The floor of the pelvis consists of layers of muscle and other tissues. These layers stretch like a hammock or sling from the tailbone to the back to the pubic bone in front. The pelvic floor muscles support the bladder and bowel (and uterus in a woman).
Pelvic floor exercises strengthen the pelvic floor muscles. As with any muscle, regular exercise can make these muscles stronger and thereby help you prevent or control urinary incontinence and other pelvic floor problems.
You can do pelvic exercises discreetly just about anytime, whether you’re driving in the car, sitting at your desk or relaxing on the couch. However, they do take practise. The first step in performing pelvic floor muscle exercises is to identify the correct muscles.
Finding the muscles
- Sit comfortably on an upright chair, knees apart and pelvis in neutral. (Keeping the natural curve in your lower spine). The buttocks should stay relaxed
- Squeeze the ring of muscle around the back passage as if you are trying to stop passing wind.
- For women, imagine your vagina is like a lift; closing its doors by bringing the two sides together and then lifting up through the floors and back down again.
- For men, stand sideways in front of a mirror (with no clothes on). As you pull in your pelvic floor muscles strongly and hold them, you should see your penis draw in and your scrotum lift up.5
- A common mistake is to use your in breath to try to lift up your muscles. So, start by breathing in normally, then as you breathe out, lift up the pelvic floor muscles and hold them while you continue to breathe. Let them relax totally between squeezes.
- You can try the stop test. You can feel your pelvic floor muscles if you try to stop the flow of urine, however, it is not recommended that you regularly stop your flow of urine midstream as this can be harmful to the bladder.
Once you have mastered finding the muscles, you can start to control and strengthen them. If you are holding your breath or tightening your buttocks, then you are trying too hard. Repeat lifting the muscle more gently.
Strengthening the muscles
- Lift up the pelvic floor muscle, add a squeeze and squeeze again. This will provide strength by working the muscle hard.
- Release completely between lifts.
Aim for 10 squeezes lasting 6-8 seconds. Then aim for 3 sets of 10.
You can also add fast squeezes to your exercise programme. Squeeze the muscles as hard and fast as you can and let go immediately. Repeat 10 times
Progressing the programme
- Do these 1-3 times per day. Work the muscles until they are tired. It is more effective than doing them little and often.
- Start in a sitting position and once you have mastered this, progress to doing them in a standing position.
- To control bladder urgency, you may need to hold the squeeze for up to 20 seconds.
Learn how to control the urgency
As soon as the urge starts, stay still and take a few deep breaths. Squeeze the muscle as hard as you can and keep squeezing until the urge begins to fade.
Remember to: Freeze Breathe Squeeze
Then once you have the control, hold the muscles gently while walking to the toilet. Squeeze hard again when undressing. You should practise using the muscles to control the bladder every time you go to the toilet so that the muscles get used to controlling the bladder again.
This information should be used as a guide only. If you are having difficulty finding your pelvic floor muscles, a specialist physiotherapist can help teach you which muscles to use, measure your muscle strength and offer biofeedback therapy.
Pelvic Floor Exercises
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