Pelvic floor exercises –  How to contract your pelvic floor!

by Dr. Alison Gault


The pelvic floor strengthening exercises otherwise known as Kegel exercises are vital if you are planning to get pregnant, are pregnant or were pregnant!     A woman can do pelvic floor exercises while waiting in a queue or sitting at her office desk, without anyone noticing so ladies there are no excuses!!!

Important things to remember while doing pelvic floor exercises…

You should look totally normal when you are doing the pelvic floor exercises, if you are screwing your face up or stopping breathing or talking you are trying to contract the muscles too hard and are going to be making the problem worse by increasing the pressure in the abdomen.

• DO NOT hold your breath. as you will be fighting against yourself.  • DO NOT bear down instead of squeezing and lifting up, this could actually do you damage.  • DO NOT tighten your tummy, buttocks or thighs.

Stage one is identifying the pelvic floor muscles:

The first stage is learning what it feels like to contact your pelvic floor so that you can reproduce it and strengthen it!  As the pelvic floor is made up of the anterior pelvic floor controlling urinary continence and the posterior controlling fecal continence, you need to learn to contract both the front and the back. A pelvic floor contraction should feel like a tightening and slight lifting.  There are several ways to identify a pelvic floor contraction.

• Imaging stopping flow of urine- this is the anterior urogenital diaphragm. • Try stopping urine in mid flow. • Inserting finger into the vagina and contract around the finger. • The back half of the floor can be contracted by imagining you are stopping diarrhoea, a stronger and deeper contraction is needed for this. You will find that you cannot contract the posterior pelvic floor without doing the anterior as well.

Stage two is contracting the pelvic floor muscles with the correct pelvic floor exercises:

A great way learn to
strengthen your pelvic floor is imaging a lift.  Gently contract your pelvic floor to shut the doors then gently lift to floors one, two and three.

You need to work on being able to contract your pelvic floor quickly and strongly for times like sneezing or coughing.   For this you want to build up to doing 60 quick, strong and sharp contractions in a row at about a level 2.    You also need to be able to contract your pelvic floor for longer periods of time which is especially important in retraining your bladder with urge incontinence and for times like long car trips where there are no toilets around.  For this you want to build up to doing a more gentle contraction and holding it for 60 seconds at about a level 1.

So to start…..

Contract both the front and the back of the pelvic floor together at level 1 and hold for 5 seconds. Contract both front and back of pelvic floor together at a level 2 and hold for 1 second. Repeat this quickly 5 times. Gradually work up over time to doing a 60 second hold and 60 fast contractions in a row.   Also start doing the exercises in different positions such as sitting, standing, lying on your front, side and back, kneeling and lifting.

You should try to do these exercises 5-6 times per day, set little cues for yourself such as:

  • when the ads come on when watching TV
  • every red light when you are driving
  • when you brush your teeth
  • every time just after you go to the toilet etc etc etc…..

As with any exercise program, starting to strengthen the pelvic floor should be done gradually.   Slowly build up the number of contractions, frequency of contractions but remember to perform the exercises regularly otherwise you will not see the desired results.    More important than having strong pelvic floor muscles is the ability to activate them quickly against sudden increases in abdominal pressure such as when sneezing, laughing, coughing or lifting.

The number of pelvic floor exercises required depends on the woman’s existing pelvic floor muscle strength but, generally, she will be required to do the exercises 5-6 times a day. It may take 2-3 months to notice a significant improvement.

Do you have urge incontinence? –  Put these pelvic floor exercises into practice with urge incontinence!

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