Traditional Chinese Medicine (TCM), acupuncture focuses on balancing energy, or Qi, through specific points along meridians. This practice is holistic, addressing systemic issues such as pain, stress, and internal imbalances.
Trigger Point Needling: A Western adaptation targeting myofascial trigger points—tight muscle knots that cause localized or referred pain. While effective for musculoskeletal issues, it is more narrow in scope compared to acupuncture.
Though different in philosophy, both methods require precision, anatomical knowledge, and an understanding of underlying health conditions to ensure safe and effective treatment.
Why Acupuncturists Should Exclusively Perform Needling
Extensive Training and Certification Licensed acupuncturists undergo rigorous education, typically including:
3,000+ hours of training in anatomy, physiology, pathology, and needling techniques.
Clinical internships under supervision to refine skills. This comprehensive preparation ensures that acupuncturists are well-versed in both traditional practices and modern safety protocols.
In contrast, dry needling practitioners (often physical therapists or chiropractors) may receive as little as 20–40 hours of training, which is insufficient for mastering the complex skill of inserting needles into the body without causing harm.
Punctured organs, such as a pneumothorax (collapsed lung)
Infection due to poor hygiene practices
Acupuncturists are trained to avoid these risks through sterile techniques, precise needle placement, and a thorough understanding of human anatomy.
Holistic Expertise Acupuncturists treat the whole body, addressing root causes of pain rather than just symptoms. Trigger point needling alone focuses on localized issues, potentially overlooking broader systemic factors contributing to pain or dysfunction.
Regulation and Accountability Acupuncturists are licensed and regulated in most regions, ensuring they meet stringent professional and ethical standards. Dry needling often operates in a regulatory gray area, where practitioners may lack adequate oversight.
Scientific Support for Acupuncturist-Led Needling
A study in Medical Acupuncture emphasized that the success of needling depends heavily on the practitioner’s training and expertise. Poor technique, often seen with minimally trained dry needling practitioners, increases the risk of complications.
Research from Complementary Therapies in Medicine found that patients treated by licensed acupuncturists reported higher satisfaction and fewer adverse events compared to those receiving dry needling from less-trained providers.
The Ethical Implications
Allowing undertrained individuals to perform invasive procedures undermines patient trust and safety. Acupuncturists have spent years mastering the art and science of needling, ensuring that they can provide safe, effective, and comprehensive care. This level of expertise cannot be matched by weekend courses or limited training programs.
Conclusion
Acupuncture and trigger point needling are valuable tools in pain management and healing, but their effectiveness depends on the skill of the practitioner. Only licensed acupuncturists have the comprehensive training necessary to safely and effectively perform these techniques. Choosing a qualified acupuncturist ensures not only better results but also the peace of mind that your health is in expert hands.
