Pelvic floor muscle training for women

Your doctor has recommended pelvic floor muscle training. Pelvic floor muscle training can help with urinary incontinence (leaking urine) and pelvic organ prolapse (when the bladder, bowel or uterus drops down into the vagina).

What are pelvic floor muscles?

• Your pelvic floor is a group of muscles that form the base of the “core” muscles. These muscles are in the pelvis and stretch like a hammock from the front to the back of your pelvis and from side to side of the bones we sit on.
• The pelvic floor muscles support the bladder, bowel and uterus and have an important role in bladder and bowel control, and in sexual function.
• Urine leakage (incontinence) can happen when you have weak pelvic floor muscles or when you do not “switch on” (squeeze) your pelvic floor muscles in time.
• Urine leakage tends to happen when you cough or lift something because this increases pressure in your tummy. You need to use your pelvic floor muscles to close the urethra (tube that removes urine from the bladder) to stop urine from leaking out of your bladder.

How can pelvic floor muscle training help?

• Pelvic floor muscle training is an exercise program to improve your pelvic floor muscle strength, endurance, power, relaxation, co-ordination or a combination of these.
• In pelvic floor muscle training, you learn how to “switch on” your pelvic floor muscles to close the urethra before doing things such as coughing or lifting.

How to do pelvic floor exercises

Step 1: Find your pelvic floor muscles

Watch this video to see where the pelvic floor is, what happens when you switch these muscles on and why it is important to train them:

Now, have a go at finding your pelvic floor muscles.

• Sit or lie down with the muscles of your thighs, buttocks and tummy relaxed.
• Squeeze the muscles around the front passage as if you are trying to stop yourself from going to the toilet. Breathe normally. Now relax this muscle so that you feel like you are letting go.
• Squeeze the ring of muscle around your back passage as if you are trying to stop passing wind. Breathe normally. Now let go and relax this muscle.
• Squeeze and let go a couple of times to be sure you have found the right muscles. You should feel these muscles around the front and back passage “squeeze and lift up” inside your pelvis.
• If you cannot feel your pelvic floor muscles squeezing, then try and change position e.g. seated, lying down or standing up.
• Remember, do not squeeze your thighs, buttocks or tummy or hold your breath. These muscles must stay relaxed and you need to be able to breathe whilst doing these exercises.

For other methods to find your pelvic floor muscles visit: Pelvic Floor First website

Step 2: Exercise your pelvic floor muscles

Once you can do step 1 and can switch your pelvic floor muscles on and off correctly, you can begin to exercise.

Start: Start practising this exercise while lying down or sitting. As you get used to the exercise, you can move to more upright positions e.g. standing or during activity.

Exercise: Squeeze and lift up your pelvic floor muscles and try to hold on for 6-8 seconds. Then, relax and feel these muscles let go. Rest for a few seconds. If you cannot hold for 8 seconds, then just hold as long as you can and try to increase it over time. Each time you switch the muscles on, you should squeeze as hard as you can while making sure your thigh, buttocks and tummy stay relaxed. Make sure you can breathe easily while you squeeze.

Repetitions: Repeat this exercise 8-12 times. You have now completed one set of exercises.

Do this exercise set 1-3 times a day.

Videos:

Pelvic floor exercise demonstrated by a women’s, men’s and pelvic floor health physiotherapist Videos

As your pelvic floor gets stronger you can make the exercise more difficult by:

• Increasing the time you hold the squeeze
• Increasing the number of times you switch the muscle on
• Reducing the rest periods
• Adding these squeezes to other exercises such as squats

What to look out for

• The exercises may not help if they are not done correctly or done too few times to benefit.
• The pelvic floor muscles are like other muscles in the body: they become stronger the more you exercise. Try and do these exercises every day. It can help to find a time to practise these exercises as part of your normal routine e.g. during the drive to work, watching evening TV show, or when standing in the shower.
• Try and “switch on” your pelvic floor before and during sneezing, coughing or lifting.
• You can try pelvic floor muscle exercises on your own. However, you may get more benefit from seeing a physiotherapist with expertise in this area who can guide and help you with pelvic floor exercises. A physiotherapist will likely begin by conducting a thorough assessment, including examination of your pelvic floor muscles. The physiotherapist may also use an ultrasound sensor to look at your pelvic floor muscles and ensure you are using the correct technique. You will also be able to see these muscles on the screen, working in real time, which can help when you cannot otherwise see them.
• Pelvic floor muscle training is considered safe. Talk with your doctor or physiotherapist if there is no change in your symptoms after 3 months of starting these exercises.