The Pelvic Floor – Advice Sheet

The pelvic floor is made up of sheets of muscles and ligaments that run from the tailbone (coccyx), at the back of the pelvis, to the pubic bone, which is at the front. Imagine it as a round, mini-trampoline, creating a platform between the legs. It is referred to as a ‘floor’ because it supports the contents of the pelvis, including the bladder, uterus (in women) and back passage.

The muscles in the pelvic floor are very important because they relax to allow fluid and excrement to leave the body and quickly tighten again to restore control. When you laugh, sneeze, cough or lift things, these muscles automatically contract to prevent leakage without you even realising.

Sometimes the muscles become weak and this can be for a variety of reasons:

  • Following childbirth
  • Lack of exercise
  • As a result of the menopause
  • Following pelvic surgery, e.g. a hysterectomy or bladder repair
  • Straining to open your bowel{s}
  • Being overweight/obesity
  • Having a chronic cough
  • Age

Exercising the pelvic floor muscles can retrain them to contract when they need to and prevent any leakages.

Finding the Pelvic Floor Muscles

It is not always easy to find the pelvic floor muscles. In exercising them, it will not be visible on the outside of the body. Rules to follow include: do not pull in the tummy muscles excessively, do not squeeze your legs together and do not hold your breath. To find the muscles:

  1. Sit on a chair or toilet lid. Make sure your feet are flat of the floor at all times, with your legs slightly apart and lean forward with your elbows resting on your knees.
  2. Close up and draw in the muscles around the back passage, as if you are stopping yourself passing wind. Do not contract the buttock muscles as you do this.
  3. Hold this contraction and then relax. This is the first part done.-
  4. Next you need to close up the muscles around the urethra/bladder, as though you are stopping yourself passing urine.
  5. Hold the contraction and then slowly relax.

Don’t be surprised if this is hard to begin with. Focus should be on gradually increasing the time you hold the contraction for. Strengthening muscles takes time and it is unlikely you will see much improvement for several weeks, so keep persevering!

Learn to Breathe Efficiently

Many of us breathe incorrectly. An early step to strengthening the pelvic floor or pelvic diaphragm is actually to learn to deep breathe.

In a sitting position, place one hand on your stomach, and the other on your chest. Take a deep breath in, and push your belly (and your hand) outwards. Try and keep the movement of your chest to a minimum, so you concentrate on the deep breathing.

Practice 10 deep breaths every day. This can take about three months before it becomes a habit.

Benefits of Strengthening the Pelvic Floor

  1. To help prevent the bladder from leaking under stress (e.g. coughing, laughing or exercising).
  2. To help you hold on longer when you need the urge.
  3. During pregnancy, it will help to support your uterus and may help reduce pressure on your bladder and spine.
  4. After pregnancy, having a strong pelvic floor will help you to recover from childbirth.
  5. Increased tone of the vagina may aid sexual activity.

Some other Pelvic Floor Exercises

  1. Sit up with good posture.
  2. Place a rolled up hand towel in between your legs.
  3. Contract both your anal muscles and bladder muscles.
  4. The towel can help guide where you need to be squeezing, and you can imagine you are trying to lift the towel up.
  5. Hold this for 10 seconds, and repeat 5x.

Contraction of the pelvic floor during sexual intercourse:

During sexual intercourse, you could try to contract your pelvic floor muscles. One of the best ways during sex is to squeeze around your partner’s penis. Hold the contraction for one or two seconds, and repeat 10 times. Or as a variation, try to hold the squeeze for longer time lengths, such as 10, 20 or 30 second lengths.

Variations:

Vary the position you are in when contracting your pelvic floor muscles.

Try to exercise your pelvic floor while standing, while lying and while sitting. When you are comfortable with that, try the strengthening exercises while walking.

Tips for Keeping Those Muscles Strong

  1. Try to do any exercises given to you by your health professional during every day activities, for example while washing the dishes or cleaning your teeth.
  2. Tighten your pelvic muscles when you feel you might be about to leak – activate the muscles when under any high strain activities, such as: coughing, sneezing, laughing or heavy lifting.
  3. Don’t change your drinking habits and drink normally. This means 6-8 glasses of water per day and try to avoid caffeine. Avoid the habit of going to the toilet ‘just in case’ and only go when your bladder feels full.
  4. Keep a healthy weight. Being overweight increases the pressure and strain on the pelvic floor and makes the muscles weaker.
  5. Once you feel you have regained control of the pelvic floor muscles, don’t forget the exercises you have learned. In continuing to do the exercises it will help to stop the problem coming back.
  6. Try Pilates – it is great for learning how to activate your pelvic floor muscles and deep abdominal muscles.
  7. Try yoga – your breathing can definitely be improved by yoga. The pelvic floor is known as the mula bandha in yoga.