Have you ever been instructed to do pelvic floor exercises to control urinary incontinence? Has anyone told you to do the Kegels, and you won’t leak?

These statements are true, but what are the pelvic floor exercises, Kegels, and for that matter, what is referred to as your pelvic floor? We are often told that we need to do something, but we don’t have an understanding of how to do it, and we don’t know if we are doing it correctly anyway.

According to our research, over 90% of our customers are aware that strengthening pelvic floor muscles will most likely help improve continence, however, less than 5% of them actually do these exercises daily to build this strength.

This article will explain all of the basic terms and importance of pelvic floor muscle strengthening.

A pelvic floor is a group of muscles and ligaments which support the bladder, uterus and bowel. They sling from the front of your body to the back and form the base of a group of muscles commonly called your core. The pelvic floor muscles attach to your pubic bone at the front and the tailbone at the back, and form the base of your pelvis.

These are some of the most important functions of these muscles:

• They offer support to the abdominal organs, such as the bladder, bowel and uterus
• The pelvic floor plays a role in sexual function and orgasm
• A strong pelvic floor assists in childbirth, by aiding in pushing bub out

Having a strong pelvic floor is essential to maintain continence by assisting the urinary and anal sphincters to operate correctly. When the pelvic floor is strong, it supports your pelvic organs to prevent problems such as incontinence and prolapse (lack of support) of the bladder, uterus and bowel.

The pelvic floor muscles also help you to control bladder and bowel function, such as allowing you to ‘hold on’ until an appropriate time and place.

Pelvic floor muscles can be weakened by simply carrying excess weight from pregnancy or obesity, through damage during childbirth or from medical conditions. During menopause, the pelvic floor can lose tone due to hormone changes in the body.

Pelvic floor weakness can lead to disorders that include urinary incontinence, faecal incontinence, or pelvic organ prolapse. Straining on the toilet can also lead to Pelvic floor weakness as can heavy lifting, high-impact exercise, and ongoing persistent coughing.

To summarise, there are several factors that can result in pelvic floor muscles weakness:

• Advancing age
• Excess weight or obesity
• Pregnancy and childbirth
• Changes in hormonal levels at menopause
• Prolonged constipation
• Persistent lifting of heavy weights
• Surgeries

Pelvic floor exercises, when done regularly will:

• Improve bladder and bowel control
• Reduce the risk of prolapse (in women)
• Aid in better recovery from childbirth and surgery (in women)
• Improve recovery after prostate surgery (in men)
• Boost sexual function

Ladies, you would have felt the pelvic floor muscles working whenever you have stopped peeing mid stream. You may also be able to feel your pelvic floor muscles by inserting a finger into the vagina to feel the walls of your vagina while lifting and squeezing your pelvic openings (the vagina, urethra, and anus).

For the boys, you’ll have felt the pelvic floor muscles working whenever you’ve stopped your pee mid-flow. Try sitting or lying down with the muscles of your thighs, stomach and bum relaxed. Squeeze the ring of muscle around the anus (back passage) as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Try not to squeeze your buttocks. You can also stand in front of a mirror with no clothes on. Pull in your pelvic floor muscles strongly and hold them. You should see the penis draw in and your scrotum should lift.

Exercise 1 – Short Squeeze:

• Find a comfortable position sitting, standing, lying down (on your back) or on your hands and knees.
• Have legs slightly apart.
• The action that tightens the pelvic floor muscles can be achieved by imagining you are trying to hold on from passing urine or wind. Tighten these muscles around your vagina/penis as well as your back passage as firmly as possible. You should feel your pelvic floor muscles ‘lift’ inside you.
• Squeeze and lift your pelvic floor muscles as firmly and quickly as possible. This is just a quick and intense squeeze – do not hold the contraction.
• Do not suck your belly button into your spine and do not hold your breath. Do not tighten your buttocks.
• Relax for a moment then repeat up to ten times or until you feel fatigue in your pelvic floor muscles.
• Try to do this exercise daily and, if possible, mix up your starting position each time.

Exercise 2 – Strength Holds:

• Find a comfortable starting position as with Exercise 1.
• Lift your pelvic floor muscles the same as you did in Exercise 1, however this time hold as tightly as possible consistently for at least 3-5 seconds.
• Then relax – you should feel your muscles noticeably releasing.
• Rest for a moment then repeat up to ten times or until you feel fatigue.

Remember, repetition is the key. Do these exercises 3 times a day and do at least 3-4 sets each time.
If you are unsure, contact your Pelvic Floor Physiotherapist, Continence Nurse, or the Continence Foundation of Australia.

*Information in this post is not medical advice. Incontinence can be caused by many reasons, and each case should be discussed with your doctor before commencing a pelvic floor muscle exercises.