The pelvic floor muscles are made up of layers of both muscle and other tissues (fascia, ligaments, tendons) some elastic and some not,  which stretch from the pubic bone to the tail bone, encircling the outlets of urethra and anal sphincter and hugging the walls of the vagina.

They support the uterus, bladder, bowel, vagina, anus and urethra.

They help to close off the bladder and bowel outlets to help prevent leakage.

 When they relax the bladder and bowel can empty effectively.

A functional pelvic floor can contribute to sexual response and sensation

The pelvic floor muscles are some of the most important muscles a woman has, yet because they are not visible, they are often neglected until there are problems.

Pelvic floor muscles weaken for similar reasons to other muscles in our body: natural ageing and inactivity, hormonal changes, being overweight, ongoing constipation, low back pain, chronic cough and pelvic surgery.

Pregnancy and childbirth will also change the strength and ability of your pelvic floor.

Research has shown that regular exercise can re-activate, improve awareness and function and strengthen the pelvic floor muscles. It is possible for women of any age to reduce or completely overcome symptoms of weak pelvic floor muscles.

 

Start by lying down on your back with your knees bent and feet flat on the bed, tighten the muscles around the urethra, vagina and anus, drawing in the muscles inside and towards your front pelvic bone. Try to hold this contraction and then release; you should have a definite feeling of letting the muscles go.

Some other ideas to help you to visualise this:

  • Think of a sea anemone closing shut and pulling within itself
  • When standing think of the muscles of your pelvic floor making a figure of eight around your vagina and anus. Squeeze and draw up the centre between the circles.
  • Think of a little dog curling the tip of his tail between his legs.

When doing pelvic floor exercises, remember not to hold your breath or squeeze your legs and buttocks together.

If you can feel your abdominal muscles tighten, this is normal and absolutely okay.

Hold the squeeze for as long as you can. Then rest. Repeat this three times to start with. Once this is easy, you can add on more contractions until you are doing ten. Do not overdo it, the muscles will tire easily.

To finish the exercise programme, do three quick, hard squeezes in a row, then rest and do three more.

You can do this easy programme every time after you have been to the toilet. We all go to the toilet at least four to five times a day, so this is a good regular time to start exercising your pelvic floor muscles.

Remember one good quality contraction is better than lots of little ineffective ones and good results take time and effort.

As you progress, try the exercises in sitting and standing positions. This is really important as the pelvic floor's job is harder when you stand, walk and move!!

When you cough, lift, sneeze or blow your nose, try squeezing your pelvic floor muscles at the same time. Aim to be doing 3-4 holds for five seconds each and 3-4 faster squeezes after practising for four weeks. Continue to increase up to ten if you can do so.

Pelvic floor exercises are very beneficial – you should try to make it a lifelong habit. Activate the muscles at traffic lights, the doctor’s waiting rooms, even right now! No-one will notice that you are exercising your pelvic floor muscles.

But do remember, just doing contractions when you think about it , is not enough for muscles to relearn and to maintain strength and speed.

If you can get yourself into a good routine, you will be less prone to problems which result from weak pelvic floor muscles later, for example, poor bladder control and urinary/bowel incontinence.

You can test your pelvic floor strength. If you want to return to playing high impact sports, you will need to pass this test. A couple of hours after going to the toilet, jump a few times, then star jump. This exercise requires very good muscle strength, so if you did not have bladder control and you leak urine, then you still need to work on your pelvic floor exercises. It would be a good idea to speak to your physiotherapist or doctor if you are noticing problems.

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