Improving Pelvic Floor Strength

Understanding the Pelvic Floor

The pelvic floor is a group of muscles and connective tissues that span the bottom of the pelvis, supporting the bladder, bowel, and reproductive organs. These muscles are essential for continence, posture, and sexual function. A weakened pelvic floor can lead to a range of health issues, including incontinence and sexual dysfunction.

Causes of Pelvic Floor Weakness

Pelvic floor muscles may weaken over time due to several contributing factors:

• Pregnancy and Childbirth: The weight of a growing baby and the process of childbirth—particularly vaginal delivery—can stretch and weaken the pelvic muscles. This may result in urinary incontinence, a feeling of heaviness in the pelvic area, or reduced muscle tone.
• Surgical Procedures: Surgeries such as hysterectomy (removal of the uterus) or prostatectomy (removal of the prostate) can damage the nerves or muscles of the pelvic floor, leading to loss of strength and function.
• Chronic Coughing: Persistent coughing from asthma, chronic bronchitis, or smoking continually increases abdominal pressure, which places strain on the pelvic floor and can lead to weakening over time.
• Constipation and Straining: Frequent straining to pass stool can put excessive pressure on the pelvic muscles, weakening them and potentially leading to prolapse or incontinence.
• Obesity: Excess body weight increases downward pressure on the pelvic floor, especially during physical activities like walking or standing for long periods.
• Heavy Lifting: Regularly lifting heavy objects without activating the pelvic floor can lead to fatigue or damage over time.
• Ageing and Sedentary Lifestyle: Natural ageing can lead to a loss of muscle mass and elasticity, and a lack of regular movement or exercise reduces circulation and strength in the pelvic region.

Symptoms of a Weak Pelvic Floor

• Leaking urine during coughing, sneezing or physical activity: is known as stress urinary incontinence and is one of the most common signs of pelvic floor weakness.
• Frequent or urgent need to urinate: Also known as urge incontinence, this can include waking often at night to urinate.
• Difficulty fully emptying the bladder or bowel: can result in urinary retention or incomplete bowel movements.
• Sexual dysfunction or reduced sensation during intercourse: Weak pelvic floor muscles may contribute to decreased pleasure or difficulty achieving orgasm.

Exercises to Strengthen the Pelvic Floor

Identifying the Right Muscles

To find the correct muscles, try stopping urination mid-flow. The muscles used in this action are your pelvic floor muscles. Do not regularly practice this as an exercise; use it only for identification.

Basic Kegel Exercises

1. Contract the pelvic floor muscles, as if you are trying to lift and hold them inward.
2. Hold the contraction for 5 seconds while continuing to breathe normally.
3. Release the contraction and rest for 5 seconds.
4. Perform 10 repetitions, three times daily.

As you gain strength, increase the contraction hold to 10 seconds. Avoid tightening surrounding muscles such as your thighs, buttocks, or abdomen, and remember to breathe normally. 

For additional Kegel exercises see our Pelvic Floor Daily Exercise Guide.

Functional Training

Try incorporating pelvic floor exercises into daily movements:

• Before Lifting, Coughing, or Sneezing: Squeeze your pelvic floor muscles just before and during these activities to prevent leaks.
• During Physical Activity: Engage the muscles when walking, climbing stairs, or exercising to build coordination and support.

Kegel Trainers

Kegel trainers are devices designed to help individuals perform pelvic floor exercises more effectively. They provide guidance, resistance, or feedback to help ensure exercises are done correctly and consistently.

There are several types of Kegel trainers available:

Manual Kegel Balls (Weighted Trainers)

These are small, often silicone balls that you insert into the vagina. The pelvic muscles naturally contract to keep them in place, providing a workout. They're inexpensive and widely available, but offer no feedback.

Best for:  Beginners who are physically able to sense and isolate pelvic floor muscles.

Smart Kegel Trainers

These combine weighted devices with smart tech to guide you through exercises, track progress, and even offer gamified workouts via apps.

Best for:  Tech-savvy users or those who want motivation through data and visuals.

Biofeedback Devices

These trainers often have sensors and connect to a smartphone app. They provide real-time feedback on muscle contractions, helping you understand how well you're performing the exercises. Some Smart Kegel trainers also provide this function.

Best for: Those who need guidance or want to track their progress.

Electronic Muscle Stimulators (EMS)

EMS devices use gentle electrical pulses to stimulate the pelvic floor muscles. They're especially helpful for people who struggle to contract their muscles voluntarily.

Best for: Individuals with significant weakness or post-surgery recovery.

When to Seek Help

Consider seeing a pelvic health physiotherapist if you experience persistent symptoms despite regular exercise. They can assess your technique and suggest tailored exercises or therapies.

 

References

• Continence Foundation of Australia - Pelvic Floor Muscles https://www.continence.org.au/about-continence/how-do-pelvic-floor-muscles-work
• Jean Hailes for Women’s Health - Pelvic Floor Exercises
  https://www.jeanhailes.org.au/health-a-z/pelvic-floor/pelvic-floor-exercises
  
• NHS - Pelvic Floor Exercises for Women
  https://www.nhs.uk/common-health-questions/womens-health/what-are-pelvic-floor-exercises/
  
• https:/www.verywellhealth.com/kegel-exercises-for-women-3520758
  

Disclaimer: This blog is for informational purposes only and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider for accurate diagnosis and appropriate treatment.