These are sometimes also referred to as ‘Kegel’ exercises.
Many patients can notice improvement in the symptoms of both stress and urge incontinence by strengthening their pelvic floor muscles. Improvement may be enough to avoid further medical or surgical treatments.
Making sure you exercise the correct muscles:
Contract the muscles around the anus (and vagina in women) as if you are trying to stop yourself from passing gas or as if you were passing urine and suddenly wanted to stop. You should be able to interrupt the urinary stream and you can try this to check you are using the correct muscles but it is not advised to keep doing this regularly as an exercise as it may interfere with normal bladder function and emptying. Practice at other times when you are not passing urine.
Women can place a finger in the vagina and feel the muscle contract around your finger. If you can’t feel anything, try two fingers.
Men can stand and try to move their penis up and down without moving the rest of their body.
You should be able to contract your pelvic floor muscles lying, sitting or standing and other people should not be able to tell you are doing the exercises.
A good pelvic floor contraction has both a sqeeze component and a lift component.
Making sure you don’t exercise the wrong muscles
You should not need to hold your breath.
You should not use your stomach muscles. Place your hand on your stomach to check you are not moving your stomach. Your stomach muscles should stay contracted or pulled in and not expand or balloon out.
You do not need to squeeze your buttocks.
You do not need to tighten your thighs.
Any movement is mainly internal and not visible from the outside. You should be able to do your exercises anywhere without other people realising.
Exercise Programmes
These vary depending on individual needs.
Try to do short maximal contractions with up to fifteen repetitions and a good 10 second rest between each contraction.
Also try to do long contractions aiming to build to hold each one for 10 seconds, with fifteen repetitions and 10 second rests between each contraction. Building muscle endurance is very important.
Repeat this programme 2-3 times a day.
It may take 6 weeks to see results and build muscle strength but 15-20 weeks for muscle hypertrophy (enlargement) to occur. For best result you need to remember to do your pelvic floor exercises every day, in different positions for the rest of your life.
Triggers to remind you when to do your exercises can help e.g. at the traffic lights, during commercial breaks on TV etc.
Getting Help
Some people have difficulty learning to perform pelvic floor exercises.
Continence Physiotherapists, Continence Nurses and Continence GP's can assist with instruction and provide a supervised exercise programme. This allows many patients to achieve better results. They can use techniques such as Biofeedback, Vaginal weights or cones or Neurostimulation to help you. They can also provide help with other conservative measures such as Bladder Training, Timed Voiding, Behavioural and Dietary Modification and advice about Continence Aids.
Pelvic Floor Relaxation
Some patients with pelvic floor dysfunction, pelvic pain, difficulty with bladder emptying or vaginismus need to learn to relax their pelvic floor properly rather than contract it. These are usually more complicated problems and assistance with these techniques is recommended. In these situations patients can be recommended not to do exercises to strengthen their pelvic floor exercises as this may exacerbate their symptoms.
