Pelvic floor exercises help to strengthen the muscles of the pelvic floor, which come under great strain in pregnancy and childbirth. The pelvic floor consists of layers of muscles that stretch like a supportive hammock from the pubic bone (in front) to the end of the backbone.
If the pelvic floor muscles are weak, you may find that you leak urine when you cough, sneeze or strain. This is quite common and you needn’t feel embarrassed. It's known as stress incontinence and it can occur during or after pregnancy. It may also occur at other times – see our section on urinary incontinence.
By performing pelvic floor exercises, you can strengthen the muscles. This helps to reduce or avoid stress incontinence.
Ruth Hawkes of the Association of Chartered Physiotherapists in Women’s Health (ACPWH) answers questions and shows just how helpful they can be in preventing and managing incontinence and prolapse.
Why are pelvic floor muscle exercises so important?
The pelvic floor muscles are arranged in the bottom of the pelvis and form a sling that supports your pelvic organs (bladder, uterus and bowel). They play a vital part in preventing bladder and bowel incontinence. They also play a part in sexual function and are important during pregnancy and childbirth. Some of the physical challenges women face during their lifetime can leave the pelvic floor muscles weak and unable to function properly – pregnancy is a great example. Whilst it is never too late to restore strength there is no doubt that prevention is better than cure.
If I haven’t had children do I really need to exercise my pelvic floor muscles?
Yes you do! There is no doubt that pregnancy and childbirth can play a part in weakening pelvic floor muscles even if your baby is delivered by caesarean section. Research has also shown that even ladies who have not had children can still be susceptible to pelvic floor weakness. This is usually due to the combination of the reduction in oestrogen during and after the menopause and the ageing process. Being overweight or constipated also does not help and the muscles can be affected by external influences such as smoking.
How do I start to exercise the muscles?
It is important to make sure that you are using the right group of muscles and contracting them in the right way. It often helps to be lying down or sitting when you first try to do the exercises and you need to breathe normally.
Imagine that you are trying to stop yourself passing urine and at the same time trying to stop yourself passing wind. The muscles should feel as though they ‘lift and squeeze’ at the same time. The buttock and thigh muscles should remain relaxed but a gentle tightening in the lower part of your tummy muscles is quite normal.
Is there a programme I should do?
You need to practise long and short squeezes.
Tighten your pelvic floor muscles and hold for several seconds and then relax for the same length of time. Make a note of how long you managed to hold the contraction (usually up to 10 seconds is a good starting point).
Repeat until the muscles feel tired. Make a note of how many repeats you were able to manage.
Tighten your pelvic floor muscles for a second and then relax. Repeat until the muscles feel tired. Make a note of how many short squeezes you were able to do. You should try to do your pelvic floor exercises at least three times a day. Most women eventually aim to do 10 long squeezes followed by 10 short squeezes but you need to start with what you feel suits you and gradually increase the number of repeats and the length of the hold over a few weeks. It can take 3-5 months before you notice an improvement.
What if I can’t feel my muscles working or they feel weak when I try to exercise them?
This is a very common problem and because it is so difficult to contract the muscle you can become disheartened. There is a combination of healthcare professionals who can help you. A women’s health physiotherapist will be able to show you how to perform the exercises effectively if you need additional help.
Chartered Physiotherapists in Women’s Health are a specially trained group of physiotherapists who will be able to assess and examine your pelvic floor muscles and use techniques to help you contract your pelvic floor muscles effectively. They will also give you a tailor made treatment programme and help you restore strength and function to this vital muscle group. They will regularly see you and review your progress which will help you to remain motivated so that you can achieve the best results possible. You can find out more and access useful information leaflets at http://acpwh.csp.org.uk/
To find out about our research follow these links:
Multi centre trial- testing pelvic floor exercises in preventing prolapse.
Investigating pelvic floor exercises and other treatments to help prolapse.
Page last updated March 2013