pelvic floor exercise, pelvic floor exercises, pelvic floor, pelvic floor strengthening

All Information listed below is from the Pelvic Floor Exercise Website.  This is research based information about providing a stronger pelvic floor.

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What is the pelvic floor?
The pelvic floor is a large hammock of muscles stretching from side to side across the floor of the pelvis. It is attached to your pubic bone in front, and to the the tail end of your spine behind. The openings from your bladder, your bowels and your womb all pass through your pelvic floor.

pelvic floor, pelvic floor muscles, pelvic floor exercises

What does the pelvic floor do?
.  It supports your pelvic organs and the contents of your abdomen, especially when you are standing or exerting yourself.
.  It supports your bladder to help it stay closed. It actively squeezes when you cough or sneeze to help avoid leaking.
.  It is used to control wind and when "holding on" with your bowels.
.  It helps to increase sexual awareness both for yourself and your partner during sexual intercourse.

What weakens the pelvic floor muscles?
Pelvic floor muscles weaken for similar reasons to other muscles in our bodies: natural ageing and inactivity. But pelvic floor muscles are also often weakened through hormonal changes in women's bodies, and through pregnancy and childbirth. Factors such as being overweight, ongoing constipation and a chronic cough can put extra pressure on the pelvic floor and pelvic surgery can also have damaging effects, particularly in men.

Weak pelvic floor muscles are very common. A new US study shows that 25% of women suffer from moderate to severe pelvic floor muscle weakness, with the figure rising to 30% or more of obese and older women. (Nygaard and others, 2008).

Why are pelvic floor exercises (also known as Kegel exercises) important?
A poorly toned, weak pelvic floor will not do its job properly. Women with weak pelvic floor muscles frequently experience incontinence and reduced sexual response. But research has shown that the pelvic floor responds to regular exercise. With regular exercise, it is possible for most women to reduce or completely overcome the symptoms of weak pelvic floor muscles, no matter what their age.

A regime of pelvic floor exercises, introduced earlier in life, will also prevent many of the problems associated with weak pelvic floor muscles emerging later. It is never too early or too late to begin to exercise the pelvic floor.

Research has also shown that pelvic floor exercise can provide relief from chronic pelvic pain syndrome.

A woman with already badly weakened pelvic floor muscles may need the advice of a women's health physiotherapist or other health professional before embarking on an exercise program, but many women with mild symptoms prefer to try a simple exercise program for themselves initially.

Pelvic floor exercises are often also called Kegel exercises, after their originator, Dr Arnold Kegel and are widely promoted as the starting point for building pelvic floor strength. Any woman can try these exercises for herself. Be aware that if they are not done correctly, they can aggravate a problem. Follow the instructions below, but seek the advice of a health professional, such as your gp or a women's health physiotherapist, if you have doubts about your ability to do the exercises correctly. Alternatively, consider using a simple device such as the Pelvic Floor Educator, to teach yourself the correct exercise technique.


Does childbearing weaken the pelvic floor?

Over half of pregnant women report symptoms of urinary incontinence and most studies have found that women who have had children are more likely to suffer from urinary incontinence than women who have never had children (Rortveit, Grodstin). A US study has found that the risk of moderate to severe pelvic floor disorders increases with the number of babies a woman has had. Problems are experienced by 12.8% of women who have never given birth, 18.4% of women who have had one child, 24.6% of women who have had two children, and 32.4% of women who have had three or more children (Nygaard & others).

For many women the symptoms that are experienced in the months after birth do diminish naturally. However, in a large Swedish study, over 1 in 5 women reported symptoms of stress incontinence a year after having a baby (Schytt) and for many they persist for life, worsening with age. A recent Danish study found that urinary incontinence increased significantly during the 12 years following the birth of a woman's first baby to the point where 47% of women in the study group had some level of incontinence (Viktrup 2009).

Some studies suggest that stress incontinence symptoms that appear after the birth, rather than during the pregnancy, are much more likely to persist, with 25% of these women still incontinent one year later.

Can a caesarean birth reduce pelvic floor damage?
Some research does indicate that women who have had caesarean deliveries have a lower rate of incontinence than women who have had vaginal deliveries (Rortveit, Farrell). Several studies have found that a forceps delivery increase a woman's chance of suffering from incontinence after giving birth.

Does pelvic floor exercising after having a baby make a difference?
Definitely, YES! Research shows that a regular program of pelvic floor exercise does make a difference; it reduces the likelihood of ongoing stress incontinence and increases muscle strength, with results of an eight-week program still sustained a year later :

[A program of] pelvic floor muscle strength training programme can add significantly to physical recovery after childbirth. (Morkved & others).

However pelvic floor exercises need to be performed for life to fully protect the pelvic floor. New mothers need to incorporate exercises into their own routines, rather than relying on supervised postnatal exercising. which research shows is unlikely to be sustained effectively once the health professional support is no longer available (Agur & others).

Is is possible to reduce the likelihood of damage to the pelvic floor by exercising before or during pregnancy?
A strong pelvic floor is an excellent insurance against stress urinary incontinence at any stage of life.There is evidence that a program of pelvic floor exercise during the first half of pregnancy can substantially reduce incontinence symptoms in later pregnancy and after birth (Sampselle) for women who are pregnant for the first time. And the strength of the pelvic muscle at 20 weeks of pregnancy is an excellent indicator of whether a woman is likely to suffer from incontinence later.A pelvic floor exercise program during pregnancy can also have a positive effect on the second stage of labour (Salvesen).

Pelvic floor weakness and stress incontinence are common after childbirth. But if your stress incontinence is still present three months after your baby is born, it is unlikely to improve on its own. Research shows that the majority of women who suffer from SUI at three months, still have the problem after 5 and even 12 years!

The following Fact sheets have been provided by Pelvic Floor Exercise