How to strengthen your pelvic floor muscles and get the most from your pelvic floor exercises
What is the pelvic floor?
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.
View an anatomical image of the female pelvic floor.
What does the pelvic floor do?
. It supports your pelvic organs and the contents of your abdomen, especially when you are standing or exerting yourself.
. It supports your bladder to help it stay closed. It actively squeezes when you cough or sneeze to help avoid leaking.
. It is used to control wind and when "holding on" with your bowels.
. It helps to increase sexual awareness both for yourself and your partner during sexual intercourse.
What weakens the pelvic floor muscles?
Pelvic floor muscles weaken for similar reasons to other muscles in our bodies: natural ageing and inactivity. But pelvic floor muscles are also often weakened through hormonal changes in women's bodies, and through pregnancy and childbirth. Factors such as being overweight, ongoing constipation and a chronic cough can put extra pressure on the pelvic floor and pelvic surgery can also have damaging effects, particularly in men.
Weak pelvic floor muscles are very common. A new US study shows that 25% of women suffer from moderate to severe pelvic floor muscle weakness, with the figure rising to 30% or more of obese and older women. (Nygaard and others, 2008).
Why do I need to do pelvic floor exercises?
A poorly toned, weak pelvic floor will not do its job properly. Women with weak pelvic floor muscles frequently experience incontinence and reduced sexual response. But research has shown that the pelvic floor responds to regular exercise. With regular exercise, it is possible for most women to reduce or completely overcome the symptoms of weak pelvic floor muscles, no matter what their age.
A regime of pelvic floor exercises, introduced earlier in life, will also prevent many of the problems associated with weak pelvic floor muscles emerging later. It is never too early or too late to begin to exercise the pelvic floor.
Research has also shown that pelvic floor exercise can provide relief from chronic pelvic pain syndrome.
A woman with already badly weakened pelvic floor muscles may need the advice of a women's health physiotherapist or other health professional before embarking on an exercise program, but many women with mild symptoms prefer to try a simple exercise program for themselves initially.
Pelvic floor exercises are often also called Kegel exercises, after their originator, Dr Arnold Kegel and are widely promoted as the starting point for building pelvic floor strength. Any woman can try these exercises for herself. Be aware that if they are not done correctly, they can aggravate a problem.
Follow the instructions below, but seek the advice of a health professional, such as your gp or a women's health physiotherapist, if you have doubts about your ability to do the exercises correctly.
Alternatively, consider using a simple device such as the Pelvic Floor Educator, to teach yourself the correct exercise technique.
Read more about why pelvic floor exercises are so important.
How to do unassisted pelvic floor exercises
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 in between.
Do this whole training plan (three sets of 8 to 12 squeezes) each day while lying down, sitting or standing. Try to vary the positions you use so that your muscles get used to working in different situations.
The ability to work these muscles quickly helps them react to sudden stresses from coughing, laughing or exercise. Practise some quick contractions, drawing in the pelvic floor and holding for just one second before releasing the muscles. Do these steadily, aiming for a strong muscle tightening with each contraction up to a maximum of 10 times. Repeat a set of quick contractions after each three sets of Squeeze Lift and Hold contractions in Exercise 1.
When you do your pelvic floor contractions, you may sense a gentle drawing in of the lower abdominal area (not all women will sense this, so don't worry if you don't). This is desirable muscle activity as these deep lower abdominal muscles can also work with the pelvic floor muscles. However, you should not strongly and intentionally draw in your general abdominal area while you contract your pelvic floor muscles.
f you do pelvic floor exercises regularly, you will see optimum results within 3 to 6 months, but you should continue them for life to fully protect your pelvic floor.
Leaflets on pelvic floor exercises are available for free from many sources including the National Continence Helpline on 1800 33 00 66.
How to achieve better results with your pelvic floor exercises
There is a growing amount of research showing many women achieve better results when they use pelvic floor exercise devices to assist them in doing pelvic floor exercises.
Dr Kegel, the originator of the kegel exercise program, never intended his exercises to be conducted on an empty vagina. He developed an exercising product similar to the perineometers (eg PFX2 and PX-IQ) in use today. Somewhere along the line, his message has been lost and for many years women have been encouraged to try unassisted exercising.
For many women, this presents difficulties and they may be able to achieve better results with the assistance of a pelvic floor exercise or strengthening device. Read more about the value of using a pelvic floor exercise or strengthening device.
Many good pelvic floor exercisers have been available for sometime but are often hard to track down, particularly for women who want to exercise independently at home. Pelvic Floor Exercise brings together a range of the best devices available on the Australian market, to make choosing and buying easier. Browse through our unique product range.
Why are women sometimes unsuccessful in strengthening their pelvic floor?
Often because they don't exercise often enough, and for long enough. Women report that they don't remember, they find it hard to fit exercises into daily life, they feel uncertain about whether the exercises are working and whether they are doing them correctly, particularly in the early stages.
Read more about the reasons women give for not exercising the pelvic floor muscles.
The use of devices can help address some of these problems and encourage women to continue their pelvic floor fitness and strengthening regimes.
Most importantly many women find that using a pelvic floor exercise device produces better results than unassisted exercising, so they are encouraged to keep going.
Maintaining your own motivation is half the battle with home-based exercising. Women drop out of assisted pelvic floor exercise programs that require clinic attendance because it's just too hard to keep appointments (MacInnes 2008), but home-based exercising can be done at any time that suits you. Exercise devices help to maintain that all-important motivation.
Read more about the value of using a pelvic floor exercise device to increase pelvic floor fitness and strength.
Browse through our unique product range.