YOUR ULTIMATE GUIDE TO PELVIC FLOOR EXERCISES
Physiotherapists, doctors and nurses know that exercising the pelvic floor muscles can help you to improve your bladder control. When done correctly, these exercises can build up and strengthen these muscles and help you to control your bladder and bowel.
What is the pelvic floor?
The pelvic floor consists of layers of muscle and ligaments that stretch from the pubic bone to the end of the backbone (coccyx) and from side to side. Firm, supportive pelvic floor muscles help support the bladder, womb and bowel, 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 and wind 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. The muscles actively squeeze when you laugh, cough, lift or sneeze to help prevent any leakage. They also have an important sexual function, helping to increase sexual awareness for both yourself and your partner during intercourse.
How can exercising the pelvic floor muscles help?
Exercising the pelvic floor muscles can strengthen them so they give the correct support. This will improve your bladder control and improve or stop the 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. Finding your pelvic floor muscles It is not always easy to find your pelvic floor muscles. Exercising them should not show at all ‘on the outside’. You should not pull in your tummy excessively, squeeze your legs together, tighten your buttocks or hold your breath!
Finding your pelvic floor muscle:
1. Sit comfortably with your knees slightly apart. Now imagine that you are trying to stop yourself from passing wind from the bowel. To do this you must squeeze the muscles 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 squeezing and lifting.
2. Now imagine you are sitting on the toilet passing urine. Picture yourself trying to stop the stream of urine. You should be using the same group of muscles that you used before, but don’t be surprised if you find this harder. (Do not try to stop the stream when you are actually passing water as this may – if repeated – cause problems with correct emptying).
3. Now try to tighten 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. It is very easy to bring other incorrect muscles into play, so try to isolate your pelvic floor as much as possible by not squeezing your legs together, not tightening your buttocks and not holding your breath. The lower tummy can very gently be drawn in as if pulling away from the zip of tight trousers. In this way, most of the effort should be coming from the pelvic floor muscles.
Practising your exercises
Now you can find your pelvic floor muscles, here are the exercises to do:
1. Your pelvic floor muscles need to have stamina. So sit, stand or lie with your knees slightly apart. Slowly tighten and pull up the pelvic floor muscles as hard as you can. Try lifting and squeezing them as long as you can. Rest for 4 seconds and then repeat the contraction. Build up your strength until you can do 10 slow contractions at a time, holding them for 10 seconds each with rests of 4 seconds in between.
2. Your pelvic floor muscles also need to react quickly to sudden stresses from coughing, laughing or exercise that puts pressure on the bladder. So practise some quick contractions, drawing in the pelvic floor and holding it for just one second before relaxing. Try to achieve a strong muscle tightening with up to ten quick contractions in succession. Aim to do a set of slow contractions (exercise 1) followed by a set of quick contractions (exercise 2) 3-4 times each day. It takes time for exercise to make muscles stronger. You are unlikely to notice any improvement for several weeks – so stick at it! You will need to exercise regularly for at least 3 months before the muscles gain their full strength.
Tips to help you
1. Get into the habit of doing your exercises during normal day-to-day activities. For example, whilst cleaning your teeth or waiting for a kettle to boil.
2. If you’re unsure that you’re exercising the right muscles, put your thumb into the vagina and try the exercises to check. You should feel a gentle squeeze as the pelvic floor muscle contracts.
3. Tighten your pelvic floor muscles when you feel you might be about to leak – pull up the muscles before you cough, laugh, sneeze or lift anything heavy. Your control will gradually improve.
4. Drink normally – about 6-8 large glasses of fluid a day, avoiding caffeine if you can. Water is best! And don’t get into the habit of going to the toilet ‘just in case’. Go only when you feel your bladder is full.
5. Watch your weight – extra weight puts extra strain on your pelvic floor muscles.
6. Once you have regained control of your bladder, don’t forget your pelvic floor muscles. Continue to do your pelvic floor exercises a few times each day to ensure that the problem does not come back. Remember: you can exercise your pelvic floor muscles wherever you are – nobody will know what you are doing!
Treating Urinary Incontinence
Pelvic floor exercises are a gradual process to repair the pelvic floor muscle and can take some time especially if the leaks are very frequent and uncontrollable. If you’re suffering from regular leaks then BTL Emsella is a breakthrough pelvic floor training therapy which delivers the equivalent of 11,000 pelvic exercises in less than 30 minutes and has a 95% percent patient satisfaction rating.
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