Pelvic floor muscles
The pelvic floor muscles are a sling of muscles across the floor of the pelvis. The opening to the bladder, vagina (birth canal) and back passage all pass through these muscles.
What makes them weaken?
Pregnancy and giving birth do have a lot to answer for!
There are a few other factors that have an influence:
- constipation
- lots of coughing
- being overweight
- menopausal changes
- frequent or heavy lifting
- pelvic surgery
What do they do?
These muscles have lots of important functions:
- supporting the pelvic organs (bladder, uterus, bowel)
- supporting the bladder to help stop leaking
- they help to control wind and “holding on” with bowels
- they help to increase sexual awareness for you and your partner
- they help to support the lower back and pelvis
If they are not working properly, all these functions can be affected.
Other treatments
If you are having trouble locating your muscles or if they are very weak on assessment, your specialist nurse may use other forms of treatment to help you. This could be in the form of stimulation, biofeedback or through using other useful tools. You will be advised on the best way forward for you.
How long does it take to improve?
Like any muscle, they take some time and effort to get stronger. You need to do a session of quick squeezes and slow holds at least once a day, more if possible.
Some people find it only takes 6 weeks of regular exercise to feel an improvement, others find it takes longer.
Once they are strong, try and get into the habit of doing them regularly (for example, after you have been to the toilet or before you get up in the morning). Pelvic floor exercises are for life, make them a habit!
Find the time
You will have found by now it takes a lot of concentration!
Make sure you set aside some time in the day to do them properly. That’s not to say you shouldn’t do them on the bus or any other time you think of them but make that an additional set rather than your only set.
Fast and slow
Your muscles have to act in 2 different ways: quickly (like when you cough or sneeze) or slowly (when you’re walking around, holding everything in place). When you do your exercises you need to make sure both quick and slow muscles get a work out.
Quick squeezes
Draw the muscles in as hard as you can and let them go straight away. Record how many times you can repeat this and the date.
Now, before you cough, sneeze or lift something heavy, do this type of exercise. It’s sometimes called “the knack” and it can really help with symptoms of stress incontinence.
Slow holds
Next, pull in the muscle and hold it for as long as you can. Count in seconds how long you can hold for. Repeat and try to improve your time. You need to repeat this as many times as you can to properly work out your muscles, if you don’t do them until you feel tired, they won’t improve. Record the date, length of hold and number of times.
This exercise is useful when you get that urge to go to the toilet and you’re trying to put it off. Once you can hold for 12 to 15 seconds this should become much easier.
Similar to this exercise, you can also pull in the muscle about half as hard as you can (less than 50%) and try and hold it for much longer. This is good to do when you are walking, just to remind you of the muscle.
How to do the exercises
There are lots of ways to think about doing these exercises, these are just a few!
- Imagine you are trying to stop yourself passing wind. Now pull in as if you are stopping yourself passing urine at the same time (don’t actually stop the flow of urine, just imagine).
- Imagine you are trying to draw your coccyx and your pubic bone together.
- Sit on a chair, lean forward and imagine you need to pick a tissue off the seat using your pelvic floor.
- Imagine squeezing your partner while having sex (or trying putting two fingers in your vagina and squeezing them).
You will be advised on the best position to do your exercises. It is sometimes easiest to start in lying, so there is nothing pressing against the muscles. The most difficult position is standing as your body weight is pressing down on the muscles, but they will need to be used in this position so it is good to get some practice in!
Points to remember
Do not hold your breath!
Try not to squeeze any other muscles while you are doing your exercises, for example, your tummy muscles, buttocks or inner thighs.
If it feels too easy, then it probably is, you either need to hold for longer or try and do more repetitions.
It is really important to be able to feel the muscle relax after you have pulled it in, you must be able to fully let go.
Keep reminding yourself why you are doing them.
Contact specialist continence
Document control
- Document reference: DP7880/07.22.
- Date reviewed: July 2022.
Page last reviewed: November 12, 2024
Next review due: November 12, 2025
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