Pelvic Floor Muscle Exercises for Incontinence
What are the Pelvic Floor Muscles?
The floor of the pelvis is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tail bone at the back to the pubic bone in front.
A woman's pelvic floor supports the bladder, the womb (uterus) and the bowel. The urethra (front passage), the vagina (birth canal) and the rectum (back passage) pass through the pelvic floor muscles. The pelvic floor muscles play an important role in bladder and bowel control and sexual sensation.
Image 1: Female Pelvic Floor MusclesA strong pelvic floor muscle is equally important for men. It is just as vital for men to be encouraged to exercise their pelvic floor muscles, especially for men with specific health conditions.
Image 2: Male Pelvic Floor Muscles
Why Do the Pelvic Floor Muscles Weaken?
The pelvic floor muscles can be weakened by:
- pregnancy and childbirth;
- continual straining to empty your bowels (constipation);
- persistent heavy lifting;
- a chronic cough (such as smoker's cough or chronic bronchitis and asthma);
- being overweight;
- changes in hormone levels at menopause (change of life);
- surgery (e.g. prostate or episiotomy),
- poor core muscle strength, and
- a lack of general fitness.
What are the Benefits of Pelvic Floor Exercises
It is important for both women and men of all ages to maintain pelvic floor muscle strength.
Women and men with stress incontinence, that is, those who regularly lose urine when coughing, sneezing or exercising, should especially benefit from these exercises.
For pregnant women these exercises help the body to cope with the increasing weight of the baby. Healthy, fit muscles pre-natally will recover more readily after the birth.
In particular, as women grow older it is important to keep the pelvic floor muscles strong because at menopause the muscles change and may weaken. A pelvic floor exercise routine helps to minimise the effects of menopause on pelvic support and bladder control.
Likewise men are more likely to have age-related onset on pelvic floor weakness.
Pelvic floor exercises may also be useful in conjunction with a bladder training program aimed at improving bladder control in people who experience the urgent need to pass urine frequently (urge incontinence).
How to Test Your Pelvic Floor Muscles
The first thing to do is to correctly identify the muscles that need to be exercised.
- Sit or lie down comfortably with the muscles of your thighs, buttocks and abdomen relaxed.
- Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea or wind. Relax it. Practice this movement several times until you are sure you are exercising the correct muscle. Try not to squeeze your buttocks.
- When you are passing urine, try to stop the flow mid-stream, then restart it. Only do this to learn which muscles are the correct ones to use and then do it no more than once a week to cheek your progress, as this may interfere with normal bladder emptying.
- If you are unable to feel a definite squeeze and lift action of your pelvic floor muscles or are unable to even slow the stream of urine as described above, you should seek professional help to get your pelvic floor muscles working correctly.
- Women and men with very weak pelvic floor muscles can be taught these exercises by a physiotherapist or continence advisor with expertise in this area.
- The good news is that your pelvic floor muscles can be tested and treated in the vast majority of cases without the need for internal examination or techniques.
What to do if you have Weak Pelvic Floor Muscles?
Your quickest and most effective way of training your correct pelvic floor muscles is with the assistance of a skilled pelvic floor physiotherapist.
They will help you to:
- assess your current pelvic floor function,
- confirm a diagnosis of urge or stress incontinence, or other condition,
- identify your correct pelvic floor muscle contraction,
- provide you with home exercises, guidance and re-assessment,
- offer real-time ultrasound as an option to assist your pelvic floor retraining.
What Else Can You Do to Help Your Pelvic Floor Muscles?
It is important to avoid activities that stress your pelvic floor. We suggest that you should:
- share the lifting of heavy loads;
- avoid constipation and prevent any straining during a bowel movement;
- seek medical advice for hay-fever, asthma and bronchitis to reduce sneezing and coughing;
- and keep your weight within the right range for your height and age.
Where to Seek Help for Your Pelvic Floor
We highly recommend that you seek the advice of a physiotherapist with an interest in pelvic floor rehabilitation.
Good results take time and it will take less time with the right advice.
In order to build up your pelvic floor muscles to their maximum strength you will need to work hard at these exercises under the guidance of an expert.