Strengthening Pelvic Floor Muscles

For men and women alike, loss of control of your bladder and bowel is horrible. It affects your confidence, how you live and what you do. I’m here to help you with this. Before I start, I wasn’t sure what image to use for this blog so have gone for an esoteric image…

 

So where is your pelvic floor and what is its job?

Your pelvic floor is a large muscle which extends from your tail bone (coccyx) at the back of your pelvis to your pubic bone at the front of your pelvis. Its job is to control what comes out of your bladder and bowel. This muscle like all other muscles, if ignored or unattended will weaken and will not do what it is designed to do properly i.e. prevent leakage from your bladder and bowel.

 

This is not good.

 

It is not ‘one of those things’ that should be accepted. In most cases the problem can be improved or at least prevented from deteriorating, if you know what to do.

 

This is good.

 

It can be an uncomfortable subject to discuss because it’s such a personal area of your body. However, this can prevent people from seeking advice until it really is a problem. At this point it can have had a major impact on your confidence, general health and how you live your life.

 

Adverts for incontinence pants, seem only to reinforce the notion that leaking wee or poo is something to live with. It’s just a matter of containing the leakage, to hide the problem. THIS IS NOT THE SOLUTION.

 

Strengthening your pelvic floor is.

 

Hiding the problem will only make the matter worse which over time, can reach a point where there is no way you can hide the problem.

 

 

How does your pelvic floor work and how can you make it work better?

Function one:

It has a background function which in effect, is a low effort ‘contraction’ occurring all the time, even when you sleep. This is called a slow twitch contraction.

 

To improve this function either:

i) Sit with your legs apart so you can feel the pressure of the seat against your pelvic floor. It is easier to lift away from something.

or

ii) Lie on your back with your knees drawn up towards your chest and your knees apart.

 

In either position, squeeze your pelvic floor by imaging you’re ‘drawing up’ the muscles between your legs, that you’d tighten to stop yourself from weeing, pooing or passing wind, when you’re not wanting to wee, poo or pass wind.

 

See how long you can hold the squeeze by counting slowly and then let go. The letting go is as important as the tightening. Letting go needs to be an active and strong muscle action, that you are in complete control of.

 

If when you come to let go, you find the muscle has already switched off, start again. Find the number you can count to, where you’re able to actively relax having actively squeezed. This may be only a count of 1 or 2.

 

It doesn’t matter.

 

What matters is that you are in control of this muscle, you understand how to squeeze and relax it AND know exactly how much control you have. From here you can more objectively measure your strengthening progress.

 

Over time, you’re aiming for a slow count to 10. If you can only reach a count of 2 for example, repeatedly squeeze for a count of 2 throughout the day. In time as the muscle strengthens you will increase how long you can hold the squeeze. The aim is for improvement or in slowing the deterioration of leaking wee, poo or wind.

 

 

Function two: 

Your pelvic floor contracts more strongly when greater force is placed upon it. For example, when you laugh, sneeze, jump, stand up etc. This is a fast twitch contraction which commonly causes problems.

 

To improve this function, position yourself in either position as described above. Squeeze strongly for a second and then relax. Remember that letting go needs to be an active and strong muscle action, that you are in complete control of.

 

Keep repeating a strong squeeze held for a second, then relax, until you reach the point where your control of letting go, is fading. 

 

Aim in time, for a count of 10. With each squeeze, ensure a strong squeeze is followed by a strong active letting go sensation. 

 

 

Tilt your pelvis to bias either your bladder or bowel muscles

Your bladder 

If controlling leaking wee is your priority, lie on your back and tilt your pelvis so your lower back lifts slightly from the floor. This biases the front of your pelvic floor that controls your bladder

 

Your bowel

If controlling leaking wind or poo is your priority, lie on your back and tilt your pelvis so your lower back presses gently into the floor. This biases the rear of your pelvic floor that controls your bowel.

 

Your bladder AND bowel

Holding your pelvis mid way between the positions described above, will engage the whole pelvic floor more evenly.

 

 

How often should you practice?

Little and often is key. Think of an activity you routinely do where you could piggy back strengthening your pelvic floor onto. It maybe cleaning your teeth, when you first sit down at your computer, scrolling, at traffic lights when you’re driving. You choose! The more difficult you find it, the fewer repetitions you’ll do effectively. So only do a few at a time. 

 

Strengthen both your fast and slow twitch muscles.

 

Strengthen both your bladder and bowel muscles.

 

As you gain greater strength and greater control of the contraction, increase the number of repetitions. Better to do a few well, than more ineffectively.

 

 

Never

Never be tempted to stop your wee mid flow. This is not a natural action you’re designed to do and can adversely affect your kidney function. Once your flow starts, let it flow! Better to practice your pelvic floor squeezes sitting on the loo, when you need to go.

 

This way, you’re training your pelvic floor to do the job you want it to do. Which is to control any leakage of pee, poo or wind, until you’re ready.

 

 

Specifically squeeze your pelvic floor

You need to squeeze your pelvic floor NOT by squeezing your knees together, tightening your thighs or your buttocks (although I would always encourage a spot of buttock squeezing for the sake of buttock squeezing because of the benefits this brings to your core stability! But I digress) or by pulling in your tummy, although your tum might squeeze with your pelvic floor and that’s ok. 

 

Essentially, unless you are squeezing your pelvic floor, you’re not squeezing your pelvic floor. Keep doing both types of exercises little and often through the day giving yourself a 4 second rest in between each series of squeezes you do. This allows the muscles to rest and recover in time to repeat again.

 

 

I’m here to help  

Don’t settle. If you can’t tell whether you are actually squeezing the right muscles and are having problems with leaking from your bladder or bowel then I strongly advise you contact your GP and ask for a referral to a physiotherapist who specialises in incontinence and pelvic dysfunction.

 

Of course you’re always welcome to contact me for further information or advice. I’m here to help even on the not so easy to talk about subjects.

Looking to make the most of the body you’re in, for more of the life you want.
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It’s not about finding more time to exercise.  Really!

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There are 5 comments

  1. elizabeth hector 10th July 2015 at 10:24 pm

    Just the exercises I need.

    many thanks

    ewh

    1. Rachel Kili 28th July 2015 at 6:15 pm

      Hello Elizabeth, I am so glad that my blog was of help. I am sorry I have not replied sooner, I have been away on holiday.
      Keep up the squeezing!!
      Rachel

  2. Karen Hunt 29th July 2015 at 7:50 pm

    Thank you for your useful advice. I had surgery at the Shrewsbury Nuffield a year ago for prolapse and looking for suitable exercise classes run by physiotherapists rather than the usually health and fitness classes at sports clubs and hotels. Do you run these classes or have any good recommendations? I have the Australian Michelle Kenway DVd and book which are brilliant for home use but there must be local help? Thank you

  3. Sylvi 20th August 2015 at 8:44 pm

    I can never be reminded often enough of these exercises. I did do a series of sessions with an NHS physio a few years ago and that helped enormously.

    Thanks Rachel

    1. Rachel Kili 9th September 2015 at 11:10 am

      I too can never be reminded often enough of these exercises!! In writing these blogs I think about not only what are very common problems other people have, but also what it is that I need to do more of too. You are not alone and I really appreciate your feedback Sylvi thank you. Rachel

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