Like any muscle your pelvic floor muscles need to be exercised so they remain strong. These muscles can become weakened after childbirth, after menopause and as a result of chronic coughing or heavy lifting.
By doing pelvic floor muscle exercises you can build up and strengthen the muscles of your pelvic floor to help you hold your urine and improve your bladder and bowel control.
These exercises are also known as Kegel exercises. When done properly and regularly they can make a big difference to your bladder control.
Kegel exercises can be done standing, sitting or lying down
Step 1: Learning to Feel the Muscles
- To locate the muscles, it is best to sit down on a firm chair. Try to squeeze the muscles which prevent you from passing rectal gas.
- Try not to tighten your abdominal or buttock muscles.
- Do not hold your breath
- Inhale as you relax your muscles and exhale as you squeeze them.
- Lie down and place one or two clean fingers into your vagina and try to squeeze your muscles around it.
Figure 1 iIlustration by Gend27/CC by 3.0
Step 2: Learning to Isolate the Muscles
- Be careful not to tighten your stomach, legs, or other muscles at the same time as you contract your pelvic floor muscles. In particular, try to relax your stomach while you squeeze the pelvic muscles. Do not hold your breath.
Step 3: Practicing Pelvic Exercises
- Slowly tighten your pelvic muscles over a count of 1-2-3.
- Slowly relax your pelvic muscles over a count of 1-2-3.
- It is easier to start doing these exercises while sitting in a firm chair so you can make sure that you are not tightening other muscles like your buttocks and abdominal muscles.
- Once comfortable with the pelvic muscle exercises while sitting you can try them lying and standing as well.
- Start by doing this at least 3 to 4 times a week. As you get better at it, try to increase your exercises to one set (10 times) 5 times a day.
When Will I Notice Improvement?
- Many women notice an improvement after 3-6 weeks of doing the exercises daily. It may even take up to 6 months, especially if you have gone through menopause.
- After you train yourself to tighten the pelvic muscles, you will have fewer accidents.
- These exercises need to be continued in order to have lasting effect, just like any other form of exercise.
What if I can’t contract my pelvic floor muscles?If you are having a hard time doing these exercises or find you are not making progress, ask your health care provider whether a pelvic floor physiotherapist or biofeedback might be helpful for you.
Pelvic floor physiotherapy
Physiotherapists have equipment which can help you learn how to contract the correct muscles, measure how strongly you are contracting your muscles and can provide motivation and guidance to help you continue doing your exercises properly. If you are interested in physiotherapy, a referral can be made. Pelvic floor physiotherapy is often covered by private insurance plans (like any other physiotherapist).
Biofeedback is a method of assisting women to perform pelvic floor exercises also known as Kegels. The nurses in the clinic use specialized computer equipment which can show you the strength of your pelvic floor muscles. This “biofeedback” is then used to coach you in an individualized exercise program designed to increase your muscle function and bladder control.