Pelvic Floor First ambassador, women’s health physiotherapist and fitness professional Shira Kramer shows you how to do your pelvic floor muscle exercises to help prevent incontinence and prolapse.
The floor of the pelvis is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in front. A woman’s pelvic floor muscles support her bladder, womb (uterus) and bowel (colon). The urine tube (front passage), the vagina and the back passage all pass through the pelvic floor muscles. Your pelvic floor muscles help you to control your bladder and bowel. They also help sexual function. It is vital to keep your pelvic floor muscles strong.
Women of all ages need to have strong pelvic floor muscles. Pelvic floor muscles can be made weaker by:
Women with stress incontinence – that is, women who wet themselves when they cough, sneeze or are active – will find pelvic floor muscle training can help in getting over this problem.
For pregnant women, pelvic floor muscle training will help the body cope with the growing weight of the baby. Healthy, fit muscles before the baby is born will mend more easily after the birth.
After the birth of your baby, you should begin pelvic floor muscle training as soon as you can. Always try to “brace” your pelvic floor muscles (squeeze up and hold) each time before you cough, sneeze or lift the baby. This is called having “the knack”. As women grow older, the pelvic floor muscles need to stay strong because hormone changes after menopause can affect bladder control. As well as this, the pelvic floor muscles change and may get weak. A pelvic floor muscle training plan can help to lessen the effects of menopause on pelvic support and bladder control.
Pelvic floor muscle training may also help women who have the urgent need to pass urine more often (called urge incontinence).
The first thing to do is to find out which muscles you need to train.
If you don’t feel a distinct “squeeze and lift” of your pelvic floor muscles, or if you can’t slow your stream of urine as talked about in Point 3, ask for help from your doctor, physiotherapist, or continence nurse. They will help you to get your pelvic floor muscles working right. Women with very weak pelvic floor muscles can benefit from pelvic floor muscle training.
Now that you can feel the muscles working, you can:
Do this whole training plan (three sets of 8 to 12 squeezes) each day while lying down, sitting or standing.
While doing pelvic floor muscle training:
Fewer good squeezes are better than a lot of half hearted ones! If you are not sure that you are doing the squeezes right, or if you do not see a change in symptoms after 3 months, ask for help from your doctor, physiotherapist, or continence nurse.
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.
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.