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Pelvic Floor

Pelvic floor exercises can help women improve bladder control. When done correctly, pelvic floor exercises can build up and strengthen the muscles to help hold urine.

What is the pelvic floor?

Layers of muscle stretch like a hammock from the pubic bone in front to the bottom of the backbone. These firm, supportive muscles are called the pelvic floor. They help to hold the bladder, womb and bowel in place, and to close the bladder outlet and back passage.

How does the pelvic floor work?

The muscles of the pelvic floor are kept firm and slightly tense to stop the leakage of urine from the bladder or faeces from the bowel. When you pass water or have a bowel motion the pelvic floor muscles relax. Afterwards they tighten again to restore control.

Pelvic floor muscles can become weak and sag because of childbirth, lack of exercise, the menopause, or just getting older. Weak muscles give you less control and you may leak urine, especially with exercise or when you cough, sneeze or laugh.

How can pelvic floor exercises help?

Pelvic floor exercises can strengthen these muscles so that they once again give support. This will improve your bladder control and improve or stop leakage of urine. Like any other muscles in the body, the more you use and exercise them, the stronger the pelvic floor will be.

Learning to do pelvic floor exercises

It is important to learn to do the exercises in the right way, and to check from time to time that you are still doing them correctly.

1. Sit comfortably with your knees slightly apart. Now imagine that you are trying to stop yourself passing wind from the bowel. To do this you must squeeze and lift the muscle around the back passage. You should be able to feel the muscle move. Your buttocks and legs should not move at all. You should be aware of the skin around the back passage tightening and being pulled up and away from your chair. Really try to feel this.

2. Now imagine that you are sitting on a toilet passing urine. Picture yourself trying to stop the stream of urine. Try doing that now as you are reading this. You should be using the same group of muscles that you used before, but don't be surprised if you find this harder than exercise 1.

3. Next time you go to the toilet to pass urine, try the 'stop test' about half way through emptying your bladder. Once you have stopped the flow of urine, relax again and allow the bladder to empty completely. You may only be able to slow down the stream. Don't worry, your muscles will improve and strengthen with time and exercise. If the stream of urine speeds up when you try to do this exercise, you are squeezing the wrong muscles.

Do not get into the habit of doing the 'stop test' every time you pass urine.

This exercise should be done only once a day at the most.

Now you know what it feels like to exercise the pelvic floor!

Practising your exercises

1. Slow pull-ups - sit, stand or lie with your knees slightly apart. Slowly tighten and pull up the pelvic floor muscles as hard as you can. Hold tightened for at least five seconds if you can, then relax. Repeat at least five times.

2. Fast pull-ups - now pull the muscles up quickly and tightly then relax immediately. Repeat at least five times.

3. Do these two exercises – five slow and five fast at least 10 times a day.

4. As the muscles get stronger, you will find that you can hold for longer than five seconds and that you can do more than five pull-ups each time without the muscle getting tired.

5. It takes time for exercise to make muscles stronger. You are unlikely to notice improvement for several weeks so stick at it. You will need to exercise regularly for several months before the muscles gain their full strength.

Tips to help you

1. Get into the habit of doing the exercises with things you do regularly – every time you touch water if you are at home, or every time you answer the phone if you are at the office whatever you do often.

2. Do the stop test once a day when passing urine. Stopping your urine should get faster and easier.

3. If you are unsure that you are exercising the right muscle, put one or two fingers in the vagina and try the exercises to check. You should feel a gentle squeeze if you are exercising the pelvic floor.

4. Use the pelvic floor when you are afraid you might leak – pull up the muscles before you sneeze or lift something heavy. Your control will gradually improve.

5. Drink normally – at least six to eight cups a day. Don't get into the habit of going to the toilet 'just in case'. Go only when you feel your bladder is full.

6. Watch your weight – extra weight puts extra strain on your pelvic floor muscles.

7. Once you have regained control of your bladder don't forget your pelvic floor.

Continue to do your pelvic floor exercises a few times each day to ensure that the problem does not come back.

You can do pelvic floor exercises wherever you are, nobody need know what you are doing.