"Pelvic floor (Kegel) exercises really do work to improve bladder and bowel problems. We see 70% of people solving their problems through pelvic floor exercise alone. But you need to get those exercises right" - Amanda Savage, specialist pelvic floor and women's health Physiotherapist.
In this article, Amanda shares some of her professional tips on how to get the most out of your Kegel exercises.
Visualise Your Muscles Before You Try to Work Them
The small sphincter ring around the anus and the opening of the vagina are just the parts of the pelvic floor that we can see. The pelvic floor is a BIG muscle, fanning out away from the openings under your skin. It sits inside the pelvic bones to prevent your organs falling through between your legs. It is the same size as your two hands held together to create a bowl shape. It has a back part (where the anus is), a front part (where the vagina & bladder tube exit), and sides too.
Use the Whole Pelvic Floor
When doing pelvic floor exercises, most people focus on contracting the muscles around the opening of the bladder tube (the urethra), as obviously this is where a urine leakage will appear from. But you should also practice tightening around the anal sphincter, as if stopping wind escaping. Contracting the back part and front part of the pelvic floor together creates more uplift and closure of the vaginal walls which gives better support to the bladder to prevent leakage or prolapse and helps you feel more closure during sex.
Vary the Types of Contractions
Like all muscles in the body the pelvic floor muscles can perform in different ways:
- Practice 10-15 short, powerful squeezes in a row - This is the skill you will need to stop a leak when you sneeze, laugh or jump.
- Practice less intense but longer contractions, holding for 5-10 seconds - Try to sustain a medium strength hold, without holding your breath. This is the skill you need to help bladder control when you feel you need a wee but still need to find a toilet and join a queue!
Remember to RELAX
Relax the pelvic floor properly between each contraction. It is possible to overwork the muscles causing tension and tightness in the pelvic floor. Some women experience pain and discomfort during sex because they find it difficult to relax their muscles. Make sure you both contract and then properly release the contraction before the next one.
Use the pelvic floor muscles when there is going to be a downward pressure that might make the bladder leak or pelvic organs bulge. “The knack” is the trick of contracting your pelvic floor muscles just before you cough, sneeze or jump to counteract the downward pressure. Practice a fake cough when your bladder is empty to build up your confidence.
Little and Often Works Really Well
Exercises only work if you actually do them. Form a pelvic floor exercise habit by doing them at the same time as other routine tasks, like when you clean your teeth or after you have a wee (it is no longer recommended to stop mid-flow). Research shows that practising fast and slow contractions 3 x a day for 8-12 weeks will improve muscle performance in 70% of women.
And It Doesn't Stop There!
My professional organisation of specialist physiotherapists, the POGP, have free detailed guides to pelvic floor exercises. Find my personal favourite drills as well as more detailed tips and exercise videos on my website www.supportedmums.com