The muscles of the pelvic floor play a crucial role in the stability of the torso, due to there connections and association in spinal movement.
The balance of these muscles is necessary for dynamic stability, i.e., strong and elastic muscles which support us to move freely, climb stairs, change direction easily, pick up loads, sneeze and laugh without worry.
What is your pelvic floor and where is it?
The pelvic floor is a sheet of muscles that extend from the tailbone (coccyx) to the pubic bone at the front, forming a ‘platform’ between the legs.
It provides the floor to the pelvis (the bottom part of the abdomen) supporting its contents; the bladder, uterus and rectum.
It also controls the openings of these organs, which pass through it:
- the urethra – the tube which you pass urine through
- the vagina – birth canal, and important during intercourse
- the anus – back passage, through which you open your bowels.
Sometimes the pelvic floor can become imbalanced, either weak in some parts or too strong or tight in others. If this happens women may experience a range of symptoms including:
- An aching or dragging sensation in their vagina.
- A feeling of something coming down inside the vagina, which may be due to a prolapse. This is where one or more of the organs in the pelvis, such as the uterus or vagina drop down from their normal position.
- A tendency to leak urine when coughing, laughing or sneezing, this is called stress urinary incontinence.
- Need to go to the toilet frequently (referred to as frequency) during the day or night.
- An urgent need to visit the toilet and to leak before you get there or if you don’t go (urge incontinence).
- An inability to control the passing of gas from the back passage.
Who should do pelvic floor exercises?
All women need to do pelvic floor exercises throughout their lives; muscles may become weak:
- following childbirth
- through a lack of exercise
- as a result of the menopause
- following pelvic surgery, for example, a hysterectomy, or bladder repair
- by straining to open your bowels
- by being overweight
- Due to having a chronic cough or being asthmatic.
Pelvic floor exercises can help strengthen or restore balance to these muscles. This may improve bladder and bowel control and improve or stop any leakage.
Pelvic floor exercises are sometimes called pelvic floor muscle training (PFMT) and also called Kegel exercises after the obstetrician who developed them.
Identifying the muscles
First, you need to find your pelvic floor muscles.
Try to tighten your muscles around your vagina and back passage and lift up, as if you are stopping yourself passing water and gas at the same time.
* A quick way of finding the right muscles is by trying to stop the flow of urine when you are in the toilet. Don’t do this regularly because you may retain urine
Pelvic floor awareness exercise
Although with practice, pelvic floor exercises can be performed anywhere and anytime, it is usually easier to learn the exercises in the following positions:
- Lying on your back with your knees bent, make sure that your feet are flat on the floor and your legs are slightly apart.
- Sitting; on a chair, toilet seat or toilet lid. Make sure that your feet are flat on the floor and your legs are slightly apart.
- Relax the muscles of your thighs, bottom and tummy.
- Squeeze in the muscles around the front passage as if trying to stop the flow of urine.
- Squeeze in the muscles around the vagina and suck upwards inside the pelvis.
- Squeeze in the muscles around the back passage as if trying to stop passing wind.
- The muscles around the front and back passages should squeeze up and inside the pelvis.
- Women who are familiar with using tampons can imagine squeezing in the vagina as if squeezing a tampon up higher in the vagina.
- Identify the muscles that contract when you do all these things together. Then relax and loosen them.
Once you’ve found the muscles, make sure you relax and empty your bladder completely. If you’re not certain, you are exercising the right muscles, put a couple of fingers into your vagina. You should feel a gentle squeeze when doing the exercise.
Fast and slow contractions
You need to train your pelvic floor muscles through repetition, in the same way as you would train a muscle group at the gym. There are two types of exercises – slow twitch and fast twitch. It is important that you do the slow twitch first and then the fast twitch each time you train your pelvic floor muscles.
Contracting the muscles correctly.
The movement is an upward and inward contraction, not a bearing-down effort. When you first start the exercises, check that you are doing them correctly, put your hands on your buttocks to make sure they stay relaxed and if your abdomen is moving it is going downwards (towards the floor if lying down,)
Help to increase the strength of your pelvic floor; they help your muscles to hold back the urine.
- Lift your pelvic floor muscles to a count of 5. Hold the muscles tight for 5 -10 seconds.
- You may find at first that you can only hold the contraction for 1- 2 seconds, which is fine, gradually increase the time until you reach 10 seconds.
- Relax your muscles completely and rest for 10 seconds.
- *Repeat 5 – 10 times, 2 x daily.
Fast contractions help your pelvic floor to cope with pressure, for example when you sneeze, cough or laugh. This works the muscles that quickly shut off the flow of urine.
- Lift your pelvic floor muscles quickly.
- Hold the contraction for one second.
- Relax the muscles and rest for one second.
- Repeat the contractions 10 times, 2 x daily.
Pelvic floor exercises are safe and effective if performed correctly but may not correct all pelvic floor problems; it is, therefore, prudent to seek advice and get a diagnosis from a health professional before beginning any new physical exercise or rehabilitation programme. While you are working without the guidance of a teacher/therapist home exercise is your responsibility, please discontinue any exercise if you feel discomfort and seek advice.
Please note: This is for guidance only, it should not be regarded as a substitute for medical advice, diagnosis or treatment given in person by an appropriately trained health professional