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Exercises to Strengthen Pelvic Floor Muscles

  • Synopsis: Published: 2009-03-24 (Revised/Updated 2014-04-28) - Pelvic floor exercises that provide the correct exercise to strengthen your pelvic floor muscles to prevent incontinence - Dr Jenny Tylee.

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Quote: "The increased tone and support you will gain should be sufficient to help your pelvic floor cope with bursts of heavy exertion such as controlling sneezes or lifting groceries or other objects."

Your pelvic floor muscles, as well as those of your abdomen, are important in helping to keep things moving so that your body is able to efficiently remove waste material.

There are many factors that can weaken these muscles and this can lead to incontinence.

Appropriate exercises can correct the problem - unfortunately many pelvic floor exercises are incorrectly carried out and actually add to the problem. This article provides the correct exercises to strengthen your pelvic floor muscles.

The rectum and anus receive what has passed through the large intestines (colon) and is ready to be eliminated. The material that passes through the colon needs to be relatively wet, bulky and soft rather than being 'dried' out and hard and difficult to pass. As well as this their needs to be plenty of bulk which places gentle pressure on the colon wall and this stimulates it into further appropriate action - moving the stool along towards the rectum and anus and exit.

The rectum, anus and pelvic floor muscles are an important part of the elimination process and need to function well. The pelvic floor muscles support the rectum and anus and keep these at the correct angle. They hold the anal sphincter in the best possible position to empty the rectum and they also have other roles to play. The pelvic floor muscles can be separated into lifting, opening and closing muscles. These muscles all have a role to play in the elimination process with the opening and closing muscles being used at the actual time of going to the toilet.

The lifting muscles support the organs in the pelvis as we move about and exert ourselves during the day - walking, standing, lifting, sneezing and toileting. They help keep the rectum and bladder in the 'right place' so that we can pass urine and feces efficiently and without straining. They give support during childbirth and are important in love making. They can be damaged or weakened by:

  • Childbirth
  • Straining to pass stools - particularly because of constipation
  • Spinal problems
  • Chronic coughs and sneezing
  • Being overweight

A part of the lifting muscle is called the deep supporting sling. It surrounds the urethra (the passage from the bladder), the vagina and the anus. This muscle works when we get the feeling of lifting the vagina or anus. Like any muscle group the pelvic floor muscles respond well to exercise programs designed to improve function. These muscles need to be 'found' and then be worked before you can go to the toilet without straining. The deep support sling will not have good tone in the months following childbirth - whereas the opening and closing or quick actions muscles will still be maintained. This can be very confusing to mothers who have been told to squeeze their muscles in post-natal classes.

The exercises outlined below will teach you how to use the muscles around your waist to support your pelvic floor when you exert yourself or wish to defecate. The exercises are organize around the following:

  • muscle awareness - feeling it working
  • finding the exercise limit - so that you can maximize the sling support
  • learning to force the maximum and thus take it to a higher level

Muscle awareness

Muscle awareness can be a problem for about 1/3 of women. When women are asked to squeeze up they actually bear down instead. This is the wrong action and it may actually cause more muscle weakness. Before you can build up the strength of your pelvic floor muscles you have to find out whether they are working. To do this sit on the toilet with you knees wide apart. Start the flow of urine and then try to stop it. It should stop dead and not just slow down to a trickle. Women who 'leak' urine while coughing or sneezing usually have weak pelvic floor muscles.

Another way of finding out if the muscles are working is to look at them while trying to squeeze them up. You will need a mirror to do this. Prop yourself up on a bed - half sitting/half lying position. Men will need to move their penis and scrotum out of the line of vision. Watch the whole perineum as well as the anus as you 'squeeze and lift' and just see what happens. Everything should move in an upward direction - away from the mirror. The anus should pucker up like a purse-string being pulled tight. If they don't seem to be working try this. Pull up as though you were about to pass wind and someone important (like the Queen or the president) has just walked into the room. Squeeze up to stop the wind from passing and making a loud and embarrassing noise. Don't worry if you seen to be squeezing the front passage as well - it is difficult to work one without the other. Now try to hold the squeeze for a few seconds. Men seem to have less trouble than women recognizing that their pelvic floor muscles are working.

For women who have weak pelvic floor muscles (if you 'leak' urine while coughing or sneezing) it will probably be necessary to use your fingers to feel the muscles contracting. Prop yourself on the bed in the position described above. Use, suitably cleaned or gloved, index and middle fingers of your right or left hand (whichever suits you). Moisten the inserting finger with a little lubricating jelly (not Vaseline or face cream as these can irritate the lining of the vagina). Gently slide your fingers into your vagina, pull your muscles up as though you need to pass water and you can't find a toilet. Can you feel the movement? If not try the 'stopping your wind from making a loud noise in front of the Queen or President routine' - described above. At the same time as you are doing the 'stop the wind' exercise, imagine that a pin is about to prick your bottom. After you have felt the changes to the area when you are have done these exercises feel what happens when you cough - feel that downward pressure? Gently bear down as though you were going to use your bowels and feel the downward movement again. This is the opposite feeling to when you are doing the floor contraction exercises properly! Now immediately squeeze up again. You should feel a definite lifting movement - it should be upward and inward. When you can feel the muscles contracting - no matter how small the movement seems to be, you are ready to begin the exercise program.

Finding the exercise limit

When you are aware of the muscles, draw up the deep supporting sling muscle around the urethra, vagina and the anus and hold this for as long as you can - 5 - 10 seconds. Initially only hold this for a few seconds. They need to be strengthened and build their 'staying power'. Having felt the muscles lift and contract you now need to feel just how long you can hold the contraction and lift. Weak muscles need time to recover after each contraction so you should rest for about 10 seconds between contractions.

Increasing the strength and endurance

No matter if you are able to lift the sling for 5, 10, 20 or 30 seconds only do a set of four repetitions at any one time. Gradually increase the time that you hold and lift - thus increasing your endurance. Do many sets during the day. You may need to use your fingers to assess and reassess your progress.

The increased tone and support you will gain should be sufficient to help your pelvic floor cope with bursts of heavy exertion such as controlling sneezes or lifting groceries or other objects.

In contrast to the lifting sling muscles the opening and closing muscles need to be used many more times in succession. To work these muscles you need to tighten them quickly, then, let them go. Do not tighten your buttocks. If you stand 'pigeon-toed' with your knees together, it will be easier to feel the sphincter muscles and harder for you to use your buttock muscles.

Keeping the pelvic floor muscles in good working order is important for effective elimination of wastes. This process can be assisted by ensuring that the material that enters the rectum and anus from the colon is relatively wet, bulky and soft rather than 'dried' out and hard and difficult to pass. This will limit the straining that occurs and will limit the strain placed on the pelvic floor muscles. As well as straining at stool there are other reasons for weakened pelvic floor muscles - for women this is childbirth but it can also include being overweight, having spinal problems and chronic coughs.

Discover how to keep you colon clean and keep yourself moving without strain and pressure on the pelvic floor muscles. Learn how to gain and maintain your health. Get your copy of Safe Colon Cleansing Your Good Health Guide (from safecoloncleansing.com) and begin now. Then get on with really enjoying life.

Reference: Chiarelli, P. and Markwell, S. Let's Get Things Moving. Gore and Osment Publication.

Dr Jenny Tylee is an experienced health professional who is passionate about health and wellbeing. She believes that health is not just absence of disease and seeks to actively promote vitality and wellness through empowering others. She encourages people to improve their health by cleansing their body, taking essential, non contaminated vitamin and mineral supplements (from healthproductssite.com) and many other methods, including herbal remedies. She also owns Healthy Living blog www.healthproductssite.com

Related Information:

  1. Fecal Incontinence - Loss of Bowel Control Information - Disabled World - (Sep 28, 2009)
    https://www.disabled-world.com/health/digestive/fecal-incontinence.php
  2. 1 in 3 Women Live with Stress Urinary Incontinence - American Urological Association Foundation - (May 16, 2011)
    https://www.disabled-world.com/health/female/urinary-incontinence.php
  3. Urinary Incontinence Has Greater Impact on Quality of Life Than Other Chronic Conditions - UnitedHealthcare - (Jun 11, 2011)
    https://www.disabled-world.com/health/aging/incontinence-impact.php


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