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Work out your pelvic floor so you can enjoy life again!

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Given the prevalence of incontinence in mums, I thought I should talk about how to best exercise your pelvic floor, writes women’s health physiotherapist Victoria Watson.

Just follow my three easy steps and you could soon be happily playing tennis or any other sport you love, or bouncing on the trampoline with the kids, without a worry in the world…

STEP 1 

Before you get started, just like at the gym or in a yoga class, you need to make sure you are doing each exercise properly. Descriptive explanations are essential in creating a good pelvic floor contraction. Here are three ways you can help your pelvic floor contract so you will attain the best possible results.

  1. Imagine you are trying to stop the flow of urine mid-stream. You should feel a tightening and lifting around your vagina and anus. Your legs and buttocks stay relaxed.
  2. Imagine you are trying to stop yourself from passing wind. You need to tighten and lift around your anus and vagina, but don’t use your legs or buttocks.
  3. Imagine you drop a pebble into a pond. You can see the ripples moving out in concentric circles toward the edge of the pond. Now imagine that sequence in reverse for your pelvic floor. The ripples moving back in are your muscles gently ‘closing’ or ‘squeezing’ the front passage or vagina opening close, followed by a lifting sensation of the muscles up towards your navel. Remember the concentric circles of the ripples coming closer together evenly to really visualise drawing the muscles together around your vagina from all directions. Watch that you keep your buttocks soft and relaxed and keep breathing.

STEP 2

Like any training, your program is determined by your goals. If you want to become stronger, you use resistance training. If you want to become more flexible, you stretch. Here are three important considerations with pelvic floor muscle training.

  1. Power – the strength of contraction. Are you strong enough to stop leakage while lifting the stroller into the car?
  2. Endurance – how long the contraction can be sustained. Can you hold on when you are at least 5-10 minutes away from getting to a toilet?
  3. Timing – can you contract and relax when you need to? For example, will your pelvic floor switch on before you sneeze.

STEP 3 

This is when you start working out.

To improve your strength and endurance, you have to work a muscle to fatigue. Obviously, having a very tired pelvic floor comes with its own set of problems. For this reason, strength training is usually done in the evening. The most effective way of improving strength and endurance is to do a combination of long holds and shorter, faster maximal contractions.

Your physiotherapist can help you work out your starting point, but a general rule of thumb is that if you can do a six-second contraction, you start by doing six six-second holds, followed by six short, fast contractions. This builds up over time as the strength and endurance improves.

To improve the timing of your pelvic floor, you first need to be aware of the times when you need it to work. If you have leakage issues, these activities will be well known to you. Lifting, sneezing, coughing, running and laughing are all very common causes of leakage. Consciously performing a pelvic floor contraction prior to, and during one of these activities comes with many benefits. Firstly, it provides support to the pelvic organs and reduces the tension on abdominal ligaments. Secondly, it helps the bladder closing mechanism, reducing or eliminating leakage. Thirdly, it strengthens the fast twitch muscle fibres of your pelvic floor. What’s not to like?

To make a positive change in your pelvic floor function, you need to be dedicated. A few contractions while you’re sitting at the traffic lights, or while you’re waiting for the kettle to boil, wont cut it.

Aim for two minutes a day.
Aim for every day.
It generally takes between six and 12 weeks of training to see a real change.

Good luck!

For more information on the pelvic floor, or to book a consultation, please contact Victoria Watson at Mosman Physiotherapy on (02) 9968 2666.

Other excellent online resources include: Pelvic Floor First, Women’s Health Training Associates Physiotherapist Directory, and Continence Foundation of Australia.

Do you do exercises to strengthen your pelvic floor? If so, how have they helped you? Let us know in the comments section below.

More on the pelvic floor…

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