The best way to start is to see a pelvic health physiotherapist for an assessment and guidance.
Exercise 1 : Building Strength
So you can hold on longer : Breathe in and as you breathe out (as if blowing out a candle or misting your glasses to clean them – long and slow) close the muscles around your anus, vagina and urethra as if trying to stop passing wind and urine at the same time then lift your anus towards your pubic bone.
It is a close or squeeze and lift action.
See the video for visual instruction.
* It is very easy to cheat – especially if the muscles are weak .
What NOT to do
Do not suck your tummy in
Do not squeeze your thighs or buttocks together
Do not hold your breath. These bigger muscles will override and take over from your pelvic floor if you let them.
Do not try too hard
- How many seconds can you hold the pelvic floor squeeze and lift without cheating or using the DO NOTs?
- If you feel these other muscles tightening, you are trying too hard , try more gently.
- It is better to do a more gentle contraction correctly than a harder one using the wrong muscles.
HOLD Build up to a maximum of 10 seconds for each pelvic floor (or kegel) exercise
REST for 5-10 seconds
REPEAT up to 10 times
- Try to do these exercises in a slow and controlled way.
- Practise your maximum number of held contractions (up to 10) in sets of 3 once a day.
- It may take a few weeks to build up to 3 sets.
DON'T do random exercises at the traffic lights or whilst brushing your teeth, you don't strengthen any other muscle group that way.
You CAN practise some quick contractions throughout the day in conjunction with activities that require a pelvic floor contraction such as coughing and sneezing. See the next exercise......
Exercise 2: Buildng Speed
The ability to work these muscles quickly helps them react to sudden stresses from coughing, laughing or exercise.
- Practise some quick contractions, squeeze and lift the pelvic floor quickly holding for just a few seconds before releasing.
FAST SQUEEZES x5
Try to do one set of slow contractions (exercise 1) followed by one set of quick contractions (exercise 2)
Exercise 3: Building Endurance
- A strong pelvic floor will help you out under strain eg a cough, sneeze or lift.
- You need endurance in these muscles for the rest of the time because they are always working to a degree.
- The ideal way to achieve this is using some pelvic floor weights or cones for a short time each day or every couple of days. These are not heavy, but they help you to keep the pelvic floor muscles switched on a little bit which will build endurance.
- 10-20 minutes per session is all you need.
- There is no need to wear them for hours as you may read in some places.
Exercise 4: Functional Use of Your Pelvic Floor
- In other words using it when it is most needed.
- Your pelvic floor should contract and tighten to protect against increases in abdominal pressure – when you cough, sneeze, jump or lift.
- If they don’t come in quickly or strongly enough, the pressure pushing down overcomes the pressure holding around your urethra and the end result can be a leak.
- Remind them to work ….tighten, hold cough….tighten,hold lift …. Tighten, hold stand up etc.
- How hard you need to hold depends on the downward force. A sneeze creates more force than a cough which creates more force than standing up.
- Use enough force to counteract or balance it. If you consciously practise to start with, the action soon becomes automatic again.
Exercise 5: Relax It
Pointless tightening it if you don’t relax it - if you do quads exercises at the gym you relax the muscles in between reps – do the same with your pelvic floor muscles.
General relaxation and stretching is also good for your pelvic floor.
Yoga and breathing exercises can be very helpful to relax the pelvic floor and co-ordinate its use with your breathing and diaphragm.
Poses that can help (if you are able to do them or modify them) :
- child's pose with knees apart
- happy baby
- deep squat
- belly breathing in crook lying
How to achieve better results with your pelvic floor exercises
There is lots of research showing many women achieve better results when they use pelvic floor exercise devices to assist them in doing pelvic floor exercises.
This can be done in several ways
Dr Kegel, the originator of the kegel exercise program, never intended his exercises to be conducted on an empty vagina.
He developed an exercising product similar to the perineometers (eg PFX2 ) in use today. Somewhere along the line, his message has been lost and for many years women have been encouraged to try unassisted exercising.
More recently, pelvic floor exercise devices have gone high tech and there are now many that link to your smart phone and via an app, you can play games that help you to progress and strengthen your pelvic floor muscles.
Why are some women not successful with pelvic floor muscle training?
Often because they don't exercise often enough, and for long enough.
Women report that :
- they don't remember
- they find it hard to fit exercises into daily life
- they feel uncertain about whether the exercises are working
- they don't know if they are doing them correctly, particularly in the early stages.
Using a device can help address some of these problems and encourage you to continue your pelvic floor strengthening program.
Maintaining your own motivation is half the battle with home-based exercising. Exercise devices can help to maintain that all-important motivation.
Pelvic floor muscle or nerve damage
This is one of the less common reasons that people fail with pelvic floor muscle training. There may be an injury especially from vaginal childbirth.
If you have been training hard with no result , ensure you see a women's health physio or your gynecologist for a full check up. Even if there has been some damage, it can often improve with time ( eg peripheral nerve neuropraxia from nerve stretching during birth will take months to heal) and if there has been an avulsion ( pelvic floor muscle deatching from bony attachment ) you can make the most of the muscle that is stil functioning. Again see a women's health physio for individual help if this is suspected.
The material presented in this information sheet is intended as an information source only. The information is provided solely on the basis that readers will be responsible for making their own assessment of the matters presented herein and are advised to verify all relevant representations, statements and information. The information should not be considered complete and should not be used in place of the advice of a health care provider. Pelvic Floor Exercise does not accept liability to any person for the information or advice provided , or for loss or damages incurred as a result of reliance upon the material contained herein.
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