Pelvic floor exercises - keeping you strong on the inside
Pelvic floor exercises - you may need help
Podcast 
Waterworks Quiz
How to do Pelvic Floor Exercises  
For further assistance

Pelvic floor exercises - keeping you strong on the inside

In Australia, more than three million women experience urinary incontinence or ‘leakage’. Many women also experience bowel incontinence. Any woman who has ever experienced regular leakage will know that the effects on self-esteem, body image, morale, sexuality and overall quality of life can be devastating. Some women with reduced pelvic floor muscle support experience pelvic organ prolapse, when one or more of the three pelvic organs (bladder, uterus and bowel) can start to push down into the vagina.

It is also important to note that it is possible to have pelvic floor muscles that are working too hard. In this case, women may experience pelvic pain and discomfort during intercourse.

It's never too late

Doing regular pelvic floor exercises every day can reduce the risk of incontinence and prolapse, by strengthening your pelvic floor muscles to help support your bladder, uterus and bowel. Regular gentle exercise, such as walking, is also important.

About the pelvic floor

The pelvic floor is a very important muscle – and one that is not talked about, or exercised, enough. Pelvic floor muscles are the layer of muscles spanning underneath the pelvis.

Along with abdominal and back muscles, the pelvic floor helps to stabilise and support the spine, digestive system, pelvic and reproductive organs (including bladder, bowel and uterus) and plays an important role in preventing incontinence and supporting the pelvic organs. The pelvic floor is also important for sexual function in women, with voluntary contractions contributing to sexual sensation and arousal.

Risk factors for pelvic floor weakening

• Pregnancy and childbirth, particularly for multiple, large birth weight (over 4kg) or instrument-assisted births, or where there has been severe perineal tearing or long labours
• Straining or constipation – Straining just once can be enough to cause a problem
• Chronic coughing, including asthma, bronchitis or smoker's cough
• Heavy lifting, such as at work or during gym training, may progressively weaken the muscles
• The ageing process
• Being overweight or obese
• Lower levels of oestrogen after menopause or when breastfeeding
• Pelvic or abdominal surgery, e.g. hysterectomy
• High impact exercise, e.g. running
• Some abdominal muscle exercises, e.g. sit-ups, crunches, double-leg raises. Learn the alternatives to keeping these muscles strong
• Having chronic low back pain

Benefits

• Improved control over bladder and bowel function
• Reduced risk of prolapse (sagging of internal organs)
• Better recovery from childbirth and surgery
• Easier bowel emptying
• Increased sexual sensation
• Increased social confidence and quality of life

Pelvic floor exercises - You may need help

Pelvic floor exercises are not necessarily easy to do correctly. The pelvic floor muscles are complicated muscles that can be difficult to isolate. Practicing the wrong technique will not help and can make problems worse.

Research shows that pelvic floor exercise is effective when done correctly. If doing them yourself doesn't help, then it is important to see a pelvic floor physiotherapist or continence nurse advisor to ensure your technique is correct and to help you develop an individually tailored program for your needs.

Exercising the pelvic floor is not a self-help treatment for incontinence. If you have a problem with bladder or bowel control, it is important to be properly assessed, since weak pelvic floor muscles are just one of the many causes of incontinence.

Contact the National Continence Helpline on 1800 33 00 66 to find a local continence physiotherapist or continence nurse advisor.

Learning to contract your pelvic floor muscles

Make pelvic floor exercise a regular habit for life. Improved control may take some time to learn and practise correctly. Results won't happen overnight, so make sure you keep doing them.

It's never too late. Don't just put up with incontinence - do something about it!

Podcast 

How to do pelvic floor exercises5.42 MB

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Waterworks Quiz

How much do you know about your waterworks? Since this is a topic that most people feel uncomfortable talking about, chances are you may be surprised to learn the truth about this ‘not so dry’ subject. Take our Bladder and bowel health quiz and see check what you know. The quiz opens in a new window.

 Bladder and bowel health quiz

How to do Pelvic Floor Exercises

• Start in a comfortable position such as lying down with knees bent or sitting in an upright chair.
• Tighten and draw in the pelvic floor muscles around the urethra, vagina and anus. Lift up as if stopping your urine flow in midstream. Do not push down - you need to tighten and draw up the muscles.
• Make sure your buttocks, thighs and back are relaxed. You may feel your lower tummy muscles drawing in slightly, as if tightening a low belt.
• Keep breathing gently as you exercise – don’t hold your breath.
• Count to five and then relax completely before repeating the exercise.
• Continue until you can hold this for up to ten seconds and repeat ten times.
• Progress to doing these exercises in other positions, e.g. while standing or walking.

This comprises one set.

Gradually increase the amount until you are able to do four to five sets daily.

Remember:

• Squeeze up hard when you cough, sneeze or lift something
• Don't practise stopping the flow of urine mid-stream as an exercise, only try it once (This can send incorrect messages to your bladder and stop it from emptying completely.)
• It will take time for you to notice improvement, so keep at it.
• If you can't feel anything happening at all, experience difficulty, or there is no improvement over time, you may need help to learn how to work these muscles effectively.
• If pelvic pain is an issue for you, you will need special help with your exercise program as, at first, you may not need a strengthening program, which could make things worse. Speak to your GP.

Further resources

What is Incontinence?

 Incontinence Fact Sheet 98.50 Kb

Urinary incontinence: busting the myths  

Contact the National Continence Helpline on 1800 33 00 66 to find a local continence physiotherapist or continence nurse advisor.

Incontinence: The Hidden Epidemic (Women’s Weekly Series)
By Kerrie Lee

Content Updated 3 November 2011