Pelvic Floor Exercises

The Pelvic Floor Exercise website has just been launched and is the definitive guide for Pelvic Floor Exercise information, research and products. This month we asked Director Linda McCelland all about these exercises and why they are so important.

Linda: Pelvic floor exercises strengthen the pelvic floor muscles hidden inside the body. The pelvic floor muscles form a hammock inside the lower part of the pelvis, and support the internal organs. Openings from the bladder and bowel pass through the pelvic floor muscles, and for women, the vagina also passes through them.

Gym routines and other fitness programs don’t strengthen these hidden muscles, so women need to make sure that they find time to do them, in addition to any other exercises that they do.

Unfortunately many women find that they can’t locate their pelvic floor muscles when they try to exercise, and others have difficulty developing their exercise technique. Research has found that over 50% of women can’t produce a correct pelvic floor contraction from brief verbal instructions and many have difficulty even after one-to-one teaching sessions.

For these women, an exercise aid can often help. Pelvic floor exercise aids are available from www.pelvicfloorexercise.com.au and come in the form of:

Exercise aids are usually used for one period of 15-20 minutes each day, rather than repeated 5-6 times per day, as with unassisted exercises.

DVDs, CDs and books can also help with specific needs. Women who find that they need further help can also consult a specialist continence service or women’s health physiotherapist.

Linda: Strong pelvic floor muscles are the best way of overcoming stress incontinence, a common problem for women of all ages. Strong pelvic floor muscles also reduce the risk of urge incontinence, which is particularly common amongst older women, and is often the main reason why elderly women are admitted to nursing homes.

But just as importantly, strong pelvic floor muscles make sex much more pleasurable both for a woman, and for her partner. The pelvic floor muscles are directly responsible for the amount of sensation a woman feels during intercourse, and for the amount of grip felt by her partner.

And finally, the International Consultation on Incontinence, the worldwide expert body on the treatment of urogynaecological disorders, has just announced that strengthening the pelvic floor muscles can reverse a prolapse and may help women to avoid gynecological surgery.

Linda: Pelvic floor exercises are extremely important for women in the childbearing years, as this is when damage is often done to the pelvic floor muscles.

Incontinence during pregnancy is common, but many women find it gets better within weeks of the birth. Because the problem has disappeared, these women tend to forget about strengthening their pelvic floor muscles, not realizing that their weakened muscles will often lead to a recurrence of incontinence, or even a uterine, bladder or bowel prolapse, in their 40s and 50s.

Pelvic floor exercises are even more important for women who are still incontinent three months after the birth of their baby. 90% of women who are experiencing stress incontinence at three months will still have the problem 5 years later, unless they take action. These women must strengthen their pelvic floor muscles or risk their incontinence becoming permanent.

For women who are planning a pregnancy, strong pelvic floor muscles will reduce the likelihood of incontinence during pregnancy and after childbirth, providing a great incentive to building muscle strength before pregnancy.

Linda: Definitely yes! Like all muscles, the pelvic floor can be strengthened through regular exercising, using correct techniques. There’s a great deal of respected research that shows that stress incontinence can be overcome, urge incontinence can be reduced, a prolapse can be reversed and sexual pleasure can be enhanced by strengthening the pelvic floor muscles.

The problem with the pelvic floor muscles is that they are not visible, so it’s easy to forget them unless they are causing problems. Young women should exercise regularly to keep them strong, but if they’ve become weak, there’s no need to despair. Pelvic floor muscles are never too untoned to improve, and it’s never too late! One recent study has shown that even amongst women in their late 70s living in residential care, a simple pelvic floor exercise program was enough to significantly reduce their incontinence.

Linda: Pelvic floor exercises can be done at any time, although like all exercise, women will gain less benefit when they are tired.

Because pelvic floor exercises can be done in any position, it’s tempting to use a specific trigger as a reminder; for example, it’s often suggested that a woman should do them whenever she sits at traffic lights. There are two problems with this approach; one is that no woman could concentrate properly on the exercise movement in these circumstances, and the second is that her body would always be in the same position.

To get the most benefit, women should concentrate fully on the exercise movement and vary their position when exercising, sometimes sitting, sometimes standing, and sometimes lying flat, sometimes on one side. Women using an exercise aid such as an electrical stimulation device or a perineometer, will need to plan one exercise session per day of 15-20 min.

Linda: Many women find it hard to exercise correctly, especially when they first start. Some find it difficult to locate the correct muscles at all, whilst others find it difficult to contract them, and even harder to hold the contraction. Exercise devices can be very useful here.

There are two main exercises recommended for the pelvic floor. When you first start, it may be easier to do the exercises lying on your side, but as muscle strength improves, try doing them in different positions, including sitting and standing.

EXERCISE 1:

Tighten the muscles around your back passage, vagina and front passage and lift up inside as if trying to stop passing wind and urine at the same time. It is very easy to bring other, irrelevant muscles into play, so try to isolate your pelvic floor as much as possible by

.   not pulling in your tummy,
.   not squeezing your legs together,
.   not tightening your buttocks and
.   not holding your breath.

The effort should be coming from the pelvic floor.   Some women find it helpful to imagine that they are trying to lift a tampon.

Try holding the contraction tightly for as long and as hard as you can. Build up to a maximum of 10 seconds. Rest for 4 seconds and then repeat the contraction as many times as you can up to a maximum of 10 contractions.

Try to do these exercises in a slow and controlled way with a rest of 4 seconds between each muscle contraction. Practice your maximum number of held contractions (up to 10) about six times each day.

EXERCISE 2:

Practice some quick contractions, drawing in the pelvic floor and holding for just one second before releasing the muscles. Do these steadily, aiming for a strong muscle tightening with each contraction up to a maximum of 10 times.

Try to do one set of slow contractions (exercise 1) followed by one set of quick contractions (exercise 2) five or six times each day. If you do pelvic floor exercises regularly, you will see optimum results within 3 to 6 months, but you should continue them for life to fully protect your pelvic floor.

The Pelvic Floor Educator is an excellent budget device for teaching the correct exercise technique, whilst feedback exercisers such as the PFX2 and Pelvexiser are also extremely helpful are useful in teaching how to hold the contraction without it slipping away. Electrical stimulation can help women to locate the correct muscle, and recognize the feeling of a muscle contraction.

Visualising what is happening inside the body is helpful for many women too. Some DVDs and CDs offer very useful visualisations.

Specialist physiotherapists and continence advisers can teach correct exercise techniques. There are links to these services on the Pelvic Floor Exercise website at www.pelvicfloorexercise.com.au