The pelvic floor muscles:
- Stretch like a muscular trampoline from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other sitting bone (side to side).
- Pelvic floor muscles are usually firm and thick. These muscles are designed to move up and down.
- The bladder, bowel, and uterus (women) all sit on the pelvic muscle floor. Normally, these muscles wrap firmly around the passages to help keep them shut. These muscles can be found around the anus and the urethra (the anal sphincter and urethral sphincter)
What do pelvic floor muscles do?
- They provide support for the organs that lie on it.
- Sphincters provide us with conscious control over bladder and bowel movements by allowing us to control the retention and release of urine and stool. This allows us to have a movement when it is ‘convenient’ for us.
- When pelvic floor muscles contract the internal organs and sphincter lift and tighten. Relaxing the muscles and sphincter allows for the elimination of stool and urine.
- In women, pelvic floor muscles are important in providing support for the baby during pregnancy and provides assistance during childbirth.
- Pelvic floor muscles work closely with abdominal and back muscles. Thus having a role in stabilising and supporting the spine.
- A Healthy Pelvic Floor is essential to support the pelvic organs. It is a sling of muscle at the bottom of the pelvis.
- The Pelvic floor can move up and down and has openings for the Vagina, Urethra, and Anus.
The pelvic organs supported by the pelvic muscles
- Men: Bladder and Bowel
- Women: Bladder, Bowel, and Uterus
When the pelvic floor is weakened in any way through things such as childbirth, chronic constipation heavy lifting, age or being overweight inability to control the need to urinate can occur as the muscles are weak
What causes the weakening of pelvic floor muscles?
- Pregnancy and childbirth
- Straining on the toilet
- Chronic coughing
- Heavy lifting
- High impact exercise
Common signs that can indicate a pelvic floor problem include:
- Accidentally leaking urine when you exercise, laugh, cough or sneeze
- Needing to get to the toilet in a hurry or not making it there in time
- Constantly needing to go to the toilet
- Finding it difficult to empty your bladder or bowel
- Accidentally losing control of your bladder or bowel
- Accidentally passing wind
- A prolapse
- In women, this may be felt as a bulge in the vagina or a feeling of heaviness, discomfort, pulling, dragging or dropping
- In men, this may be felt as a bulge in the rectum or a feeling of needing to use their bowels but not actually needing to go
pain in your pelvic area, or
- painful sex.
Strengthening pelvic floor muscles
- Method 1 - Stopping the flow
- The first step in performing pelvic floor muscle exercises is to identify the correct muscles. There are several ways that may help you to correctly identify the different parts of your pelvic floor muscles. One way is to try to stop or slow the flow of urine midway through emptying the bladder. Stopping the flow of urine repeatedly on the toilet is not an exercise, but a way of identifying your pelvic floor muscles. This should only be done to identify which muscles are needed for bladder control.
- This 'stop-test' may help you identify the muscles around the front passage which control the flow of urine. It is not recommended as a regular exercise.
- Method 2 - Visualisation
- Another method to identify your pelvic floor muscles is to imagine stopping the flow of urine and holding inflatus (wind) at the same time. This can be done lying down, sitting or standing with legs about shoulder-width apart.
- Relax the muscles of your thighs, bottom, and tummy.
- Squeeze in the muscles around the front passage as if trying to stop the flow of urine.
- Squeeze in the muscles around the vagina and suck upwards inside the pelvic.
- Squeeze in the muscles around the back passage as if trying to stop passing wind.
- The muscles around the front and back passages should squeeze up and inside the pelvis.
- Women who are familiar with using tampons can imagine squeezing in the vagina as if squeezing a tampon up higher in the vagina.
- Identify the muscles that contract when you do all these things together. Then relax and loosen them.
- Getting the technique right
- This is the most important part of the pelvic floor muscle exercises as there is no point in doing them if you are not doing them correctly.
- Imagine letting go like you would to pass urine or to pass wind. Let your tummy muscles hang loose too. See if you can squeeze in and hold the muscles inside the pelvis while you breathe. Nothing above the belly button should tighten or tense. Some tensing and flattening of the lower part of the abdominal wall will happen.
- Try tightening your muscles really gently to feel just the pelvic floor muscles lifting and squeezing in. If you cannot feel your muscles contracting, change your position and try again. For example, if you cannot feel your muscles contracting in a seated position, try lying down or standing up instead.
- After a contraction, it is important to relax the muscles. This will allow your muscles to recover and prepare for the next contraction.
- Doing pelvic floor muscle exercises the wrong way can be bad for you, so please see a health professional if you cannot feel your muscles hold or relax.
More information can be found here: http://www.pelvicfloorfirst.org.au/