Pelvic floor muscle exercises for women
How can I find my pelvic floor muscles?
Method 1 - Stopping the flow
The first step in performing pelvic floor muscle exercises is to identify the correct muscles. There are several ways which may help you to correctly identify the different parts of your pelvic floor muscles. One way is to try to stop or slow the flow of urine midway through emptying the bladder. Stopping the flow of urine repeatedly on the toilet is not an exercise, but a way of identifying your pelvic floor muscles. This should only be done to identify which muscles are needed for bladder control.
If you can, stop the flow of urine over the toilet for a second or two, then relax and finish emptying without straining. This 'stop-test' may help you identify the muscles around the front passage which control the flow of urine. It is not recommended as a regular exercise.
Method 2 - Visualisation
Another method to identify your pelvic floor muscles is to imagine stopping the flow of urine and holding in flatus (wind) at the same time. This can be done lying down, sitting or standing with legs about shoulder width apart.
- Relax the muscles of your thighs, bottom and tummy.
- Squeeze in the muscles around the front passage as if trying to stop the flow of urine.
- Squeeze in the muscles around the vagina and suck upwards inside the pelvic.
- Squeeze in the muscles around the back passage as if trying to stop passing wind.
- The muscles around the front and back passages should squeeze up and inside the pelvis.
- Women who are familiar with using tampons can imagine squeezing in the vagina as if squeezing a tampon up higher in the vagina.
- Identify the muscles that contract when you do all these things together. Then relax and loosen them.
Getting the technique right
This is the most important part of the pelvic floor muscle exercises as there is no point doing them if you are not doing them correctly.
Imagine letting go like you would to pass urine or to pass wind. Let your tummy muscles hang loose too. See if you can squeeze in and hold the muscles inside the pelvis while you breathe. Nothing above the belly button should tighten or tense. Some tensing and flattening of the lower part of the abdominal wall will happen. This is not a problem, as this part of the tummy works together with the pelvic floor muscles.
Try tightening your muscles really gently to feel just the pelvic floor muscles lifting and squeezing in. If you cannot feel your muscles contracting, change your position and try again. For example, if you cannot feel your muscles contracting in a seated position, try lying down or standing up instead.
After a contraction it is important to relax the muscles. This will allow your muscles to recover from the previous contraction and prepare for the next contraction.
It is common to try too hard and have too many outside muscles tighten. This is an internal exercise and correct technique is vital. Doing pelvic floor muscle exercises the wrong way can be bad for you, so please see a health professional if you cannot feel your muscles hold or relax.
Exercising your pelvic floor muscles
If you have mastered the art of contracting your pelvic floor muscles correctly, you can try holding the inward squeeze for longer (up to 10 seconds) before relaxing. Make sure you can breathe easily while you squeeze.
If you can do this exercise, repeat it up to 10 times, but only as long as you can do it with perfect technique while breathing quietly and keeping everything above the belly button relaxed. This can be done more often during the day to improve control.
When to seek professional help
Seek professional help when you have bladder or bowel control problems with symptoms such as:
- needing to urgently or frequently go to the toilet to pass urine or bowel motions
- accidental leakage of urine, bowel motions or wind
- difficulty emptying your bladder or bowel
- vaginal heaviness or a bulge, or
- pain in the bladder, bowel or in your back near the pelvic floor area when exercising the pelvic floor or during intercourse.
These problems may not necessarily be linked to weak pelvic floor muscles and should be properly assessed.
Like all exercises, pelvic floor exercises are most effective when individually tailored and monitored. The exercises described are only a guide and may not help if done incorrectly or if the training is inappropriate.
Incontinence can have many causes and should be individually assessed before starting a pelvic floor muscle training program. Tightening or strengthening pelvic floor muscles may not be the most appropriate treatment so speak to a health professional if you have persistent problems with your bladder or bowel.
Health professionals
Continence and women's health or pelvic floor physiotherapists specialise in pelvic floor muscle exercises. They can assess your pelvic floor function and tailor an exercise program to meet your specific needs. They can also prescribe other treatment options such as biofeedback and discuss relevant lifestyle factors with you.
For a list of continence and women's health or pelvic floor physiotherapists, visit the Australian Physiotherapy Association or call the National Continence Helpline on 1800 33 00 66.
