Q 1. What is the pelvic floor and why does it become weak?
A. The pelvic floor is a complex layer of muscles and ligaments which stretches like a hammock from the pubic bone (at the front) to the tail end of the backbone (the coccyx, see the diagram).
The pelvic floor has several functions:
It supports your pelvic and abdominal organs, especially when you are standing or straining
It helps the opening of the bladder to stay closed when you cough, sneeze or strain
It is used to control leakage of wind or motions from your lower bowel
It helps to increase sexual awareness by tightening during intercourse
The pelvic floor can become weak because of childbirth, prolonged straining to empty your bowels, lack of exercise and the menopause or simply as a result of ageing. A weak pelvic floor gives you less control so that you may leak urine when you exercise, cough, lift or sneeze.
Q 2. How can exercising the pelvic floor muscles help?
A. Exercising the pelvic floor muscles can strengthen them so that, once again, they provide the support you need. This will improve your bladder control and improve (or even stop) leakage of urine. Like any other muscles in the body, the more you use and exercise them, the stronger they become
Q 3. How do I find the pelvic floor muscles?
A. It is not always easy to identify your pelvic floor muscles. Exercising them should not show at all “on the outside”.
Here is what to do:
Sit comfortably with your knees slightly apart. Imagine that you are trying to stop yourself from passing wind from the bowel. To do this, you must squeeze the muscle around the back passage. Try lifting and squeezing the muscle as if you have wind; you should be able to feel the muscle move and your buttocks or legs should not move at all. You should notice that the skin around your back passage tightens up and creates the sensation of lifting you from your chair.
Imagine that you are sitting on the toilet to pass urine and try to stop yourself from producing a stream of urine. You should be using the same group of muscles that you used before but you will find this a little more difficult. (Do not try to stop the urinary stream when you are actually passing water because this may cause problems with bladder emptying).
Try to tighten the muscles around your back passage and vagina, lifting up inside as if you are trying to stop passing wind and urine at the same time. Try to avoid tensing your abdomen, squeezing your legs together, tightening your buttocks or holding your breath. If you can master this most of the muscle contraction should be coming from the pelvic floor.
Q 4. How do I practise the exercises?
A. You need to develop two type of muscle activity, slow and fast.
To practice slow contractions, do the exercises above and try to hold the pelvic floor tight for up to 10 seconds. Rest for four seconds and then repeat the contraction as many times as you can up to a maximum on 10 contractions.
To practice quick contractions, which will protect you against leakage during coughing, laughing or exercise, draw the pelvic floor rapidly upwards and hold this for one second. Repeat up to a maximum of 10 times.
Aim to do one set of slow contractions followed by one set of fast contractions six times a day.
Don’t
Pull in your tummy muscles excessively
Squeeze your legs together
Tighten your buttocks
You should aim to perform at least 10 contractions of the muscles, up to 6 times during the day, every day.
Muscles only develop when you challenge them to work harder than normal. This will be different for everyone.
Develop a habit of bracing your pelvic floor muscles gently during everyday activities (lifting, carrying and during strenuous exercise) and particularly during any task which might challenge the bladder or put pressure through the pelvis.
Do not exercise using the pelvic floor muscles to stop and start the flow of urine as it may interfere with normal bladder emptying.
