How to strengthen your pelvic floor muscles

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Yes, you can do Kegel exercises on the bus!

By Rhalou Allerhand and Dr Juliet McGrattan (MBChB)

Pelvic floor exercises, also known as Kegels, are simple exercises involving repeatedly contracting and relaxing the muscles that form part of the pelvic floor, in order to make it stronger.

But what are the benefits and how do you know you’re doing it correctly? We spoke to Specialist Pelvic Health Physiotherapist Samantha Vincent about the importance of strengthening your pelvic floor to benefit everything from childbirth to enhanced sexual sensation:

What is the pelvic floor?

The pelvic floor consists of layers of muscle that stretch from the coccyx (tailbone) to the pubic bone, says Vincent. ‘Good pelvic floor muscles help support the organs in the pelvis and can help prevent descent of the bladder, uterus and bowel,’ she explains.

The pelvic floor muscles can be weakened when excess pressure is applied to them. Many things can do this including:

  • Pregnancy – the pressure of a growing baby on the muscles
  • Childbirth – forceful contractions and delivery of the baby
  • Being overweight
  • Long term coughing
  • Straining from constipation
  • Ageing – reduced level of oestrogen reduce the suppleness of the tissues.

What problems does a weak pelvic floor cause?

Having weak pelvic floor muscles can cause all sorts of issues. It depends on which part of the floor is weakened. Symptoms can be mild and occasional or severe and continuous:

  • Stress incontinence

When you laugh, jump or sneeze, the pressure inside your pelvis increases and this stresses the pelvic floor. If the muscles supporting the bladder are weak then urine can leak out.

  • Faecal incontinence

The pelvic floor supports the rectum (lower part of the bowel) and it relaxes in order to let faeces pass. A weak floor can result in unintentional loss of faeces or being unable to hold on for long once you need to go.

  • Pelvic organ prolapse

The bladder, uterus and bowel can all slip down from their normal positions and bulge through the sling of pelvic floor muscles. They press on the vagina and can cause a lump in the front or back walls or in more severe cases a bulge that comes right out of the vagina. This can result in difficulty passing urine and faeces, painful sex and an aching or dragging feeling.

What are kegel exercises?

Arnold Kegel was an American gynaecologist who invented an instrument to measure the force of pelvic floor muscle contractions and realised that they could be strengthened through training them.

Just like all the muscles in your body, training your pelvic floor takes a little bit of work, but strengthening the muscles around the bladder, vagina or penis can be a huge benefit to both men and women.

The good news is, once you’ve mastered your pelvic floor exercises, you can do them anytime, anywhere — including sitting on the bus!

Pelvic floor exercise benefits

Don’t wait until you have a weak pelvic floor before you start doing pelvic floor exercises. By incorporating them into your daily routine you can reap the benefits including:

  • A strong core – your pelvic floor is connected to your lower back and abs.
  • Preparation for pregnancyand recovery from childbirth.
  • Enhanced sexual sensation including increased sensitivity and stronger orgasms.
  • Regained or improved bladder control including stress urinary incontinence (SUI).
  • Reduced risk of pelvic organ prolapse.
  • Reduced symptoms of erectile dysfunction.

How to find your pelvic floor muscles

It can be tricky to identify your pelvic floor muscles, especially if they’re weak. ‘Imagine you are squeezing the muscles around your back passage like you are holding in wind,’ explains Vincent. ‘Then pull up and forward to the muscles around the vagina, like you are holding in the wind and urine at the same time. You should feel a very small upwards and forwards movement. If you are pushing down, this is incorrect.’

To locate your pelvic floor muscles, try the following:

  1. Hold your wind

Try to tighten the muscles around your back passage as if you’re in an important meeting and you really mustn’t break wind. Studies have shown that this is the most accurate way to identify and work the right muscles.

  1. Stop the flow

Go for a pee and then try to stop the flow of urine. That clench and release feeling? Bingo, that’s your pelvic floor muscle. Don’t do this regularly, just to identify the muscles.

  1. Try the fingers squeeze

If you’re not sure if you are exercising the right muscles, put a couple of fingers into your vagina. You should feel a gentle squeeze while doing the exercise.

How to strengthen your pelvic floor muscles

You need to train your pelvic floor muscles through repetition, the same way you would train any muscle group at the gym.

There are two different types of muscles fibre, fast twitch which react quickly and powerfully and slow twitch which can contract over a longer period. You need to work both of these for the best benefit to your pelvic floor.

You can do pelvic floor exercises in any position but a good starting point is to do them whilst sitting upright on a chair with your back straight and legs slightly apart.

Slow squeezes. Begin with slow squeezing and lifting of the muscles. You may only be able to hold for a few seconds at first if your pelvic floor is weak. Build up to doing ten slow squeezes for ten seconds each.

Fast squeezes. Follow with ten short, intense, firm squeezes in quick succession holding for only one second each.

It’s important to get the right technique. Vincent recommends the following:

✔️ The movement is an upward and inward contraction, not a bearing-down effort.

✔️ When you first start doing Kegal exercises, check that you are doing them correctly. Put your hands on your abdomen and buttocks to make sure you can’t feel your belly, thighs, or buttocks moving.

✔️ You should be able to hold a conversation at the same time, so try counting aloud while you’re doing the exercises.

Net Doctor

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