Why exercise the pelvic floor?
Life events often can weaken pelvic muscles. Pregnancy, childbirth, and being overweight can all contribute to weakening of the pelvic muscles. Usually when these muscles are weak, you can help them get strong again with exercise. Ideally the muscles of the pelvic floor are always at some level of contraction. Activities that may put 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, exercise of the pelvic floor can be useful, even, and especially following, surgical correction.
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 three levels of support to the vagina:
- At the top of the vagina are combinations of supportive tissues that largely cannot be consciously controlled via exercise.
- At the middle portion of the vagina, with the bladder resting on top, are several flat muscles, the "hammock" muscles, that together with ligamentous tissues are supportive. These flat muscles form a "V" shape around the vagina and with contraction (that can be consciously controlled) can help to close the vagina and thereby support the bladder.
- At the most external portion of the vagina is a triangular series of muscles, the "triangle" muscles, that with contraction (also consciously controlled) can close the vagina.
Kegel 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.
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 three methods to check for the correct muscle contractions:
- Try and stop the flow of urine when you sitting on the toilet. If you can, you're using the right muscles.
- Imagine trying to stop from passing gas. Squeeze the muscles you would use. Done correctly 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.
- Don't squeeze other muscles at the same time.
- Be careful not to tighten your stomach, legs or any other muscles besides the "hammock" and "triangle" muscles. Squeezing the wrong muscles can put more pressure on your bladder control muscles.
- Do not hold your breath when you're doing these exercises.
- Repeat, but don't overdo it.
- At first, find a quiet spot to practice, your bathroom or bedroom, so you can concentrate. Lie on the floor. Pull in the 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 three times a day.
- Every day, use three positions, lying, sitting, and standing, to do your Kegel exercises. You can exercise while lying on the floor, sitting at a desk, or standing in the kitchen. Using all three positions may make the muscles strongest.
- Be patient.
- Don't give up! It's just five minutes, three times a day. You may not feel your bladder control improve until three to six 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 healthcare provider can arrange to have you seen by a physical therapist that can help you more.
- 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.
- Weak pelvic muscles can worsen or cause bladder problems.
- Daily exercise can help strengthen pelvic muscles.
- Pelvic exercise does improve bladder control.
- Ask for help in identifying the "right" muscles to contract.
- Tighten your pelvic muscles before sneezing, lifting, or jumping.
- Be patient and keep at it!