How to do pelvic muscle exercise
|The Pelvic Floor Muscles
The pelvic floor is a muscular sling which supports the abdomino-pelvic organs including the bladder in front, the uterus centrally and the lower bowel and rectum behind. These muscles function to provide good control of your vagina, urethra and anus, assisting in control of bladder and bowel function. They also help to withstand the pressure increases that occur when coughing, sneezing, lifting or straining, and help to increase sexual satisfaction for both partners.
Many factors contribute to weakening of the pelvic muscles' the most important being childbirth, where the muscles, nerves and ligaments are directly traumatised, and the menopause when waning of ovarian function reduces hormone levels which normally serve to maintain muscular strength. Other factors including obesity, constipation and chronic cough also contribute to pelvic muscle weakness.
A good way to learn the exercise is to pretend that you are lying on your back, with knees bent and wide apart. Imagine that someone is trying to stick a needle into the area between the vagina and anus. Try to pull this vaginal area away from the needle, back inside your body.
Don't hold your breath and make sure that your bottom is relaxed. Another good way to learn the exercise is to imagine that you are trying to avoid passing wind. Think about the way you tighten (or contract) the muscles to keep the gas from escaping.
To get most benefit from pelvic muscle exercise
1. Maximal effort needs to be put into each contraction
2. Try to contract only the pelvic muscles. If you feel your abdomen, thighs or buttocks tightening, relax, aim just for the pelvic muscles, and use a less intense muscle contraction.
3. Initially hold each contraction for 2 seconds, then for 4,6,8 & 20 seconds, as your muscles get stronger. Ten contractions in one "set" is ideal.
4. Rest for at least 10 seconds (longer if you need to) between each contraction, so that each one is as strong as you can make it.
5. The above set of exercises is best repeated 4 times a day. This can be easily achieved if you do them:
Avoid bearing down motions with pelvic muscle exercise
- When you finish going to the toilet
- During commercials on TV
- At the red lights when driving.
The most serious mistake women make when doing pelvic muscle exercise is to strain down instead of drawing the muscles up and in. To keep from straining down when you do a pelvic muscle contraction: Exhale gently and keep your mouth open each time you tighten your muscles. Rest a hand lightly on your abdomen. If you feel your stomach pushing out against your hand, your are straining down.
Use planned muscle contraction to avoid leakage
Once you have learned the correct pelvic muscle contraction technique, it can help you right away to avoid leakage. When you feel a cough or sneeze coming on (or any situation that you know can cause you to leak), tighten your pelvic muscles as tight as you can. Keep them tight throughout the cough or sneeze. Planned pelvic muscle contraction has been show to reduce or eliminate leakage, and as your muscles get stronger over the exercise program you will see even more benefit from this trick.
Making a change in your personal health care program
It is a challenge to work any new health habit into your everyday life. Everyone who is making a change like this has lapses. You may forget for several days at a time. Don't get discouraged and think that you won't be able to continue the exercise program. Just resume the program and remind yourself that every day that you do the exercises helps your muscles get into better shape.
Monitor your progress. You might want to keep a daily diary of whether or not you have had a leaking accident. Another way to check your progress is to see whether you can slow down or stop your urine stream when you are going to the bathroom. We recommend that you try this no ore than once a week. As your pelvic muscles get stronger, you will find that you are able to stop the stream more quickly.
Finally, don't expect an overnight cure. We know that daily pelvic muscle exercises will strengthen your muscles and eventually stop or greatly improve any leakage. But that takes time, maybe 12-16 weeks. Expect to exercise for at lease 3-4 weeks before you see evidence of improvement. This is a major commitment, but there is a good chance that the program will help you avoid surgery or medication that has unpleasant side effects.
4 TIMES A DAY
BUILD UP TO 10 SECONDS DURATION FOR EACH CONTRACTION.
10 SECONDS REST BETWEEN EACH CONTRACTION
GOOD LUCK ON YOUR PROGRAM OF PELVIC MUSCLE EXERCISES! PLEASE CALL THE PHYSIOTHERAPY DEPARTMENT OR THE BLADDER CLINIC ON 07 4727 4097
. IF YOU HAVE ANY QUESTIONS OR CONCERNS.
The Townsville Hospital,
J. Hagerty, A. Corstiaans & Prof. A. Rane: Updated January 2006