Pelvic Floor Muscles

What are they?

The pelvic floor muscles form a hammock in the pelvis, helping to support the bladder, vagina and rectum (front and back of the body). The whole network is commonly known as ‘the pelvic floor’.The bladder neck, the area where the bladder and urethra meet, is partly supported in its position by the pelvic floor muscles.

The pelvic floor helps to hold the urethra in position on the underside of the pelvic bone. In this position, the increased pressure in the abdomen caused when you cough, sneeze or exercise is transmitted to the urethra, as well as the bladder, and has an equal effect. This is known as the pressure transmission theory and forms the basis of our understanding of continence. The pressure transmission theory is also the principle on which most surgical operations are based.

Why do the pelvic floor muscles not work properly?

The muscles can be damaged in many ways. Like any muscle it could be susceptible to injury and damage. The following could place considerable strain on the pelvic area:

Damage caused during pregnancy
A chronic or smoker’s cough
After childbirth
Lack of general fitness
Changes due to the menopause and age
Too much lifting of heavy things
After prostate surgery
A history of chronic constipation
Being overweight

Cough, sneeze, laugh, exercise, blow your nose, lift or get up from a chair, bend or stretch.

Differences between the strong and weak pelvic muscles

It is not uncommon for some people lose control of their bowel and bladder if the muscles are very weak. Pelvic floor muscle exercises may help. The bladder, womb and bowels usually rest on the pelvic floor muscles. They may start to fall down in the pelvis if these muscles are weak. If they push against the walls of the vagina, this is called a pro lapse.

Keeping them in shape!

A good exercise to practice is to deliberately stop urination during midstream urination. This controls the frontal pelvic muscles.

The rear muscles can be identified, by squeezing in and upwards the back passage area. The muscles work as a team and the rear muscles in action will coordinate with the muscles found around the bladder.

How to Exercise Your Pelvic Floor Muscles

If you experience any bladder weakness, you should consult your doctor or health care professional before starting any sort of pelvic floor exercise.

Which Type of Pelvic Floor Exercises should I do?

There are two types of pelvic floor exercises:
Quick pelvic floor exercises are when the muscles are rapidly tightened then relaxed repeatedly. This helps the muscle to stop the urine leaking when your sneeze, laugh or exercise (typical in stress incontinence)
Slow pelvic floor exercises are when the muscles are tightened and held for at least 10 seconds then relaxed. Never strain of force the exercise. This helps the muscles provide support for your bladder and bowel.
In this instance remember NO PAIN DOES NOT MEAN NO GAIN! Only exercise.

How many times a day should I exercise?

Your pelvic floor workout build up.
10 slow exercises and 10 fast exercises - 4 times each day.

How to carry out the exercises.

You can take any comfortable position for you. Sit, stand or lie down with your legs slightly apart and the muscles in your thighs, buttocks and abdomen relaxed.

Tips:

Do not hold your breath
Do not push down instead of squeezing and lifting up.
Do not tighten your stomach, bottom or thigh muscles.
This is a gradual routine. Build up slowly to your own pace.
There are several aids available to help exercise the pelvic muscles, such as the pelvic toner, the pelvicisor, vaginal cones, see your continence nurse for a list of aids. Remember these aids will not do the work for you, you have to make the effort, they are only aids to assist.

How will I know if I am getting better?

You would expect to have fewer leaks in your underwear after about 3 months of exercising.
It is advisable to seek medical assistance if there is no improvement after 3 months.
You may need to exercise for up to 6 months before you see a full improvement.
Remembering to do the exercises is a problem with most people.
It can be hard to remember to do your exercises. Choose something that you do about 4 times a day. Do your pelvic floor exercises every time you do this activity. For example, you could choose to do the exercises each time you switch on the kettle. Strong pelvic floor muscles may improve your sex life.

Your muscles should become stronger and you will stop leaking urine. You must still do the workout 3 times a week for the rest of your life. If you do not, your muscles may become weak again.

How can I cope with leaks of urine while building up the strength of the muscles?

Incostress is a new medical device to control stress incontinence in women. It is made from a medical grade silicone and worn inside the vagina using the same method as a tampon.
You may need to use pads while you are waiting for your muscles to get stronger. You put these in your underwear and they soak up the leaks of urine. There are different sorts of incontinence pads. Throw away and washable. There are also special pants (underwear) with pads already in them.