Pelvic Floor Exercises

These useful and inobtrusive exercises often help with many anal and rectal conditions such as prolapse and incontinence.

Anal incontinence and prolapse can sometimes arise because of weak supporting pelvic floor muscles.  Sometimes these muscles are damaged during vaginal childbirth and these muscles often slowly become weaker with age.  Pelvic floor muscles can also become weakened from chronic straining to defecate and from repeated anal intercourse.  Pelvic floor exercises help to bulk up the important muscles that support the rectum, bladder, uterus and vagina and they help to guard against urinary and faecal incontinence.  Patients must understand that these exercises are a life sentence once started but they can often be performed without anyone else knowing at any time of day such as when sitting on a bus!

How do you do the exercises?

1. Identify the muscles

First you need to find your pelvic floor muscles.Try to tighten your muscles around your vagina and anus and lift up, as if you’re stopping yourself passing water and wind at the same time.A quick way of finding the right muscles is by trying to stop the flow of urine when you’re in the toilet. Don’t do this regularly because you may start retaining urine.If you’re not sure you are exercising the right muscles, put a couple of fingers into your vagina. You should feel a gentle squeeze when doing the exercise.

2. Contract the muscles correctly

The movement is an upward and inward contraction, not a bearing-down effort.When you first start the 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.

  • Don’t hold your breath. You should be able to hold a conversation at the same time, or try counting aloud while you’re doing the exercises.
  • Don’t tighten the tummy, thigh or buttock muscles – you’ll be exercising the wrong muscle groups.
  • Don’t squeeze your legs together.

3. Fast and slow contractions

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

Slow contractions
Slow contractions help to increase the strength of your pelvic floor. They help your muscles to hold back urine and rectal contents.

  • Lift your pelvic floor muscles to a count of ten.
  • Hold the muscles tight for 10 seconds.
  • You may find at first find that you can only hold the contraction for one or two seconds, so concentrate on lifting your muscles and holding the contraction for as long as you can.
  • Gradually increase the time until you reach 10 seconds.
  • Relax your muscles and rest for 10 seconds.
  • Repeat the contractions up to 10 times.

Fast contractions
Fast contractions help your pelvic floor to cope with pressure, for example when you sneeze, cough or laugh. This works the muscles that quickly shut off the flow of urine, rectal contents or wind.

  • Lift your pelvic floor muscles quickly.
  • Hold the contraction for one second.
  • Relax the muscles and rest for one second.
  • Repeat the contractions 10 times.

How often should I do the exercises?

Try to do one set of slow exercises and one set of fast contractions six times a day.

The Chartered Society of Physiotherapists also recommends that you do a quick contraction just before you cough, sneeze or laugh.

You may also find it useful to do a fast contraction just before you get out of a chair. This is because the movement of getting up puts pressure on your bladder, rectum and pelvic floor.

The pros of pelvic floor exercises:

  • They’re simple.
  • They’re cheap.
  • They’re effective.
  • You can do them when sitting, standing or lying down.
  • You don’t need any special equipment, but until you get into the habit of doing them, you may find that a tick chart helps to remind you to do your exercises.

The downside of pelvic floor exercises:

  • You have to keep doing them for the rest of your life.
  • It can take up to 15 weeks before you see any difference.

If you haven’t noticed a difference after three months, ask your GP to see a continence adviser or physiotherapist to check whether you’re doing them correctly or if there’s another problem.

Alternatively, click here for the Continence Clinic Directory of the Bladder and Bowel Foundation which gives details of advisers in your area.