Pelvic Floor Exercises for women

The pelvic floor is an up-side down, dome shaped group of muscles which lie between your pubic bone (the front of the pelvis) and the base of your spine (coccyx). Within the pelvic floor are the openings to the urethra (for passing urine), vagina and anus (for passing bowel motions and wind).

The pelvic floor muscles have a number of functions; they support your pelvic organs – keeping them in the correct positions, they support your bladder from leakage and they help you keep hold of bowel motions until you reach the toilet. Think of the pelvic floor as a supportive hammock.

Life events can weaken the pelvic floor muscles, such as pregnancy, childbirth, pelvic surgery, hormonal changes and obesity. Straining on the toilet, chronic coughs and heavy weight lifting may also contribute to the pelvic floor weakening. If this area weakens you may notice leakage or control issues with either the bladder or bowel. Some women may also experience a heaviness or dragging discomfort within the pelvic area – these are signs of potential prolapse.

The pelvic floor muscles contain two types of fibres; fast twitch fibres (which contract quickly when we laugh, cough and sneeze to avoid leakage) and slow twitch fibres (which contract slowly to maintain tone, for instance when we need to hold onto urine for longer). In order to keep the two fibres within the muscles strong and healthy we need to exercise them regularly. Similarly to other muscles within the body. ‘If we don’t use it, we lose it!’.

1. Sit or lay comfortably, with knees/thighs slightly apart (preferably knees bent) and feet in contact with the surface or floor beneath you.
    
2. Take a calm breath in through your nose and a calm breath out through your mouth. The aim is to draw in your pelvic floor (step 3) on your outward breath.
    
3. Tighten the muscles around your 3 openings (urethral, vaginal and back passage). Some ladies find it easier to imagine holding onto wind, drawing a tampon inside and stopping a wee. Your external bottom muscles, thighs and chest should remain calm.
    
4. Aim to hold the squeeze for approximately 5 seconds and then release. You may not reach 5 seconds initially, in this case aim for 2-3 seconds and build up gradually.
    
5. You can also complete the same process for ‘nips’, which are quick tighten and release exercises or pulses.
    
6. Aim to complete a set of 10-15 repetitions, 2-3 times daily and work up to a 10 second hold. Build them into your everyday routine. For example, before you go to bed, sat feeding a baby or waiting for the kettle boil.

If you struggle with your pelvic floor exercises and/or have bladder, bowel or prolapse symptoms, please discuss this with your Pelvic Health Physiotherapist, or request a referral to the Pelvic Health team via your midwife, GP or known health care professional.