Pelvic Floor Exercises
What are they?
Pelvic floor exercises are especially useful for stress incontinence and can reduce the effects of this condition considerably. They can be done at almost anytime or anywhere, at home, work or even queuing for a bus! Once you have learnt to tighten your pelvic floor muscles, you can squeeze them and hold when you sneeze, lift or jump to prevent leakage. However, please note that you may have to do them for a few months before you notice any improvement.
What is the "pelvic floor"?
The pelvic floor muscles are a group of muscles inside the pelvis that forms a floor in the body. They surround the urethra, vagina and rectum and should, along with the sphincter muscles, maintain control over these openings. The muscles should also support the urethra, bladder and womb and withstand all increases in abdominal pressure that occur during physical exercise.
If the pelvic floor muscles are weak the urethra can fall during exertion, resulting in leaking.
Where is it?
In order to find your pelvic floor muscles try interrupting the flow when you urinate. Feel which muscles you are using to do this. These are the same muscles you use when trying to hold back wind. These are the muscles you need to work on.
Correct contraction of the pelvic floor muscles feels like a small lift under the pelvis up into the body. There should be no accompanying movement of other parts of the body, e.g. the buttocks, stomach or the inner thighs. If you have a problem identifying the right muscles or if you are not sure that you are training correctly contact your doctor and/or physiotherapist.
How do I do them?
- Stand, sit or lie with your knees slightly apart (sitting is easiest). Now imagine that you are trying to stop yourself passing wind from the back passage; to do this, you must tighten the muscles round the back passage. Squeeze and lift those muscles as if you really do have wind: you should be able to feel the muscles move and the skin round the back passage tightening. Your legs and buttocks should not move at all.
- Next, imagine that you are sitting on the toilet passing urine. Imagine yourself trying to stop the stream of urine (the stop test) – really try hard. You will be using the same group of muscles as in the first exercise, but you will find it more difficult.
- Next time you go to the toilet to pass urine, try the stop test about half way through emptying your bladder. (If the flow of urine speeds up, you are using the wrong muscles.) Once you have stopped the flow of urine, relax and allow the bladder to empty completely. Do not worry if you find you can only slow up the stream, and cannot stop it completely. Do not do this every time but only to help you identify the correct muscles.
- If you are unsure you are exercising the right muscles, put one or two fingers in the vagina and try the exercise to check. You should feel a gentle squeeze if you are exercising the pelvic floor. A common mistake is to just clench your buttocks and hold your breath; if you cannot hold a conversation at the same time, you are doing the exercises wrongly. Counting aloud while you do the exercises will stop you holding your breath. Do not tighten the tummy, thigh or buttock muscles or cross your legs. Only use your pelvic floor muscles.
- When you have learned to use the muscles correctly train as hard as you can without using other muscle groups. Gradually increase the number of repetitions to 10 times. Try to hold each muscle contraction for 6-8 seconds.