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What do the pelvic floor muscles do?

When the pelvic floor is strong, it supports the pelvic organs to prevent problems such as:
•    incontinence (the involuntary loss of urine or faeces)
•    prolapse (lack of support) of the bladder, uterus and bowel.

The pelvic floor muscles also allow you to control bladder and bowel function, such as allowing you to 'hold on' until an appropriate time and place.

What causes pelvic floor muscle weakness?

Some of the common causes of pelvic floor muscle weakness are:
•    childbirth - particularly following delivery of a large baby or prolonged pushing during delivery
•    being overweight
•    constipation (excessive straining to empty your bowel)
•    persistent heavy lifting
•    excessive coughing - causing repetitive straining
•    changes in hormonal levels at menopause
•    growing older.

How do I strengthen my pelvic floor muscles?

It is recommended that all women exercise their pelvic floor muscles regularly throughout life, to prevent or correct weakness. Exercising weak muscles regularly, over a period of time can strengthen them and make them work effectively again. Regular gentle exercise, such as walking can also have a positive effect on the strength of your pelvic floor muscles.

Exercise 1

Step 1. Sit, stand tall or lie on you back with your knees bent and legs comfortably apart.

Step 2. Close your eyes, imagine what muscles you would tighten to stop yourself from passing wind or to 'hold on' from passing urine. If you can’t feel a distinct tightening of these muscles, ask for some help from a women’s health physiotherapist. She will help you to get started.

Step 3. Now that you can feel the pelvic floor muscles working, tighten them around your front passage, vagina and back passage as strongly as possible and hold for three to five seconds. By doing this, you should feel your pelvic floor muscles ‘lift up’ inside you and feel a definite ‘let go’ as the muscles relax. If you can hold longer (but no more than a maximum of eight seconds), then do so. Remember the squeeze must stay strong and you should feel a definite 'let go'. Repeat up to ten times or until you feel your pelvic floor muscles fatigue. Rest for a few seconds in between each squeeze.

Exercise 2 (quick squeeze for power)

Squeeze and lift the pelvic floor muscles as strongly and as quickly as possible. Do not hold on to
the contraction, just squeeze and let go. Rest for a few seconds in between each squeeze. Repeat this 10 to 20 times or until you feel your pelvic floor muscles fatigue.

If you can, do this exercise set three times per day.

During both exercises you should:
•    feel your pelvic floor muscles lift inside you, rather than feel a downward movement
•    relax your thighs and buttocks
•    keep breathing normally
•    stop exercising if your muscles fatigue.

What can I do to prevent damage?
To prevent damage to your pelvic floor muscles, avoid:
•    constipation and/or straining with a bowel motion
•    persistent heavy lifting
•    repetitive coughing and straining
•    putting on too much weight.

Make training part of your life by:
•    tightening your pelvic floor muscles every time you cough, sneeze or lift
•    doing some regular exercise, such as walking
•    progressing your exercises by doing them during the day in different positions e.g. standing, sitting or on your hands
     and knees.

For many women, it is important to follow a specific exercise program tailored to their individual needs. If you are unsure of whether you are exercising your pelvic floor muscles correctly or you have urinary problems, you should make an appointment with the Royal Women’s Hospital Physiotherapy Department. A referral (doctors letter) is not required if you are a patient of this hospital.

The Royal Women’s Hospital offers a range of consumer health information that has been produced in collaboration with women and medical health professionals. We appreciate feedback about all of our information. Please contact the Women’s Consumer Health Information rwh.publications@rwh.org.au
 
Disclaimer
The Royal Women’s Hospital does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided in this fact sheet or incorporated into it by reference.
We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance, currency and accuracy.
Women are encouraged to discuss their health needs with a health practitioner.
If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.
 © The Royal Women’s Hospital, July 2007