Pelvic floor exercises

What are pelvic floor exercises?

Pelvic floor exercises, also known as Kegel exercises, are muscle-contracting movements that strengthen your pelvic floor muscles. Pelvic floor muscle exercises have long been associated with women, but are also important for men. In women, pelvic floor muscles support the pelvic organs including the bladder, uterus and bowel. In men, pelvic floor muscles support the bladder and bowel. In both men and women, pelvic floor muscles are important in controlling the functions of these organs.

Role of pelvic floor muscles in women

Pelvic floor muscles are tightly drawn between the coccyx and the pubic bone to support the bladder, bowel and uterus. Important muscular bands (sphincters) surround the urethra, vagina and rectum as these openings pass through the pelvic floor. These muscular bands are always contracted to prevent any release of bladder or bowel contents. Muscles are then relaxed to allow the passage of urine and feces.

Role of pelvic floor muscles in men

Similar to women, pelvic floor muscles in men are drawn between the coccyx and the pubic bone. The muscles not only support and control bladder and bowel function, but can also assist in preventing erectile dysfunction and premature ejaculation.

Signs and symptoms of a weak pelvic floor

Signs and symptoms that may indicate weak pelvic floor muscles include:

• Urinary incontinence, which involves leaking urine when running, laughing, sneezing or coughing;
• Fecal incontinence;
• Inability to reach the toilet in time;
• Reduced sensation in the vagina, and;
• Dislodging of tampons.

Causes and risk factors of a weak pelvic floor

The pelvic floor can be weakened from various causes affecting the strength of the muscles. These can include:

• Pregnancy;
• Particularly prolonged pushing during labor and overstretching of vaginal muscles;
• Decreased levels of estrogen that occur after menopause;
• Constipation and straining to empty the bowel;
• Obesity;
• Ageing;
• Diabetes and an overactive bladder;
• Persistent coughing causing repetitive straining, and;
• Surgery that involves cutting the pelvic floor muscles (e.g. prostate gland operations).

Pelvic floor exercise methods

Pelvic floor exercises can be performed almost anywhere and any time. First you will need to locate the various muscles within the pelvic floor and then you can perform exercises to contract and relax them.

Finding the correct muscles

It is possible to identify different areas of the pelvic floor muscles. This can be done by stopping urination midstream. The muscles that are contracting will be closer to the pubic bone and can be useful in controlling urinary continence and sexual function. Other muscles can be identified by 'holding in' when needing to break wind; this can be used to locate the pelvic floor muscles that are closer to the coccyx and are used to control fecal continence.

Exercise techniques

Exercises can be performed after you have emptied your bladder. It is important not to stop urine midstream as a means of exercise, as this can weaken the pelvic floor muscles. Exercises are most easily performed lying down at the beginning, but can also be done while sitting or standing.

A simple starting technique is to contract the muscles for one second and relax the muscles for one second. You will be able to feel a slight lifting in the area of muscle contraction, followed by a lowering feeling as the muscles are relaxed. Build up to contracting the muscles for 10 seconds and relaxing for 10 seconds. Perform this process 10 times, termed a 'set', and repeat three sets each day. Strengthening of the pelvic floor muscles will occur after about 12 weeks and exercises must be maintained to keep these muscles in shape.

For the best results, try to focus on contracting only the pelvic floor muscles and avoiding contracting muscles in the stomach, thighs or buttocks. It is also important to breathe while performing the exercises and avoid holding your breath, as this will cause other muscles to contract.

Benefits of pelvic floor exercises

Pelvic floor exercises can benefit both men and women who are suffering from incontinence. These exercises are particularly useful for women who have given birth vaginally and as a result have stretched or strained pelvic floor muscles. Women who have decreased sexual function, possibly due to childbirth, can also benefit from pelvic floor exercises. These exercises also can benefit men in helping to prevent premature ejaculation and erectile dysfunction.

Prevention of pelvic floor damage

To prevent pelvic floor muscle damage, it is important to avoid constipation or straining while going to the toilet, to limit any regular heavy lifting or coughing and maintain a healthy body weight. It is also important to not fatigue your pelvic floor muscles by over exercising them - reduce your exercise regime if this occurs.

References

1. Citak Nevin Cetin Cam Hediye Arslan Ates Karateke Niyazi Tug Reyhan Ayaz and Cem Celik. Postpartum Sexual Function of Women and the Effects of Early Pelvic Floor Muscle Exercises. Acta Obstetricia Et Gynecologica Scandinavica 89 no. 6 (June 2010): 81722. doi:10.3109/00016341003801623.
2. Female Pelvic Floor Muscles - Mayo Clinic. Accessed August 20 2014. link here
3. Kegel Exercises for Men: Understand the Benefits - Mayo Clinic. Accessed August 20 2014. link here
4. Kegel Exercises: A How-to Guide for Women - Mayo Clinic. Accessed August 20 2014. link here
5. Male Pelvic Floor Muscles - Mayo Clinic. Accessed August 20 2014. link here
6. Meldrum David R. Arthur L. Burnett Grace Dorey Katherine Esposito and Louis J. Ignarro. Erectile Hydraulics: Maximizing Inflow While Minimizing Outflow. The Journal of Sexual Medicine 11 no. 5 (May 2014): 120820. doi:10.1111/jsm.12457.
7. Pelvic Floor. Better Health Channel. Accessed August 20 2014. link here
8. Pelvic Floor Muscle Exercises. Accessed August 20 2014. link here
9. The Pelvic Floor | The Royal Womens Hospital. Accessed August 20 2014. link here

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