Pelvic Floor Exercises – Dos and Don’ts

What is the pelvic floor?

The pelvic floor is a sling of muscles that sit in the base of the pelvis. It runs from front to back, attaching to the pubic and tail bones. This muscle supports the organs in the pelvis and plays a critical role in bladder and bowel control. In fact, it’s the muscle you clench when you want to ‘hold on’.

It makes sense, therefore, that a strong muscle will be more effective and improve continence.

There are many reasons the pelvic floor muscle becomes weak, including being overweight, pregnant, giving birth, persistent constipation and smoking. The impact of a weak muscle is an inability to ‘hold on’, especially when under the pressure of a sneeze, cough or laugh. When these things happen, and you leak urine or faeces, it’s called stress incontinence.

You can read more about female stress incontinence here and male stress incontinence here

How do I find the right muscle?

Imagine you’re trying not to break wind. You should feel a squeezing-in and drawing-up of the muscle that surrounds your anal passage, vagina if you’re a female and urethra. If you’re not sure you have found it, try stopping your urine stream when you’re next on the toilet – that’s the same muscles. You should have a sensation of the muscle being drawn into the middle (from the front and back) and lifted into your pelvis

How do I find the right muscle?

Imagine you’re trying not to break wind. You should feel a squeezing-in and drawing-up of the muscle that surrounds your anal passage, vagina if you’re a female and urethra. If you’re not sure you have found it, try stopping your urine stream when you’re next on the toilet – that’s the same muscles. You should have a sensation of the muscle being drawn into the middle (from the front and back) and lifted into your pelvis.

Once you’ve located the muscle, don’t stop and start your urine flow as an exercise. Although it’s an easy way to identify the muscle, it’s not a good bladder habit.

These Continence Foundation of Australia videos give a three-dimensional view of the pelvic floor and explain the sensation you should experience when clenching.

Basic pelvic floor exercises

Pelvic floor exercises are simply a series of clenching and relaxing of the muscle. They can be done standing, sitting or even lying down.

Start by sitting on a firm chair with feet planted on the ground. Clench your pelvic floor and hold for a slow count of three to ten – just as long as you can manage. Then relax. If you don’t feel a release at the end of your count, the grip has slipped away, so have another go for a shorter count.

Once you’ve found a comfortable count, do a series of ten of clenches, resting for ten seconds in between. This is called a set, and you should aim to do six sets across the day.

You can read more about Basic pelvic floor exercises here.

Dos

• Persist. It should only take 3 to 4 weeks to start noticing an improvement, and even then, keep going! This article, Integrating pelvic floor exercises into your day might be helpful. Like all muscle toning, it’s not just a goal of improvement, but maintenance as well.
• Find a way of reminding yourself. While most people don’t find pelvic floor exercises challenging, remembering to do them is. Think of something you do several times a day and then use that as a reminder to a set of exercises. This could be:
• Answering the phone
• Checking email or social media
• After going to the toilet
• When you put the kettle on
• At the red lights when you’re out driving
• Stay hydrated. Some people wrongly believe that restricting their fluid intake will help curb incontinence, but that’s not true. In fact, your urine becomes increasingly concentrated, which can irritate your bladder, causing it to spasm or contract suddenly. This is urge incontinence, also referred to as an overactive bladder. You can read more about male urge incontinence and for females, this article, Small or overactive bladder. You should aim to drink around two litres of fluid a day, with water being your best choice.
• Avoid constipation. The straining associated with persistent constipation weakens the pelvic floor. Make sure you’re getting enough fibre in your diet, drinking plenty of water and being physically active. You can read more tips on managing constipation in this article
• Clench the muscle before sneezing, coughing, laughing or lifting. Doing this will not only reduce the chance of a leak but also protect the muscle from undue strain - clenching braces against the downward pressure, which avoids damaging jarring.
• Discuss it with your doctor. There are many causes of incontinences. Most, like a weak pelvic floor muscle, aren’t a huge health risk, but others, like bladder or prostate cancer, are. For that reason alone, it’s worth discussing it with your doctor who’ll be able to diagnose the underlying issue correctly. Some people find the prospect of discussing incontinence overwhelming. If you’re one of them, his article, Questions for the Doctor has tips to prepare and how to broach the subject.
• See a continence physiotherapist if you’re not experiencing any results. If you’ve not noticed any change after four weeks, speak to your GP about a referral to a continence physiotherapist. These health care professionals are able to determine if you’re exercising correctly, give you personalised instruction and develop a plan specifically to meet your requirements. You can read more about continence physios in this article; What to expect when seeing a continence physiotherapist
• Use a protective product. While you’re getting your pelvic floor muscle into shape, use a purpose-made product to manage leaks and give you the confidence to get on with everyday life. Browse the full range of TENA Products here or head to the TENA Product Finder that steps you through a few questions and then suggests some suitable products. You can even order free samples.

Don’ts

• Hold your breath. This can have the consequence of engaging your abdominal muscles, reducing the effectiveness of your pelvic floor workout. If your sitting, make sure your posture is upright, then take a couple of deep, slow breaths before you begin. Be conscious of breathing normally.
• Clench your buttocks, thighs or tummy. Clenching these muscles can reduce the effectiveness of pelvic floor exercises by sharing the load. They can also be a tiring distraction from correct technique and even from using the pelvic floor muscle at all! To check that you’re not using these muscles, place your hand on each (buttocks, thighs and tummy) one at a time while you’re doing your pelvic floor clenches. If you feel any movement, those muscles are being engaged.
• Make excuses. It doesn’t matter if you’re not physically fit or have had children – you can still strengthen your pelvic floor with exercise. Read about other Common Myths about You Pelvic Floor here
• Lift heavy weights or do high-impact exercise. Until the muscle is strong, avoid these activities as they can further weaken the pelvic floor. The jarring from sports like running, tennis and netball are damaging if the muscle can’t be braced (clenched) against the impact. Similarly, repeatedly lifting heavy weights like children, will have the same effect.
• Go to the toilet ‘just in case’. This is a habit that can train the bladder into holding less. Wait until your bladder is full and you have a genuine urge to urinate.
• Do exercises with a full bladder. There’s no need to put this type of pressure on yourself or your bladder! Exercising with a full bladder and a weak muscle could lead to a leak.
• Cross your legs while exercising. If you’re sitting, put both feet firmly on the floor. If you can’t reach, place a book or step under your feet.
• Smoke. It’s the chronic cough associated with smoking that causes the pelvic floor muscle to weaken and stress incontinence to occur.

Sources:

• http://www.pelvicfloorfirst.org.au/news/471/what-not-to-do-at-the-gym
• https://www.brighamandwomens.org/obgyn/urogynecology/forms-and-education-materials/kegels-pelvic-muscle-exercises

Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.