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.

Bladder

An organ in the lower abdomen that stores urine for excretion.

Uterus

The hollow organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. Also known as the womb.

Bowel

The part of the digestive tract that comprises the small and large intestines.

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 faeces.

Pelvic floor muscles used for Kelgel exercises.In women, the pelvic floor muscles support the bladder, bowel and uterus. 

Bladder

An organ in the lower abdomen that stores urine for excretion.

Coccyx

A small, triangular bone joined to the sacrum at the base of the vertebral column.

Rectum

The final part of the large intestine, leading to the anus.

Urethra

The duct through which urine flows from the bladder to outside the body.

Uterus

The hollow organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. Also known as the womb.

Bowel

The part of the digestive tract that comprises the small and large intestines.

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.

Bladder

An organ in the lower abdomen that stores urine for excretion.

Coccyx

A small, triangular bone joined to the sacrum at the base of the vertebral column.

Bowel

The part of the digestive tract that comprises the small and large intestines.

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;
  • Faecal incontinence;
  • Inability to reach the toilet in time;
  • Reduced sensation in the vagina, and;
  • Dislodging of tampons.

Incontinence

The uncontrollable loss, small or large, of bladder or bowel control, resulting in leakage of their contents.

Faecal incontinence

A lack of bowel control that results in leakage of stools. Also known as bowel incontinence.

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 labour and overstretching of vaginal muscles;
  • Decreased levels of oestrogen 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).

Bladder

An organ in the lower abdomen that stores urine for excretion.

Diabetes

A metabolic disorder that is caused by problems with insulin secretion and regulation and which is characterised by high blood sugar levels. Also known as diabetes mellitus.

Labour

Signals the end of a pregnancy and the process of giving birth to a baby from the uterus to the outside world.

Oestrogen

One of a group of steroid hormones involved in the development and maintenance of female sex characteristics. These are the primary female sex hormones.

Prostate gland

A male reproductive organ that surrounds parts of the bladder and urethra. It secretes a sperm-nourishing component of semen.

Bowel

The part of the digestive tract that comprises the small and large intestines.

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 faecal 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.

Bladder

An organ in the lower abdomen that stores urine for excretion.

Coccyx

A small, triangular bone joined to the sacrum at the base of the vertebral column.

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.

Incontinence

The uncontrollable loss, small or large, of bladder or bowel control, resulting in leakage of their contents.

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 overexercising them - reduce your exercise regime if this occurs.

Fatigue

A state of exhaustion and weakness.