Strengthening the Pelvic Floor
As you get older, your pelvic floor muscles get weaker. Women who have had
children may also find they have weaker pelvic floor muscles.
The pelvic floor is a large hammock of muscles
stretching from side to side across the floor of the pelvis. It is attached to
your pubic bone in front, and to the the tail end of your spine behind. The
openings from your bladder, your bowels and your womb all pass through your
pelvic floor. Your muscles near your pelvis are very important to
stretch. They get tight
very quickly and can become a serious problem if not handled. The pelvic floor
muscles can be separated into lifting, opening and closing muscles. These
muscles all have a role to play in the elimination process with the opening and
closing muscles being used at the actual time of going to the toilet. The
lifting muscles support the organs in the pelvis as we move about and exert
ourselves during the day --
walking, standing, lifting, sneezing and toileting. They help keep the
rectum and bladder in the 'right place' so that we can pass urine and faeces
efficiently and without straining. They give support during
childbirth and are
important in love making. They can be damaged or weakened by:
Childbirth- Evidence suggests that
problems can start during
pregnancy and not just after
birth. Women who
have had multiple births, instrumental births (with forceps or ventouse),
severe perineal tearing or large babies (birth weight over 4kg) are at greater
risk of pelvic floor muscle damage. If you're trying to get
fit after the birth
of your baby, don't do straight-leg sit-ups and double-leg lifts. These put
severe pressure on your pelvic floor and your back.
Straining to pass stools - Chronic or
repeated straining on the toilet (associated with
lead to pelvic floor weakness and/or prolapse of the organs into the vagina or
to a rectal prolapse (the rectal lining protrudes from the anus). It is
important to teach the underlying bowel problem and good toileting habits.
Chronic coughs and sneezing- Chronic
coughing for any reason (for example,
asthma, bronchitis or
a smoker's cough) increases the risk of urinary incontinence and prolapse.
Being overweight- Being
overweight increases the
risk of leaking urine and may place greater strain on the pelvic floor.
Heavy lifting- Heavy lifting can
create pressure on the pelvic floor and ultimately lead to prolapse. Women in
certain professions such as nursing or courier services are at particular
risk. Women performing heavy
at a gym can also be at risk of straining the pelvic floor.
High impact exercise Women involved in
high impact sports such as basketball, netball or
running are at
increased risk of leaking urine. This applies to elite athletes as well.
Age Pelvic floor muscles tend to get
weaker with increasing age. Pelvic floor muscle exercises can help strengthen
them at any age.
Strong pelvic floor muscles
can help you to:
reduced risk of
'sagging' of internal organs)
Support the baby during
prepare for, and recover
and orgasmic potential; and
increased social confidence and quality
Help to stabilise and support the spine
Identifying the Pelvic Floor muscles
First try to find your pelvic floor muscles, by one of these ways:
Try to tighten your muscles around your vagina and back passage and lift
up, as if you're stopping yourself passing water and wind at the same time.
A quick way of finding the right muscles is by trying to stop the flow of
urine when you're in the toilet. Don't do this regularly because you may start
retaining urine. Once you've found the muscles, make sure you
relax and empty your bladder
If you're not sure you are exercising the right muscles, put a couple of
fingers into your vagina. You should feel a gentle squeeze when doing the
Why should I do pelvic floor muscle
The reproductive system lies with in the lower part of the abdomen and is
protected by the bony pelvic girdle. This area needs to be open and relaxed so
that energy can circulate freely through the reproductive system and conception
is unhindered. Regular movement of the pelvis brings energy,
strength to this area.
Besides, regular pelvic floor muscle exercises make the muscles that support
your pelvic organs stronger and helps you use the muscles more effectively.
Women who have a problem with urine leakage have been able to eliminate or
greatly improve this problem just by doing pelvic floor muscle exercises each
Pregnant and postpartum women who do pelvic floor muscle exercises have
significantly less urine leakage.
Exercises to work the pelvic floor
A helpful stretch to loosen you inner thighs is called the
butterfly stretch. You may be familiar with this but you should know how to do
it correctly. Sit on the floor on your butt. Stretch your legs straight out
and then bring your feet in towards your pelvis. Put the bottoms of your feet
together and pull them into your body. You can also lean over to feel a more
Another stretch is the side split. Stand up with your feet
slightly farther out to the sides. Slowly push each of them farther away from
your body. Go down as far as you can to the floor. Hold your lowest position
for a count of ten. After that, it is easier to just fall onto your butt and
then get up.
This stretch is called the Eye Of The Needle stretch. You
will feel a pull in your outer
buttocks. Lie down on your back and putt both
of your feet in the air. Put one of your legs on top of the other's thigh.
Keep the straight leg high in the air. Now grab the back on your straight leg
and pull it into your body. Repeat this with both legs.
Pelvic stretch-Sit on
the edge of a sturdy chair with feet apart and set firmly on the floor. Place
your hands on your thighs above your knees, with fingers turned in and elbows
turned out. Lean forward, bend your elbows and take your upper body weight on
your thighs. This frees the pelvis-think of it as a bowl and tip it forward at
the front "rim" (the pubic bone) and up at the back "rim" (where the sacrum
joins the spine). Open the front of the body by spreading your arms with palms
up, lifting your chest and tucking your pelvis under so that the front pelvic
"rim" rises and the back "rim" is lowered. This movement stretches the spine
and releases tension. It also tightens the lower abdominal muscles that hold
the pelvis in place. Repeat these two movements several times and practice
frequently in order to increase mobility in the pelvic area.
The most well-known pelvic
floor exercises are the
Kegels. Squeeze and draw in the muscles around
your back passage, vagina and front passage and lift up inside as if trying to
stop passing wind and urine at the same time. Try to hold the muscles strong
and tight as you count to 8. Now let them go and relax. You should have a
distinct feeling of letting go. Repeat the "Squeze, Lift and Hold" movement
and let go It is best to rest in between each lift up of the muscles. If you
can't hold for a count of 8, just hold for as long as you can. Repeat this
"Squeeze, Lift and Hold" contraction as many time as you can, up to a limit of
8-12 contractions. Try to do three sets of 8 to 12 squeezes each, with a rest
The pros of pelvic floor exercises
You can do them when sitting, standing or lying down.
You don't need any special equipment.
You can do them with or without vaginal cones.
The downside of pelvic floor exercises
You have to keep doing them for the rest of your life.
It can take up to 15 weeks before you see any difference.
If you haven't noticed a difference after three months, see your
continence adviser again to check whether you're doing them correctly or if
there's another problem.
Important Tips for pelvic floor muscle exercises
Each contraction should involve a concentrated effort to get maximum
tightening. To strengthen your pelvic floor muscles, sit comfortably and
squeeze the muscles 10-15 times in a row.
Try to contract only the pelvic muscles. (If you feel your abdomen,
thighs or buttocks tightening then relax and aim just for the pelvic muscles
by using a less intense muscle contraction. If it seems impossible not to
tighten the abdomen, thigh, or buttock muscles, then concentrate on full
relaxation and try gentle flicks? of the pelvic muscles, working the muscles to higher layers with each flick.)
Be sure to breathe while holding the
When you get used to doing pelvic floor exercises, you can try holding each
squeeze for a few seconds. Every week, you can add more squeezes, but be careful
not to overdo it, and always have a rest in between sets of squeezes.
Practice fully relaxing the muscle for at least 10 seconds between each
Experiment with contracting the muscles in many different positions
(standing upright, lying, sitting, on hands and knees, feet together, feet
Do not forget to, record your progress. You might want to keep a daily diary of whether or
not you have had a leaking accident. Over the weeks you should begin to see a
decrease in the frequency and amount of unwanted urine loss. Another way to
check your progress is to see whether or not you can slow or stop your urine
stream when you are going to the bathroom. We recommend that you try this no
more than once a week. As your pelvic muscles get stronger you will find that
you are able to stop the stream more quickly.
Dated 21 February 2014