HealthInfo Canterbury

Pelvic floor exercises for women

Your pelvic floor muscles (PFMs) lie at the base of your pelvis between your pubic bone at the front and your tail bone at the back. The outlets from your bladder (urethra), vagina, and back passage (anal canal) pass through your PFMs.

The PFMs support your pelvic organs (bladder, uterus and rectum – the lower part of your bowel). They help to prevent leakage of urine (wee) from your bladder, and wind or faeces (poo) from your back passage. They also support your pelvis and lower back.

When your PFMs get weak or are damaged, they don't work as well. Common causes of this are:

• pregnancy and childbirth
• hormonal changes (pregnancy, menstrual cycle, menopause)
• excessive straining when passing a bowel motion (poo)
• repeated heavy lifting
• being overweight.

Exercising your PFMs can help to:

• improve or maintain bladder and bowel control
• give support to your pelvic organs, helping to prevent or relieve symptoms of vaginal prolapse
• make sex more pleasurable.

How to strengthen your PFMs

1. Lie on your side. You may like to have a pillow in front of your tummy or between your thighs. You need to feel comfortable.
2. Relax your tummy, bottom and thighs (when you're relaxed you will see your tummy gently rise and fall as you breathe). It's important that you do this step before you tighten your PFMs.
3. Squeeze and lift up into your vagina (or imagine lifting a tampon up inside or stopping passing wind or urine). Ensure that your tummy stays relaxed and you continue to breathe normally.
4. Try to lift and hold for one to three seconds then rest for five seconds. Repeat eight to 10 times, three times per day.

If you've been assessed by a pelvic floor physiotherapist at Christchurch Women's Hospital, they'll give you a specific PFM exercise programme to follow.

More advanced PFM exercises

• Try to tighten your PFMs when you're sitting. For example:
  • sit at a table, lean forward keeping your back straight, and rest your elbows on the table
  • sit with your back well supported on a comfortable chair
  • sit on an exercise ball (only if you're familiar with how to sit on a ball correctly).
• Follow steps 2 to 4 above.
• Aim to hold for longer, five to 10 seconds. Make sure you relax your PFMs completely between each lift and rest them for a few seconds before you lift again. If your PFMs stop lifting properly they may be tired. Stop and rest.
• As your PFMs get stronger and you're able to lift and hold more easily, try to tighten your PFMs when you're standing.

Your goal is to be able to tighten your PFMs strongly before you cough, sneeze or lift something heavy.

Pregnancy and your pelvic floor

If you're pregnant, you should receive a booklet from your midwife or LMC, or from the maternity ward called "Looking after your body after childbirth". This contains a section specifically on PFM exercises after childbirth.

An exercise called abdominal bracing will help to support your baby and lessen the strain on your back while you're pregnant. It will also make it easier for you to regain your muscle strength and tone once your baby is born. Pelvic Floor First has a page explaining how to do abdominal bracing when you're pregnant and after your baby is born.

It's very important to give your pelvic floor muscles time to recover, and not to return to high-impact sport too soon after your baby is born. A leaflet from Pelvic Floor First explains how returning to sports too early can damage your muscles further, and sets out a programme for a safe and healthy return to sport.

  HealthInfo recommends the following pages

• Continence Foundation of Australia
  • Pelvic Floor First

    Pelvic Floor First is a programme run by the Continence Foundation of Australia. It aims to reduce the number of men and women who have pelvic floor problems caused by inappropriate exercise programmes.

  • Pelvic floor safe exercise app

    The Continence Foundation of Australia has developed a free, safe-exercise app. The app aims to help prevent incontinence and allow you to exercise without straining your pelvic floor or having embarrassing accidents. Before you use the app, it's a good idea to have a pelvic floor assessment to know how intensely you can exercise.

Written by Allied Health – Physiotherapy Services, Christchurch Women's Hospital. Adapted by HealthInfo clinical advisers. Last reviewed June 2018.

Source

Page reference: 21184

Review key: HIPFM-21184