Top 5 Pelvic Floor Exercises
The pelvic floor is a group of muscles that support the organs in the pelvis. These muscles act as a hammock for organs such as the bladder, bowel and uterus. These muscles attach to bony landmarks in the front, back and base of your pelvis. They help to squeeze sphincters preventing us from urinating or dropping a log.
It is important to keep a healthy pelvic floor, when the pelvic floor is strong it provides support for your pelvic organs. A strong pelvic floor is usually a healthy pelvic floor. This reduces the risk of incontinence, prolapse and sexual dysfunction, these muscles help you to control your bowel and bladder until ‘you need to go’.
Some of the common causes for weakness in the pelvic floor are linked to:
- Pregnancy/childbirth - giving birth to a large baby, having an assisted vaginal birth or a significant tear.
- Obesity – increases the pressure on the pelvic floor
- Chronic Constipation – straining often when going to the toilet
- Lifting heavy objects consistently – strain on your abdominal muscles can put further pressure on your pelvic floor.
- Menopause (hormonal changes)
- Ageing – pelvic floor muscle loses their tone and strength with age.
Some of the above reasons are preventable, and some are not. By far the biggest win is losing weight and exercising, as obesity is a major problem with prolapse.
Symptoms vary from person to person but mostly include:
- Urinary incontinence – difficulty controlling your urine, leakage when coughing or sneezing
- Bowel incontinence – difficulty controlling your bowels, leakage during activity, going to the toilet often or leakage of wind.
- Pelvic pain – abdominal or vaginal pain, heaviness in the pelvic region
- Sexual dysfunction – Difficulty maintaining an erection, pain during sex or loss of sensation.
However, the good news is that there are several ways to strengthen the pelvic floor and prevent these issues from arising or alleviate their symptoms. Pelvic floor or Kegel exercises are a great way of strengthening the pelvic floor muscles. These are done by contracting and relaxing the pelvic floor muscles. Firstly, identify how to contract the pelvic floor, this is done by imagining you are trying to stop urinating. There are also sphincters controlling your bowel so imagine you are squeezing your bottom hole. Once identified tighten your pelvic floor muscles and hold it for as long as possible then repeat, this is known as a long squeeze. Secondly engage in quick contractions and relaxation of the pelvic floor. Do as many until the pelvic floor muscles get fatigued. Focus first on the front sphincter, then the back sphincter.
In addition to pelvic floor exercises, lifestyle changes can also help to support pelvic floor health. Maintaining a healthy weight, avoiding constipation by eating a balanced diet rich in fibre and staying hydrated, and avoiding heavy lifting can all help to reduce the strain on the pelvic floor. Smoking cessation and avoiding prolonged sitting or standing can also benefit the pelvic floor.
If you are experiencing pelvic floor issues or are unsure about how to perform Kegels correctly, come and see us in clinic. At Surrey Physio we can advise on your pelvic floor function and provide personalised recommendations to improve its health. At Surrey Physio we will take a case history and perform an assessment to determine if there are other factors that are contributing factors.
Try these 5 exercises that we recommend at Surrey Physio. You can perform holds for 5 seconds, and repeat each exercise 10 times:
Pelvic Floor Exercises - Identify Your Pelvic Floor Sitting
Sit comfortably on a chair with your knees hip distance apart. Imagine that you are trying to stop your flow of urine mid-stream at the same time as stopping yourself from passing wind. The feeling is one of squeeze and lift around your front and back passages. You may feel more happening at the front or conversely around your bottom. As long as you can feel a tightening in at least one of these areas, you will be exercising your pelvic floor. Try to avoid pulling in your tummy, squeezing your legs together, tightening your buttocks or holding your breath. Send your breath into your abdomen, and on exhalation gently squeeze and lift with your pelvic floor muscles. Practice a few times and then try and maintain this lift as you continue to inhale and exhale. Strengthening your pelvic floor while continuing to breathe naturally can help with stress incontinence when coughing or sneezing.
Pelvic Floor Exercises - Contract Your Anal Sphincter Standing
Stand comfortably with upright posture and feet hip distance apart. Breathe normally. On exhalation, squeeze the muscles around your anus, and imagine you are trying to stop yourself from passing wind. The feeling is one of a slight squeeze and lift around your back passage. Hold the contraction for the required length of time, and then relax your anal sphincter muscles. Try to avoid holding your breath, squeezing your legs together or tightening your buttocks. This will help to isolate and strengthen the back of your pelvic floor muscles.
Pelvic Floor Exercises - Pelvic Floor Contraction in Four Point Kneeling
Sit on your heels. Bring yourself onto your hands and knees. Once in this position, inhale and lift your pelvic floor muscles, drawing them up towards your naval. Hold them tight while exhaling and inhaling once. Then release them gradually with your next exhalation. Repeat as required. This exercise will help strengthen your pelvic floor muscles.
Pelvic Floor Exercises - Pelvic Floor Contraction Squatting
Stand with your feet wider than hip distance apart, turning them out slightly. Bend your knees as you lower your pelvis into a squat, keeping your heels on the floor if you can. Place your hands in front of you or rest them on the floor. Use the wall to support your back if needed or squat onto a low stool. Once in this squatting position inhale and lift your pelvic floor muscles, drawing them up towards your naval. Hold them tight while exhaling and inhaling once. Then release them gradually with your next exhalation. Repeat as required. This exercise will help strengthen your pelvic floor muscles.
Pelvic Floor Exercises - Contract your Pelvic Floor Walking
As you walk, you may wish to practice some pelvic floor contractions. Breathe normally. On exhalation, squeeze the muscles around your bladder and anus, and imagine you are trying to stop yourself from passing urine and passing wind at the same time. The feeling is one of a slight squeeze and lift around your front and back passage. Hold the contraction for the required length of time, and then relax your bladder and anal sphincter muscles. Try to avoid holding your breath, pulling your tummy in, or tightening your buttocks. This will help to strengthen your pelvic floor muscles while being on the move.
The pelvic floor is an essential part of the body that plays a critical role in several bodily functions. Maintaining its health is crucial to prevent or alleviate issues such as incontinence, pelvic organ prolapse, and sexual dysfunction. Pelvic floor exercises, lifestyle changes, and pelvic floor physiotherapy are all effective ways to strengthen the pelvic floor and maintain its health. By prioritising pelvic floor health, you can improve your quality of life and maintain overall well-being. Incontinence is a real problem that causes a lot of embarrassment, and we can support you at Surrey Physio with these issues.
(Therapists reading this page, these videos are provided by Rehab My Patient – the best exercise prescription software for therapists to prescribe exercises www.rehabmypatient.com. If you are a patient needing advice, call Surrey Physio to book a telephone/video consultation with one of our expert physios or osteopaths, or book in face-to-face for an appointment. You can call us on 0208 685 6930 or book online by clicking the link at the top of the page).