Exercises » Pelvic Floor & Exercise
The Importance of The Pelvic Floor
If there is one exercise which is essential in pregnancy (and for the rest of your life) it is to exercise your pelvic floor
Every expert from midwife to gynaecologist, from physiotherapist to urologist would agree
However it is often over looked, possibly because we cannot see it?
But a weak pelvic floor can lead to some embarrassing and unpleasant side effects such as urinary incontinence, uterine prolapse and be a passion killer in the bedroom with lack of sexual enjoyment
The pelvic floor
The pelvic floor is a strong muscular platform between your legs.
It is a sling of muscles which pass from the pubic bones in the front to the coccyx at the base of your pelvis and consists of 2 halves joined in the middle to allow the 3 openings of the urethra, vagina and anus to pass through.
There are 3 main layers. The deep levator ani muscle, the middle triangular shaped ligamental layer and the superficial layer known as the perineal muscle
Slow and fast twitch
The skeletal muscles of the pelvic floor contain both slow and fast twitch fibres.
The slow twitch fibres have the ability to produce a long contraction at a low level to support the pelvic organs and maintain continence and are slow to fatigue.
The fast twitch fibres have the ability to produce immediate strong contractions to counteract a sudden rise in the intra abdominal pressure (such as when you cough) These muscles are quick to tire out.
This is why it is important to exercise both slow, controlled pelvic floor exercises as well as fast quick ones like the ones below
Functions of the pelvic floor
- To support the pelvic organs (bowel, uterus and bladder)
- To have a sphinteric action to maintain continence
- To resist sudden rise in intra abdominal pressure such as sneezing
- To aid the rotation of the baby’s head during delivery
- Improve sexual function/ enjoyment
- To work in harmony with the deep abdominal muscles to maintain pelvic/ spinal stability
Pelvic floor in pregnancy
In pregnancy it comes under a huge amount of stress.
The stretching effect effect of relaxin on the pelvic ligaments plus the increased pregnancy weight being forced downwards on the pelvic floor makes it highly vulnerable to weakness and overstretching.
The inclusion of high impact exercises during late pregnancy may also put further pressure upon the already stressed pelvic floor muscle
Pelvic floor exercises
A strong pelvic floor will actually strech more effectively than a weak one
Thereby aiding the 'pushing' second stage of labour
Even if the delivery was a c/s the pelvic floor will still have been weakened by pregnancy alone.
These exercises should be started as soon after delivery as possible (well okay you are allowed a cup of tea first!)
A word of caution....
The emphasis should be placed on contract and release of the whole of the pelvic floor area. A common mistake is to be taught to simply mimic 'stopping the flow of urine'
However this only targets 1/3rd of all the pelvic floor muscle and is certainly not as effective as the BloomingFit pelvic floor exercises detailed below:
Find a comfortable position (sitting, lying or standing) Pelvic floor exercises can be performed just about anywhere!
Slow Action pelvic floor exercises:
- Relax the body
- Breath gently throughout the exercises
- Visualise a hammock of muscles attached to the front pubic bone, which then run between the legs and attach into the coccyx
- Think of the 3 openings in this area, the front opening where you pass urine, the middle vagina opening and the rear rectal opening
- Now draw up and tighten each separate opening in turn, the front, middle and rear like a wave
- Picture them being lifted and drawn up inside you
- Hold for a few seconds continuing to breath gently throughout
- Release each separate opening, front, middle then rear and lower with control
- Repeat but this time reverse the direction to rear, middle then front
- In total repeat 10- 20 times
Quick Action pelvic floor exercises:
- Relax the body
- Breath gently throughout the exercises
- Visualise a hammock of muscles attached to the front pubic bone, which then run between the legs and attach into the coccyx
- Think of the 3 openings in this area, the front opening where you pass urine, the middle vagina opening and the rear rectal opening
- Now tighten and lift the whole of the pelvic floor in one fast contraction
- Quickly hold for 1 second then release, hold and release
- Repeat rapidly 10- 20 times
Technique tips:
- Keep the rest of the body relaxed, especially the buttock muscles
- Try to picture the actual hammock of pelvic floor muscle and the specific openings to focus the exercise
- For the first few weeks it may seem difficult to feel the pelvic muscles contract, however with practise sensation and tone will be restored so don’t give up
- Progression can be made by lengthening the hold of the slow contraction and increasing the repetitions
- There is no limit to the amount of pelvic floor exercises to perform daily, providing there is no muscle fatigue
One last thing.....
A helpful tip is to make an association of doing pelvic floor exercises to an activity you do daily such as waiting for the kettle to boil, having a shower or when watching your favourite 'soap' on TV! These will help to act as a trigger to perform the exercises
Pelvic floor (or Kegel) exercises should be continued for life
More on pelvic floor click here