Pelvic Floor Exercises

The pelvic floor refers to a muscle group that supports organs within the pelvis. These organs include the bladder and rectum; The woman also has a uterus.

Pelvic floor muscles play an important role in bladder and bowel control. Like any muscle, it can be injured or weakened. These muscles can also weaken over time due to pregnancy, vaginal birth, obesity, certain types of surgery, or just normal aging.

What do pelvic floor exercises do?

The purpose of these exercises (also called "Kegel" exercises) (you can read the relevant section on the website) strengthen the pelvic floor muscles. When these muscles weaken, the following problems may increase:

• Urinary incontinence: This is when a person leaks urine or loses bladder control. Stress incontinence, a type of urinary incontinence, occurs when the muscles and tissues around the urethra do not close properly when intra-abdominal pressure increases (for example, when a person coughs, sneezes, or does something strenuous). Stress incontinence is common in those who have given birth. Another type of urinary incontinence is an overactive bladder, where a woman has a sudden need to urinate on a regular basis.
• Fecal incontinence: This refers to the involuntary loss of liquid or solid stool. "Anal incontinence" means involuntary gas escape. Injury to the pelvic floor muscles (for example, during vaginal delivery) can cause incontinence./
• Pelvic organ prolapse: It occurs when the bladder, rectum or uterus protrudes from the vagina. This can happen if the pelvic floor is weakened and unable to support the organs. Some people with pelvic organ prolapse have no symptoms, while others have a feeling of fullness or swelling in the vagina.

If you have any of the problems mentioned above, exercising to strengthen your pelvic floor can help improve symptoms. However, it has not been shown that these exercises always prevent the emergence of new problems.

If you're interested in trying pelvic floor muscle exercises, it's a good idea to talk to your doctor first. There are some situations where these exercises are not recommended: for example, in some cases of injury from birth (because it needs to heal before exercise). These exercises may also worsen symptoms in people with myofascial pelvic pain syndrome (abnormalities of the pelvic muscles and surrounding tissues that can cause pain during sex or bladder problems). People with this disease should be treated by a physiotherapist with specialized training. Your doctor can teach you how to do the exercises correctly and refer you to a physiotherapist if necessary.

Learning the right technique

As noted above, your doctor will tell you which muscles to contract for these exercises. They may do this by inserting a finger into your vagina and asking you to tighten your pelvic muscles.

Basically, you'll be tightening your muscles as if you're trying to hold back urine or gas, but that doesn't mean you can't actually pee while you're on the toilet. Constantly holding your urine can lead to a urinary tract infection.

While doing the exercises, you can imagine using your pelvic muscles as if you were lifting your hips from a chair, and you could try to tighten the muscles closest to your vagina and anus.

Although it can be difficult to learn how to contract your pelvic floor muscles without using your abs, hips, and thighs, it is important to do so for the exercises to be effective. It will get easier with time and practice.

Once you know how to isolate the right muscles, you can begin to strengthen them. To do this:

• Tightening- Tighten your pelvic floor muscles. Contraction - Keep contracting the muscles for 8 to 10 seconds. At first, you may not be able to hold it for that long, but over time, you will increase the strength.
• Relax - Completely relax your pelvic floor. This step is as important as contracting the muscles.

Over time, try to hold the contraction harder and longer without relaxation. As with other types of exercise, you will get stronger with practice and will need to be in your daily routine to see long-term results. Working with a pelvic floor physical therapist can also help; they are trained professionals who can teach you how to do these exercises effectively.

You can do these exercises in any position; You can do it standing, sitting or lying down and work in a way that suits you in your daily routine.

How often should I do these exercises?

A typical regimen involves doing this exercise (contracting, holding, then relaxing your pelvic floor muscles) 8 to 12 times per session, three times a day if possible. This routine should continue for at least 15 to 20 weeks. Your doctor can talk to you about your particular situation and whether you should follow a different regimen. Strengthening your pelvic floor muscles takes time, especially if they are weakened or injured, so try to be patient and keep working on them.

In addition, these providers may use other methods to help you improve your technique and maximize results

• Biofeedback- This usually involves placing a sensor in your vagina that can identify which muscles you contract and measure the strength of each contraction. This can give you an idea of ​​progress as you are having trouble isolating your pelvic floor muscles and strengthening those muscles over time.
• Electrical stimulation- This can be done with feedback. It involves inserting a device into the vagina or anus; The device provides a small electrical current that causes the pelvic floor muscles to contract.
• Vaginal weights- You can help increase strength by purchasing weighted cones that you keep in your vagina. You use your pelvic floor muscles to hold the weight in place during your normal daily activities. While there is limited evidence to support this approach, some people find it helps them strengthen their pelvic floor. Vaginal weights are easy to use, relatively inexpensive, and can be purchased online.

Benefits of pelvic floor muscle exercises

Treating existing problems - In addition to generally strengthening your pelvic floor muscles, exercises can sometimes be helpful in the following situations:

• Preventing urine leakage in stress incontinence - Stress incontinence (ie leaking urine while doing certain things that stress the pelvic muscles) is common. Once you know how to effectively contract your pelvic floor muscles, you can do it any time you're about to laugh, cough, sneeze, lift something heavy, or do anything that might cause a leak
• Controlling the urge to urinate – People with an overactive bladder (people who get tight) suddenly feel the need to urinate. When this urge occurs, instead of running to the bathroom, sit or stand still and tighten your pelvic muscles. You should go to the toilet when the urge subsides.
• Improvement of stool and anal incontinence (unintentional leakage of stool or gas).
• Relief of symptoms of pelvic organ prolapse, such as feeling of fullness or pressure in the vagina

If you have any of these problems and pelvic floor muscle exercises aren't helping after a few months, talk to your doctor. They may change the way you do the exercises or suggest other approaches. While pelvic floor muscle exercises can be very helpful, many people with incontinence or pelvic organ prolapse may need other treatments as well.

Preventing new problems from occurring - People often wonder if the risk of incontinence or pelvic organ prolapse is reduced after pregnancy and childbirth. Evidence is mixed as to whether doing pelvic muscle exercises during pregnancy can help with this. While there is no definitive preventative way to weaken the pelvic floor (due to pregnancy, childbirth, obesity, or aging), exercises can be beneficial as they strengthen the muscles that support the pelvic organs. In addition, no harm from pelvic floor exercises has been shown.