Pelvic floor muscle exercises are designed to strengthen or lengthen the pelvic floor muscles. These exercises may also be called Kegel exercises. They affect the muscles that support your uterus, bladder, small intestine, and rectum. Pelvic floor muscle exercises are a non-surgical method for treating:
- Overactive bladder
- Sexual dysfunction
How do you exercise the pelvic floor muscles?
Find the right muscles. This is important. Your doctor or other health care provider will help you make sure you are doing the exercises correctly. You should try to tighten both the "hammock" and "triangle" muscles. Here are 3 methods to check for the correct muscle contractions:
- Try to stop the flow of urine when you are sitting on the toilet. If you can, you're using the right muscles. Once you find the muscles, we do not recommend routinely doing the exercises when you are trying to pass urine. It can interrupt the normal emptying mechanism for the bladder.
- Imagine trying to stop from passing gas. Squeeze the muscles you would use. You should sense a "pulling" feeling within your pelvis.
- Lie down and put your fingers inside your vagina. Squeeze as if you were trying to stop urine from coming out. If you feel tightness on your finger you are using the correct muscles.
Why exercise the pelvic floor?
Life events often can weaken pelvic floor muscles. Pregnancy, childbirth, and being overweight can all contribute to a weakening of the pelvic floor muscles. Usually, when these muscles are weak, you can help them get strong again with exercise. Activities that may put a strain on the pelvic floor can induce more contraction from these muscles. You also may consciously contract these muscles. Pelvic floor muscles are just like other muscles; exercise makes them stronger. Whether a woman has bladder or pelvic organ prolapse, exercising the pelvic floor muscles can be useful, even after surgical correction.
Pelvic floor exercises increase endurance and help relax the pelvic muscles. This provides support and can help with pain relief. There are 3 types of pelvic floor exercises.
- Endurance contractions help to strengthen the slow-twitch fibers that are used for support. These types of Kegels are also used for fatiguing out the pelvic floor during relaxation.
- Pelvic floor relaxation lengthens the muscles for patients with pelvic pain, constipation, and bladder dysfunction. To relax the pelvic floor muscles, breathe and release any muscle tension in the pelvic floor.
- Quick flick contraction exercises can be used for urge suppression techniques during the day and night.
Exercising your pelvic floor muscles for just 5 minutes 2 to 3 times a day can make a big difference to your bladder control.
Pelvic floor muscle exercises and your body
The part of your body including your hipbones is called the pelvic area. At the bottom of the pelvis are several layers of muscles and ligamentous tissue. These muscles and tissues span the openings within the pelvic bones.
There are 3 levels of support to the vagina
- At the top of the vagina, there are combinations of supportive tissues that cannot be consciously controlled with exercise.
- At the middle portion of the vagina, there are several flat muscles with the bladder resting on top. These are the "hammock" muscles. Together, the "hammock" muscles and surrounding ligaments provide support. These muscles form a "V" shape around the vagina. With conscious contraction, these muscles can help to close the vagina and support the bladder.
- At the most external portion of the vagina is a triangular series of muscles. These "triangle" muscles, with conscious contraction, can also help close the vagina.
Pelvic floor muscle exercises mostly contract the middle and most external muscles of the pelvic floor. This exercise strengthens the muscles that contribute to holding the bladder and pelvic organs in place.
Some important points to remember
- At first, find a quiet spot to practice, in your bathroom or bedroom, so you can concentrate. Lie on the floor. Contract or tighten your pelvic muscles and hold for a count of 10. Relax for a count of 15. Work up to 10 to 15 repetitions each time you exercise.
- Do your exercises at least 3 times a day. Every day, use 3 positions, lying, sitting, and standing, to do your pelvic floor muscle exercises. You can exercise while lying on the floor, sitting at a desk, or standing in the kitchen. Using all 3 positions may make the muscles strongest.
- Do not hold your breath when you're doing these exercises.
- Don't squeeze other muscles at the same time.
- Be careful not to tighten your stomach, buttocks, legs, or any other muscles besides the "hammock" and "triangle" muscles. Squeezing the wrong muscles can put more pressure on your bladder control muscles.
- Repeat, but don't overdo it.
- Be patient. Don't give up! It's just five minutes, 3 times a day. You may not feel your bladder control improve until 3 to 6 weeks after starting your exercises, but many women do note some improvement in just a few weeks.
Other ways to strengthen and protect the pelvic floor muscles
Exercise aids can help
- You can also exercise by using special vaginal weights or biofeedback. Additionally, if you need more help, your health care provider can arrange to have you seen by a physical therapist that can provide more help.
Hold the squeeze until after you sneeze
- You can protect your pelvic muscles from more damage by bracing yourself. Think ahead, just before sneezing, lifting, or jumping, and contract your pelvic muscles. After you train yourself to tighten the pelvic muscles for these moments, you may have fewer accidents.
- Ask for help in identifying the "right" muscles to contract.
- Daily exercise can help strengthen pelvic muscles.
- Pelvic exercise does improve bladder control.
- Tighten your pelvic muscles before sneezing, lifting, or jumping.
- Weak pelvic muscles can worsen or cause bladder problems.
- Be patient and keep at it!