♀ Urinary Incontinence: What are pelvic floor exercises?

What are pelvic floor exercises?

Pelvic floor exercises were first developed in the late 1940s. They are designed to strengthen the pelvic floor muscles and reduce stress incontinence. Stronger pelvic floor muscles will help the urethra to stay closed and prevent leakage.

On the next occasion that you go to empty your bladder, prevent the flow starting for a minute or so: you will become aware that you are lifting the pelvic floor.

Next, allow the bladder to become really full and practise tensing the pelvic floor muscles to prevent leaks. When you do empty your bladder, ensure that it really is empty: otherwise there is a risk of infection.

Try stopping your urine flow in mid-stream and you will be aware of that lifting sensation within the lower pelvis caused by the pelvic floor muscles. If the muscles are weak, you may have difficulty initially stopping the flow. It is probably easier to stop the stream at the beginning or end of the flow. As the muscles become stronger it should become possible to stop the flow at any stage. To begin, you will have to learn to become conscious of your ability to contract the pelvic floor muscles. You may find that if you place a finger in the vagina, you will be able to feel the muscles contracting.

Once you have learned to contract the pelvic floor muscles, keep them contracting for five seconds squeezing them as much as possible. Relax the muscles for five seconds and repeat this cycle six times in a minute. You may find the exercises easier whilst sitting or lying down at least to begin with. Keep a record of how many minutes you do the exercises each day. Gradually build up until you can do them for three to five minutes three times daily. The exercises can be undertaken at any time. The important thing is to keep doing these exercises. The daily record should help you to keep going. Some physiotherapists use a perineometer which measures the pressure that you are able to exert. This biofeedback can provide encouragement, as you are able to measure progress.

Electrotherapy is conducted by physiotherapists using electrical stimulation to make the pelvic floor muscles contract. This may be particularly beneficial if you are having difficulty starting the exercises.

As with any exercise, muscles take a while to become stronger so perseverance and patience are essential. If you were planning to swim the channel you would not prepare by trying to swim across from Dover on the first day. You would start with just a few hundred yards and gradually build up over months rather than days. The same is true for pelvic floor exercises. You have to be patient, gradually building up the muscle strength over a few months and then keeping the muscles strong. The aim is to build up gradually to five minutes three times each day. Hopefully you will begin to see progress after a couple of weeks and this should provide any encouragement you may need. It may, however, take two or three months so do not give up too quickly. Once improvement has been achieved, it is important to keep the exercises going although the amount of time spent may be reduced to perhaps two minutes daily.

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This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
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- Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.

David Viniker retired from active clinical practice in 2012.
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