Pelvic Floor Exercise

Purpose

• Strengthen pelvic floor muscles for better bladder and bowel control
• Prevent or correct prolapse (drooping) of bladder, uterus or bowel due to weakening pelvic floor muscles
• Prevent urine leakage when you cough, sneeze or jump
• Improve muscle tone, especially during pregnancy and postnatal period so as to prevent stress incontinence after delivery
• Increase vaginal tone that may help to improve sex life

What are pelvic floor muscles?

The pelvic floor is made of layers of muscles stretching from the pubic bone in the front to the base of spine at the back. It consists of 3 groups of muscles surrounding the urethra, vagina and rectum.

What causes pelvic floor muscle weakness?

1. Multiple childbirth
2. Being overweight or obese
3. Chronic constipation
4. Persistent heavy lifting
5. Chronic coughing
6. Changes in hormonal levels at menopause
7. Normal ageing

Becoming familiar with your pelvic floor muscles

• While you are passing urine, try to stop your urine flow midway. Hold for 3 seconds and then relax. If you are able to control the urine flow, it means you can master this skill successfully
• While you are concentrating on tightening the muscles around your vagina, you should have a ‘tightening and lifting inward’ feeling. You may be unable to feel this at the beginning if your pelvic muscles are weak
• To know the muscles that control your anal sphincter, tighten the muscles around your anus as if you are holding flatus. Hold for 3 seconds and then relax

Once you are able to identify the above muscle groups, you may start practising the following pelvic floor exercise

*Remember! This only helps you to become familiar with your pelvic floor muscle. You should NOT do it very often as it may cause problems with correct bladder emptying

How to perform pelvic floor exercise?

• Lie, sit or stand with your knees slightly apart
• First relax your thighs, buttocks and abdomen
• Concentrate and use all 3 different groups of pelvic floor muscles together, i.e. the urethral, vaginal and anal muscles
• Tightening this group of muscles slowly as if you are trying to withhold passing urine or flatus. You should have a ‘tightening and lifting inward’ feeling

‘Long Squeezes’ or ‘Slow Contractions’

When you have tightened your muscles to your limit, hold the contraction for 10 seconds, release gradually, rest for 10 seconds and then repeat the above steps. These are called ‘long squeezes’ or ‘slow contractions’, which help to build up the endurance of the muscle group.

‘Short Squeezes’ or ‘Quick Contractions’

You can also do the same exercise quickly and hold the contraction for a second or two and then relax. These are called ‘short squeezes’ or ‘quick contractions’, which helps your muscles react quickly to sudden pressure (from coughing, sneezing or jumping) on the bladder.

Start with 3 cycles every day; for each cycle, you may combine ‘slow contractions’ and ‘quick contractions’.

For ‘slow contractions’, contract, hold and release the muscles up to 10 to 30 times; for ‘quick contractions’, contract, hold and release the muscles up to 5 to 10 times.

When to perform the exercise?

For beginners, do it while you are lying down on the bed; when you are getting used to it later, you can do it while you are sitting or standing during your daily living, e.g. doing housework.

Important Notes

• You should squeeze and lift the pelvic floor muscle (do not push as if you are passing faeces)
• Don’t practise the pelvic floor exercise during urination
• Don’t hold your breath or stop breathing while doing the pelvic floor exercise
• Don’t squeeze other muscles at the same time as you squeeze your pelvic muscles, for example, the back muscles or the buttocks
• Don’t give up! Sometimes it takes 2 to 6 months to notice the improvement
• Incontinence can have many causes. Seek advice from your health care providers if you have any queries