Strengthening the Pelvic Floor
Pelvic floor exercises, during pregnancy and after birth, can help reduce the risk of urinary incontinence. Some women will experience urinary leakage during pregnancy or after birth. This can occur due to weakened pelvic floor muscles (the muscles between your anus and vagina). You can do simple, daily pelvic floor exercises, such as Kegel exercises, throughout your pregnancy to strengthen your pelvic floor muscles. Talk to your healthcare provider about how to do Kegel exercises effectively.
What is the pelvic floor?
Layers of muscle stretch like a hammock from the pubic bone in the front to the end of the backbone. These firm, supportive muscles are called the pelvic floor and they hold the bladder and bowel, as well as the uterus in women in place. Certain conditions may cause the pelvic muscles to weaken.
How does the pelvic floor work?
The muscles of the pelvic floor are firm and slightly tense to control the flow of urine from the bladder, or feces from the bowel. When you urinate or have a bowel movement, these muscles relax. Afterward, they tighten again and stay that way to restore control. Pelvic floor muscles can sag, however, because of an injury, lack of exercise, childbirth, or just getting older. When this happens, there is less control, and urine and feces can leak.
How can pelvic floor exercise help?
Pelvic floor exercises can help strengthen the pelvic hammock so it will, once again, give support. This will help you improve your bladder control and reduce or stop the leaking of urine.
Learning to do Pelvic Floor Exercises
Pelvic floor exercises are designed to strengthen the muscles of the pelvic hammock. Make sure you learn how to do the exercises the right way and, from time to time, check that you are still doing each exercise correctly.
How to “Feel” the Muscles of the Pelvic Floor
It is important to learn how to feel the muscles of the pelvic floor as you contract them to be sure that you are exercising correctly.
Here are ways to identify the muscles:
1. When you go to the toilet try to stop the stream of urine about halfway through emptying your bladder then relax the muscles and allow the bladder to empty completely. The muscles you use to stop the flow of urine are the same muscles you will be squeezing when doing the Kegel exercises. Do not repeat this as an exercise.
2. Women may place one or two clean fingers in the vagina. Tighten the pelvic floor muscles to squeeze your fingers. Your doctor or your health-care professional may be able to help you with this the next time you have a vaginal examination.
3. Imagine trying to stop yourself from passing wind from the bowel. You would squeeze the muscle around the anus. Try squeezing that muscle as if you really did have wind. Do it now. You should be able to feel the anus tightening and the anus being pulled up and away from whatever you are sitting on.
How to do the Kegel Exercises
Kegel exercises can be done any time and anywhere. You can do them in the morning, noon or night. The exercises can be done while sitting, standing, lying on your back or taking a bath. Always urinate (empty your bladder) before starting. Do these exercises each day or as direct by your caregiver.
- Lying on the floor or bed, breathe deeply (don’t hold your breath) and tighten the anal muscle, pulling inward and upward. This should feel like you are trying to hold back urine or gas.
- Hold these muscles for a count of 10.
- Slowly release these muscles and relax for a count of 10. Repeat the cycle again.
- Do five to 10 quick, strong contractions after you are finished doing the slow contractions. These exercises may help you prevent an accident by quickly stopping urine leaks.
A Few Simple Rules to Remember
Now that you know how to do exercises:
- Do them properly. Check often to be sure that you are using the correct muscles.
- Do them regularly in sets of five to 10 contractions at a time in the morning, at noon, in late afternoon and before going to bed. After three or four weeks, increase the number of contractions in each set and hold each one longer, up to the count of 10. When you can comfortably hold the contractions for 10 seconds, you might consider gradually increasing the length up to 20 seconds.
- Do them intelligently. Learn to use the muscles when you need them the most, especially during times of stress, excitement, or when you feel you need better bladder control. Keep on doing them. Muscles work best when they are exercised. Once you have learned how to improve your bladder control, continue to do the exercises to keep the pelvic hammock in good shape.
- Watch your weight. Keeping yourself fit also means staying at your best weight.
- Drink plenty of fluids, six to eight glasses of water every day. And don’t fall back into the habit of going to the toilet “just in case”. Go only when you feel the need to pass urine.
- Do not stop doing Kegel exercises until you have talked to your caregiver. Kegel exercises may be useful for the rest of your life.
- Tighten your pelvic muscles before sneezing, coughing or lifting to prevent urine leakage.