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.11
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.
Fast squeezes
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.
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