Pelvic Floor Exercises
The floor of the pelvis is made up of layers of muscles and other tissues. These layers stretch like a hammock from the tailbone at the back to the pubic bone in front. A woman’s pelvic floor supports the bladder, the womb (uterus) and the bowel. The urethra (front passage), the vagina (birth canal) and the rectum (back passage) pass through the pelvic floor muscles. The pelvic muscles play an important role in bladder and bowel control and sexual sensation.
Reasons why the pelvic floor muscles may weaken include:
Pregnancy and childbirth in women
Continual straining to empty your bowels (constipation)
Persistent heavy lifting
A chronic cough (such as smokers cough, chronic bronchitis and asthma)
Being overweight
Changes in hormone levels at menopause
Lack of general fitness
It is important for women of all ages to maintain pelvic floor strength. Women with stress incontinence, that is, those who regularly lose urine when coughing, sneezing or exercising should benefit from these exercises. For pregnant women these exercises help the body to cope with the increasing weight of the baby. Healthy, fit muscles prenatally will recover more readily after the birth.
As women grow older it is important to keep the pelvic floor muscles strong because during and after menopause the muscles change and may weaken. A pelvic floor exercise routine helps to minimise the effects of menopause on pelvic support and bladder control. Pelvic floor exercise may also be useful in conjunction with a bladder training program aimed at improving bladder control in people who experience the urgent need to pass urine frequently (urge incontinence).
How to contract the pelvic floor muscles
The first thing to do is correctly identify the muscles that need to be exercised.
Sit or lay down comfortably with the muscles of your thighs, buttocks and abdomen relaxed
Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea or wind. Relax it. Practice this movement several times until you are sure you are exercising the correct muscle. Try not to squeeze your buttocks.
When you are passing urine, try to stop the flow mid-stream then restart it. Only do this to learn which muscles are the correct ones to use and then do it no more than once a week to check your progress as this may interfere with normal bladder emptying.
If you are unable to feel a definite squeeze and lift action of your pelvic floor muscles or are unable to even slow the stream of urine as described above, you should seek professional help to get your pelvic floor muscles working correctly. Even women with very weak pelvic floor muscles can be taught these exercises by a physiotherapist or continence advisor with experience in this area.
Good results take time. In order to build up your pelvic floor muscles to their maximum strength, you will need to work hard at these exercises. The best results are achieved by seeking help from a physiotherapist or continence advisor who will design an individual exercise program especially suited to your muscles.
There are many health professionals qualified to assist you with bladder control problems. You may seek assistance from your doctor who may offer treatment directly or refer you to a specialist or to a qualified continence advisor. You may also seek help and obtain information directly from the following sources:
Continence Foundation of Australia helpline 1800 330 066
Continence services and clinics
Continence nurse advisors
Local community health centres
Local doctors
Domiciliary nursing services
Independent living centres
Australian Physiotherapy Association
All text (only) herein is the intellectual property of Dr Melissa White. Update July 2014.