Pelvic Floor Exercises

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1 Pelvic Floor Exercises Information for service users and carers RDaSH leading the way with care

2 Pelvic Floor Muscles The pelvic floor muscles are a sling of muscles across the floor of the pelvis. The opening to the bladder, vagina (birth canal) and back passage all pass through these muscles. Pubic bone Bladder What makes them weaken? Pregnancy and giving birth do have a lot to answer for! There are a few other factors that have an influence: Constipation Colon Uterus Lots of coughing Being overweight Pelvic Floor Muscles Urethra Vagina Anus Tail bone Menopausal changes Frequent/heavy lifting Pelvic surgery What do they do? These muscles have lots of important functions: 1. Supporting the pelvic organs (bladder, uterus, bowel) 2. Supporting the bladder to help stop leaking 3. They help to control wind and holding on with bowels 4. They help to increase sexual awareness for you and your partner 5. They help to support the lower back and pelvis If they are not working properly, all these functions can be affected. Other treatments If you are having trouble locating your muscles or if they are very weak on assessment, your specialist nurse may use other forms of treatment to 2 Pelvic Floor Exercises

3 help you. This could be in the form of stimulation, biofeedback or through using other useful tools. You will be advised on the best way forward for you. How long does it take to improve? Like any muscle, they take some time and effort to get stronger. You need to do a session of quick squeezes and slow holds at least once a day, more if possible. Some people find it only takes 6 weeks of regular exercise to feel an improvement, others find it takes longer. Once they are strong, try and get into the habit of doing them regularly (e.g. after you have been to the toilet or before you get up in the morning). Pelvic floor exercises are for life make them a habit! Find the time!! You will have found by now it takes a lot of concentration! Make sure you set aside some time in the day to do them properly. That s not to say you shouldn t do them on the bus or any other time you think of them but make that an additional set rather than your only set. Fast and slow Your muscles have to act in 2 different ways: quickly (like when you cough or sneeze) or slowly (when you re walking around, holding everything in place). When you do your exercises you need to make sure both quick and slow muscles get a work out. Quick squeezes Draw the muscles in as hard as you can and let them go straight away. Record how many times you can repeat this here: Date.. Number of squeezes.. Now, before you cough, sneeze or lift something heavy, do this type of exercise. It s sometimes called The Knack and it can really help with symptoms of stress incontinence. 3

4 Slow holds Next, pull in the muscle and hold it for as long as you can. Count in seconds how long you can hold for. Repeat and try to improve your time. You need to repeat this as many times as you can to properly work out your muscles if you don t do them until you feel tired, they won t improve. Date Length of hold. Number of times.. This exercise is useful when you get that urge to go to the toilet and you re trying to put it off. Once you can hold for seconds this should become much easier. Similar to this exercise, you can also pull in the muscle about half as hard as you can (less than 50%) and try and hold it for much longer. This is good to do when you are walking, just to remind you of the muscle. How to do the exercises There are lots of ways to think about doing these exercises, these are just a few! 1. Imagine you are trying to stop yourself passing wind. Now pull in as if you are stopping yourself passing urine at the same time (don t actually stop the flow of urine, just imagine) 2. Imagine you are trying to draw your coccyx and your pubic bone together 3. Sit on a chair, lean forward and imagine you need to pick a tissue off the seat using your pelvic floor 4. Imagine squeezing your partner while having sex (or trying putting two fingers in your vagina and squeezing them) You will be advised on the best position to do your exercises. It is sometimes easiest to start in lying so there is nothing pressing against the muscles. The most difficult position is standing as your body weight is pressing down on the muscles, but they will need to be used in this position so it is good to get some practice in! 4 Pelvic Floor Exercises

5 Points to remember: Do not hold your breath! Try not to squeeze any other muscles while you are doing your exercises e.g. your tummy muscles, buttocks or inner thighs. If it feels too easy, then it probably is you either need to hold for longer or try and do more repetitions. It is really important to be able to feel the muscle relax after you have pulled it in i.e. you must be able to fully let go. Keep reminding yourself why you are doing them. 5

6 Pelvic Floor Exercise Diary Use this diary to record the exercises given to you by your specialist nurse Week 1 Monday Tuesday Wednesday Week 2 Week 3 Week 4 Specialist Continence Service Opal Centre, Opal Way, Tickhill Road Site, Balby, Doncaster, DN4 8QN Pelvic Floor Exercises

7 Pelvic Floor Exercise Diary Use this diary to record the exercises given to you by your specialist nurse Thursday Friday Saturday Sunday 7

8 This information is correct at the time of publishing Last Reviewed: February 2015 get We are a smokefree organisation. Please provide a smoke free environment approved for your healthcare provider DP7880/06.17

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