All you hear about in pregnancy is “are you doing your pelvic floor exercises?” When asked this, I think most women nod frantically because they think they should know how to do it but in reality inside they are thinking “how do I know if I am doing them right?”
It is important to remember that the pelvic floor is a muscle, just like in your leg. If you don’t use it, you will lose it. These are the wise words from Jenny Constable, a specialist physiotherapist who specialises in the pelvic floor. Jenny shares her top tips on the best pelvic floor exercises to strengthen muscles and avoid incontinence.
The 5 reasons pelvic floor exercises are important
- The reason we want you to do your pelvic floor exercises is to prevent bladder leaking problems during pregnancy and afterwards. 1 in 3 women experience stress urinary incontinence during and after pregnancy. Stress incontinence is when you leak some urine when you cough, sneeze, laugh or run. It is mainly due to weak pelvic floor muscles not squeezing around your urethra and stopping the urine escaping.
- The pelvic floor is a key core muscle group, which helps support your back and pelvis. This can help prevent pelvic girdle or back pain.
- It can help improve the sensation during intercourse and orgasms, as the muscles link into your clitoris.
- The pelvic floor helps support your pelvic organs and can help prevent pelvic organ prolapse.
- The muscles can help turn your baby’s head during the last stages of labour.
The problem is that around 30% of women will be doing the wrong thing when they try to contract their pelvic floor muscles. One of the main reasons is that as we can’t see the muscles, it is really difficult to know how to tighten them.
Where are the pelvic floor muscles and how do they work?
The muscles start around your tail bone, then come forward and wrap around your back passage, vagina and urethra (the tube urine comes out of) and attach to your pubic bone on the front of your pelvis. It might help to think of it like a jelly fish: it moves up and down as it squeezes and lets go.
Now you understand a bit about where the pelvic floor muscles are, this is how and why it’s important to do your pelvic floor exercises, and how we want you to do the exercises:
- Start in a relaxed position (sitting or lying down).
- Take a breath in, and as you breathe out try to tighten around your back passage (imagine you are stopping passing wind).
- Then keep squeezing up and forward towards your vagina (imagine you are closing your vagina or trying to pull a tampon further inside you)
- Then just let the muscle drop and relax.
- Some people find that the best thing is to get a mirror and just have a look! You will see the back passage and the perineum (skin between vagina and back passage) draw in. Then when you release the squeeze, the muscles should drop back to their starting position.
The ideal exercises that we teach to work the pelvic floor muscles are:
- Squeeze the muscles as above, then try to hold the squeeze while you breathe in and out for up to 10 seconds. If you can’t hold it for 10 seconds then just hold as long as you can.
- Then let the muscles go, take another breath in and out again before you squeeze again.
Try to repeat this exercise 10 times in a row 3 times a day.
- Quick squeezes are a short sharp squeeze and release without holding.
- Wait for a few seconds between each set.
- Repeat this again 10 times in a row 3 times a day.
You might feel that these exercises are a lot, but just try to get into a routine of doing them a few times a day, for example when you’re having breakfast, breast feeding or watching TV during an advert break.
What to do if you need help
If after following this guide to pelvic floor exercises and you’re still struggling, then help is out there. A women’s health physiotherapist will be able to check your pelvic floor muscles and set a specific routine to follow. Don’t suffer in silence!
By Jenny Constable, Specialist Physiotherapist at Six Physio
To find a physiotherapist that can help, visit https://www.squeezyapp.com/directory/.