LET’S TALK ABOUT PELVIC FLOOR

What do the pelvic floor muscles do?

When the pelvic floor is strong, it supports the pelvic organs to prevent problems such as:

  • incontinence (the involuntary loss of urine or faeces)
  • prolapse (lack of support) of the bladder, uterus and bowel

The pelvic floor muscles also help you to control bladder and bowel function, such as allowing you to ‘hold on’ until an appropriate time and place.

What causes pelvic floor muscle weakness?

Some of the common causes of pelvic floor muscle weakness are:

  • childbirth – particularly following delivery of a large baby or prolonged pushing during delivery
  • being overweight
  • constipation (excessive straining to empty your bowel)
  • persistent heavy lifting
  • excessive coughing – causing repetitive straining
  • changes in hormonal levels at menopause
  • growing older

How do I strengthen my pelvic floor muscles?

It is recommended that all women exercise their pelvic floor muscles every day throughout life, to prevent weakness or improve strength. Exercising weak muscles regularly over a period of time can strengthen them and make them work effectively again.

Exercise for Women (there is section for men below as well)

Step 1: Lay on your back with your knees bent and legs comfortably apart.
Step 2: Close your eyes and imagine what muscles you would tighten to stop yourself from passing urine.

Another way of describing the activation of your pelvic floor is to imagine you have a tampon inserted and that you are trying to squeeze the tampon in and up.

If you need a stronger queue, try stopping the flow of urine when you are next on the toilet to get the sensation of activating your pelvic floor – but DO NOT use this is as pelvic floor activation method.  This is just a once off to help you recognize the sensation of pelvic floor activation.

If you still can’t feel a distinct tightening of these muscles, it’s probably a good idea to seek some help from a women’s health physiotherapist – we would recommend Megan Bergman at Physiologix at the Gap (Brisbane North)

Step 3: Now that you know how to feel if your pelvic floor muscles are working, take a natural breath in, and on the OUT BREATH activate your pelvic floor and hold for three to five seconds . This is NOT a clenching movement or sensation.  It’s a subtle and gentle movement and should not involve clenching.

When you activate your pelvic floor, you should feel your pelvic floor muscles ‘lift up’ inside you and feel a definite ‘let go’ as the muscles relax. If you can hold longer (but no more than a maximum of eight seconds), then do so. Remember, the squeeze must stay consistent and you should release and ‘let go’ after each pelvic floor activation. Repeat up to ten times or until you feel your pelvic floor muscles fatigue. Rest for a few seconds in between each activation.

Steps one to three count as one exercise set.

If you can, do three sets per day in different positions (sitting, standing, laying down).

Do your pelvic floor exercises every day for the rest of your life.

During both exercises you should:

  • feel your pelvic floor muscles ‘lift up’ inside you, rather than feel a downward movement
  • relax your thighs and buttocks
  • keep breathing normally
  • stop exercising if your muscles fatigue.

What can I do to prevent damage?

To prevent damage to your pelvic floor muscles, avoid:

  • constipation and/or straining with a bowel motion
  • persistent heavy lifting
  • repetitive coughing and straining
  • being overweight

Make training part of your life by:

  • tightening your pelvic floor muscles every time you cough, sneeze or lift
  • doing some regular exercise
  • progressing your pelvic floor exercises by doing them during the day in different positions e.g. standing, sitting or on your hands and knees

For many women, it is important to follow a specific exercise program tailored to their individual needs. If you are unsure of whether you are exercising your pelvic floor muscles correctly or you have urinary problems, you should make an appointment with a women’s health physiotherapist.

Exercises for men:

  • Squeeze and draw in the muscles as though you are shortening your penis and lifting base of scrotum at the same time. Lift them UP inside. You should have a sense of “lift” each time you squeeze your pelvic floor muscles. Try to hold them strong and tight as you count to 3. Now, let them go and relax. You should have a distinct feeling of “letting go”.

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