What are pelvic floor exercises, how do you do them correctly and how often? We spoke with Continence Foundation of Australia member, Brisbane physiotherapist Sue Croft who offered this advice.
How often should I do my pelvic floor exercises?
In our videos we are emphasizing the importance of establishing a habit with your pelvic floor exercises and so performing them around 30 times per day will help with this. You should feel lift and squeeze when doing a pelvic floor contraction. It is important to concentrate on relaxed breathing while you do the exercises and to work on the endurance (or length of hold) of the muscles. After you have initially improved your awareness of the muscles and built up your strength, then contracting your PF muscles in conjunction with other movements or exercises, will further enhance your strength (through added resistance). To help you with improving stress urinary incontinence (the type of leakage that occurs with coughing and sneezing), it is important to learn the knack – that is contracting your pelvic floor muscles before and during the increase in intra-abdominal pressure such as lifting or coughing.
Are there any precautions about starting a programme of pelvic floor exercises myself without supervision?
Firstly, if you have any pelvic pain, or difficulty emptying your bladder or bowel, then it is important to have a consultation with a health professional used to examining your muscles internally (such as a Pelvic Health Physiotherapist) before you embark on an exercise programme. This is because you may have PF muscles which may be overactive, and doing too many PF exercises may increase any pelvic pain that may be present or make emptying your bladder or bowel more difficult. With an assessment and treatment plan, you will learn how to relax the muscles completely, assisting with any pelvic pain and then you can embark on a strengthening programme for the pelvic floor. The value of this is that you will also ensure you are doing the correct action with your muscles, as up to 30% of women perform the pelvic floor muscle contraction incorrectly (bearing down instead of lifting up).
I have no idea how to start with pelvic floor exercises – are there any Do’s or Don’tswith doing these exercises when first learning them?
Yes there are many pitfalls when doing pelvic floor exercises. Here are some reminders to think about when first attempting them.
- Do not use your inner thigh muscles.
- Do not tilt your pelvis.
- Do not clench your buttocks.
- Do not strongly contract your abdominal muscles.
- Do not hold your breath.
- Do not flare your ribs
- Do not bear down.
- Yes, you should feel lift and squeeze of the pelvic floor.
- Yes, your lower tummy may draw gently in.
- Yes, initially gentle is better than trying too hard to ensure the correct activation.
- Yes, when you are sure you have the correct activation, you can add some maximal contractions.
- Yes, always remember to let go and relax your pelvic floor muscles after exercising them.
How long do I have to do these exercises for? A few weeks? A few months?
These exercises are ones we must do for life. We pass through different life-stages with hormonal changes and the effects of ageing taking their toll on our continence state (whether we are having urinary leakage episodes or not). It is this life-time adherence (sticking to your plan forever) that most of us have trouble with. It is a lot like cleaning your teeth or putting on moisturiser on your face. You would not only do that for 6 months and then stop. You do that twice daily as a habit and that’s what we are trying to establish for you now with pelvic floor exercises.