Pelvic Floor Exercises

Source: The Continence Foundation, UK

Introduction

Physiotherapists, doctors and nurses know that pelvic floor exercises can help you to improve your bladder control. When done correctly, pelvic floor exercises can build up and strengthen the muscles to help you to hold urine.

What is the pelvic floor?

Layers of muscle stretch like a hammock from the public bone in front to the bottom of the backbone. These firm supportive muscles are called the pelvic floor. They help to hold the bladder, womb and bowel in place, and to close the bladder outlet and back passage.

How does the pelvic floor work?

The muscles of the pelvic floor are kept firm and slightly tense to stop leakage of urine from the bladder or faeces from the bowel. When you pass water or have a bowel motion the pelvic floor muscles relax. Afterwards, they tighten again to restore control.

Pelvic floor muscles can become weak and sag because of childbirth, lack of exercise, the change of life or just getting older. Weak muscles give you less control, and you may leak urine, especially with exercise or when you cough, sneeze or laugh.

How can pelvic floor exercises help?

Pelvic floor exercises can strengthen these muscles so that they once again give support. This will improve your bladder control and improve or stop leakage of urine. Like any other muscles in the body, the more you use and exercise them, the stronger the pelvic floor muscles will be.

Learning to do pelvic floor exercises

It is important to train to do the exercises in the right way, and to check from time to time that you are still doing them correctly.

Sit comfortably with your knees slightly apart. Now imagine that you are trying to stop yourself passing wind from the bowel. To do this you must squeeze the muscle around the back passage. Try squeezing and lifting that muscle as if you really do have wind. You should be able to feel the muscle move. Your buttocks and legs should not move at all. You should be aware of the skin around the back passage tightening and being pulled up and away from your chair. Really try to feel this.
Now imagine that you are sitting on the toilet passing urine. Picture yourself trying to stop the steam of urine. Try doing that now as you are reading this. You should be using the same group of muscles that you used before, but don’t be surprised if you find this harder than Exercise 1.
Next time you go to the toilet to pass urine, try the ‘stop test’ about half way though emptying your bladder. Once you have stopped the flow of urine, relax again and allow the bladder to empty completely. You may only be able to slow down the stream. Don’t worry; your muscles will improve and strengthen with time and exercise. If the stream of urine speeds up when you try to do this exercise, you are squeezing the wrong muscles

Do not get into the habit of doing the ‘stop test’ every time you pass urine. This exercise should be done only once a day at the most.

Now you know what it feels like to exercise the pelvic floor!

Practising your exercises

Sit, stand or lie with your knees, slightly apart. Slowly tighten and pull up the pelvic floor muscles as hard as you can. Hold tightened for at least 5 seconds if you can, then relax. Repeat at least 5 times (slow pull-ups).
Now pull the muscles up quickly and tightly, then relax immediately. Repeat at least 5 times (fast pull-ups).
Do the two exercises — 5 slow and 5 fast — at least 10 times every day.
As the muscles get stronger, you will find that you can hold for longer than 5 seconds, and that you can do more than 5 pull-ups each time without the muscle getting tired.
It takes time for exercise to make muscles stronger. You are unlikely to notice improvement for several weeks — so stick at it! You will need to exercise regularly for several months before the muscles gain their full strength.

Tips to help you

Get into the habit of doing your exercises with things you do regularly — every time you touch water if you are at home, every time you answer the phone if you are at the office… whatever you to often.
Do the ‘stop test’ once a day when passing urine. Stopping your urine should get faster and easier.
If you are unsure that you are exercising the right muscle, put one or two fingers in the vagina and try the exercises, to check. You should feel a gentle squeeze if you are exercising the pelvic floor.
Use the pelvic floor when you are afraid you might leak — pull up the muscles before you sneeze or lift something heavy. You control will gradually improve.
Drink normally — at least 6-8 cups every day. And don’t get into the habit of going to the toilet ‘just in case’. Go only when you feel that the bladder is full. Watch your weight — extra weight puts extra strain on your pelvic floor muscles. Once you have regained control of your bladder, don’t forget your pelvic floor. Continue to do your pelvic floor exercises a few times each day to ensure that the problem does not come back.

You can do pelvic floor exercises wherever you are. Nobody need know what you are doing!

Do you have any questions?

This information is designed to teach you how to control your bladder, so that you’ll be dry and comfortable. If you have problems doing the exercises, or if you don’t understand any part of this information, ask your doctor, nurse, continence advisor or physiotherapist for help.

Do your pelvic exercises every single day. Have faith in them. You should begin to see good results in a few weeks.