Bladder and Bowel
Pelvic floor exercises – keeping you strong on the inside
In Australia over three million women experience urinary incontinence. Any woman who has ever gone through pregnancy and childbirth, or menopause, will know that the effects on self esteem, body image and morale, sexuality and overall quality of life can be devastating.
It’s never too late
The good news is that incontinence can be prevented, or the effects lessened, by adopting healthy lifestyle habits including good nutrition and regular physical activity.
Doing regular pelvic floor exercises every day can reduce the risk of incontinence by strengthening your pelvic floor muscles to help support your bladder and bowel. This will help improve bladder control and can reduce or stop leakage. Regular gentle exercise, such as walking is also important.
About the pelvic floor
The pelvic floor is a very important muscle – and it’s one that doesn’t gets talked about, or exercised, enough. Pelvic floor muscles are the layer of muscles spanning underneath the pelvis.
Along with abdominal and back muscles, the pelvic floor helps to stablise and support the spine, digestive system, pelvic and reproductive organs (including bladder, bowel and uterus) and it plays an important role in preventing incontinence and supporting the pelvic organs. The pelvic floor is also important for sexual function in women, with voluntary contractions contributing to sexual sensation and arousal.
Risk factors for pelvic floor weakening
- Pregnancy and childbirth, particularly for multiple, large birth weight (over 4kg) or instrument-assisted births, or where there has been severe perineal tearing or long labours
- Straining or constipation
- Chronic coughing, including asthma, bronchitis or smoker’s cough
- Heavy lifting, such as at work or during gym training
- Being overweight or obese
- Lower levels of oestrogen after menopause or when breastfeeding
- Pelvic or abdominal surgery
- Improved control over bladder and bowel function
- Reduced risk of prolapse (sagging of internal organs)
- Better recovery from childbirth and surgery
- Increased sexual sensation
- Increased social confidence and quality of life
Pelvic floor exercises – you may need help
Pelvic floor exercises are not necessarily easy to do correctly. The pelvic floor muscles are complicated muscles that can be difficult to isolate. Practicing the wrong technique will not help incontinence, and can make the problem worse.
Research shows that pelvic floor exercise is effective when done correctly. If doing them yourself doesn’t help then it’s important to see a pelvic floor physiotherapist or continence nurse advisor to ensure your technique is correct and to help you develop an individually tailored program for your needs.
Exercising the pelvic floor is not a self-help treatment for incontinence. If there is a problem with bladder or bowel control, it is important to be properly assessed as weak pelvic floor muscles are just one of the many causes of incontinence.
Contact the National Continence Helpline on 1800 33 00 66 to find a local continence physiotherapist or continence nurse advisor.
Learning to contract your pelvic floor muscles
These two exercises will help you to correctly identify your pelvic floor muscles.
- Try to stop the flow of urine mid-stream and then restart it. Only do this to help you determine which muscles you need to exercise or occasionally to check your progress as it may interfere with emptying of the bladder.
- Practise tightening and relaxing the ring of muscle around the back passage (anus) as if you are trying to control wind – without squeezing your buttocks.
- Good pelvic floor control – a lifelong habit
- Make pelvic floor exercise a regular habit for life. Improved control may take some time to learn and practise correctly. Results won’t happen overnight, so make sure you keep doing them.
It’s never too late. Don’t just put up with incontinence – do something about it!
How to do Pelvic Floor Exercises
- Tighten and draw in the pelvic floor muscles around the urethra, vagina and rectum. Lift up as if stopping your urine flow in midstream. Do not push down – you need to tighten and draw up the muscles.
- Count to five and then relax completely before repeating the exercise.
- Continue until you can do this eight or ten times.
This comprises one set.
Gradually increase the amount until you are able to do four to five sets daily.
Concentrate on working only the pelvic floor muscles – not the thighs or buttocks.
Get in the habit of exercising your pelvic floor several times each day.
- Squeeze up hard when you cough, sneeze or lift something
- Don’t practise stopping the flow of urine mid-stream as an exercise. This can send incorrect messages to your bladder and stop it from emptying completely.
- It will take time for you to notice improvement, so keep at it.
- And if you can’t feel anything happening at all, experience difficulty or there is no improvement over time, you may need help to learn how to work these muscles effectively.