Your Pelvic Floor
Explained
Department of Health and Social Care
Rheynn Slaynt as Kiarail y Theay
NH622
This leaflet tells you about how your pelvic floor works and why it becomes weak.
It also tells you how to do pelvic floor exercises and gives you other pelvic floor
advice.
This leaflet outlines the anatomy & function of the pelvic floor, sources of pelvic floor weakness
and the consequences, how to do pelvic floor exercises and other pelvic floor advice.
What
is Is
my
Floor?
What
MyPelvic
Pelvic Floor?
This leaflet outlines the anatomy & function of the pelvic floor, sources of pelvic floor weakness
and the consequences, how to do pelvic floor exercises and other pelvic floor advice.
Uterus
What Is My Pelvic Floor?
Back
Bladder
Bowel
Front
Uterus
Bladder
Bowel
Tail
bone
Anus
Tail
(Swash,bone
1990)
Vagina
Pubic bone
Urethra
Pubic bone
PELVIC
OR M
U SCLES
PELVICFLO
FLOOR
MUSCLES
Anus
Urethra
Vagina
The pelvic floor is a sling of flat muscles that attach to the pubic bone at the front and to the tail
The pelvic
is aThese
slingmuscles
of flatform
muscles
to thethepubic
at the
bone at floor
the back.
the floorthat
of theattach
pelvis, hence
name bone
‘pelvic floor’.
Thefront
(Swash, 1990)
PELVIC FLO O R M U SCLES
and to
the
tail
bone
at
the
back.
These
muscles
form
the
floor
of
the
pelvis,
that
terms ‘Levator ani’ also describe the pelvic floor.
is why The
it ispelvic
called
floor’.
Youthat
may
hear
thepubic
term
‘Levator
ani’andwhich
floorthe
is a ‘pelvic
sling of flat
muscles
attach
to the
bone
at the front
to the also
tail
Whatthe
Does
My floor.
Pelvic Floor Do?
describes
pelvic
bone at the back. These muscles form the floor of the pelvis, hence the name ‘pelvic floor’. The
Theterms
pelvic‘Levator
floor has
many
roles
thatfloor.
are explained below:
ani’
also important
describe the
pelvic
Does
My Pelvic
Floor Do?
Supports
baby
WhatWhat
does
my
Pelvic
Floor
do?
during pregnancy
Relaxes during labour to
allow delivery of baby
The pelvic floor has many important roles that are explained below:
The pelvic floor has many important
roles that are explained below:
Pelvic Floor
Supports bladder, uterus
Supports
baby
Supports
baby
(womb), vagina
& bowel
by
during
pregnancy
duringthe
pregnancy
lifting them inside
pelvis
to prevent PROLAPSE
Supportsbladder,
bladder,uterus
uterus
Supports
(womb),vagina
vaginaand
& bowel
(womb),
bowelbyby
Supports our core along with
lifting
liftingthem
theminside
insidethe
the pelvis
pelvis
back & tummy muscles
totoprevent
preventPROLAPSE
PROLAPSE
Maintains our ability to hold onto
Relaxes
labour to
to
Relaxes during labour
urine and stools by squeezing our
allow
of baby
baby
allow delivery of
front & back passages closed to
Pelvic Floor
Pelvic
Floor prevents INCONTINENCE
Maintains
our onto
abilityurine
to hold
Helps
to hold
andonto
stools
by squeezing
our front our
urine and
stools by squeezing
Increases vaginal sensation &
and
passages
closed
to to
frontback
& back
passages
closed
sexual satisfaction
prevent
preventsINCONTINENCE
INCONTINENCE
Increases
vaginal sensation
sensation&
Increases vaginal
and
sexual
satisfaction
sexual
satisfaction
Works
with our
and tummy
Supports
our back
core along
with
muscles
support
our core
back &totummy
muscles
Women’s Health Physiotherapy/ Continence Advisor. Review Date: May 2018
2
Women’s Health Physiotherapy/ Continence Advisor. Review Date: May 2018
How Does My Pelvic Floor Weaken?
are many events and activities that cause pelvic floor weakness by red
Why yourThere
Pelvic
Floor weakens
floor muscle, increasing pelvic floor strain or reducing its nerve supply. Some
There are many events and activities that cause pelvic floor weakness. They do
changed.
this by reducing
the integrity of our pelvic floor muscle, increasing pelvic floor
strain or reducing its nerve supply. Some of these risk factors cannot be changed.
Risk factors that cannot be changed
How
Does
Mythat
Pelvic
Weaken?
Risk
factors
cannotFloor
be changed
Floor Weaken?
There are many events and activities that cause pelvic floor weakness by red
ities that cause pelvic floor weakness by reducing the integrity of our pelvic
floor muscle, increasing pelvic floor strain or reducing its nerve supply. Some
or strain or reducing its nerve supply. Some of these risk factors cannot be
changed.
Vaginal delivery
Floor Weaken?
Pregnancy &
Heavy birth weight
Ageing
(incl. perineal tearing and assisted
deliveryRisk
E.g Forceps)
factors that cannot be changed
Risk factors that cannot be changed
ties that cause pelvic floor weakness by reducing the integrity
our pelvic
Riskof
factors
that can be changed
or strain or reducing its nerve supply. Some of these risk factors cannot be
Vaginal delivery
aginal
(incl. perinealMenopause
tearing and assisted
Ageing
Risk delivery
factors that cannotPregnancy
be changed
&
eal tearing and assisted
delivery E.g Forceps)
Heavy birth
weight Repetitive heavy
Smoking &
Straining
on toilet
ery E.g Forceps)
lifting
Chronic coughing
(Constipation)
High impact
exercise
Risk factors that can be Risk
changed
factors that can be
changed
In
Risk factors that can be changed
ginal delivery
al tearing and assisted
ry E.g Forceps)
y
Ageing
Ageing The Symptoms
Menopause
What Are
Of Pelvic Floor Weaknes
Having a weak pelvicRepetitive
floor does
not meanSmoking
that you&will have symptoms to beg
heavy
Straining on toilet
I
Smoking that
&
lifting BMI
High
impact
Chronic
coughing
Not exercising
(Constipation)
Risk factors
can
betochanged
ways
compensate Increased
for pelvic
floor weakness,
however as we
age,
this becom
Chronic coughing
High impact
exercise
your pelvic floor
exercise
Common complaints that indicate pelvic floor weakness include:
What
Areincontinence
The Symptoms
Floorsneezing
Weakne
Stress
urinary
Leaking Of
urinePelvic
when coughing,
or du
oms Of Pelvic Floor
Weakness?
Smoking &
Urge
urinary
incontinence
Being
less
ableyou
to hold
on to symptoms
urine, having
to
Increased
BMI not
Not
exercising
Having
a weak
pelvic
floor does
mean
that
will have
to be
High impact
Chronic
coughing
your
pelvic
floor
not mean that you will have symptoms to begin with. The
body
maythe
findway
urine
along
waysexercise
to compensate for pelvic floor
weakness,
however as we age, this beco
y
oor weakness, howeverProlapse
as we age, this becomes less effective.
Feeling a bulge or like something is ‘coming d
Common
complaints that indicate
pelvic
weakness
include:
Faecal
incontinence
Being less
ablefloor
to hold
onto wind
& stool and
icate pelvic floor weakness include:
oms
Of Pelvic Floor Weakness? 3
↓Sexual sensation
Feeling less sensation during sexual activity
Stress urinary incontinence
Leaking urine when coughing, sneezing or d
Leaking
when
sneezing
during
exertion
(exercise)
ot
mean urine
that you
willcoughing,
have
symptoms
to or
begin
with.
The
body
maywith
findpelvic floor exercises. Pel
Pelvic
floor
weakness
can
be
improved
Urge urinary incontinence
Being less able to hold on to urine, having t
What are the symptoms of Pelvic Floor weakness?
Having a weak pelvic floor does not mean that you will have symptoms to begin
with. The body may find ways to compensate for pelvic floor weakness, however
as we age, this becomes less effective.
Common complaints that indicate pelvic floor weakness include:
Stress urinary incontinence
Leaking urine when coughing, sneezing or
during exertion (exercise)
Urge urinary incontinence
Being less able to hold on to urine, having to
rush to the toilet, and leaking urine along the
way
Prolapse
Feeling a bulge or like something is ‘coming
down’ inside your vagina
Faecal incontinence Being less able to hold onto wind & stool and
having to rush to the toilet
Sexual sensation
Feeling less sensation during sexual activity
How can you make a difference?
Pelvic floor weakness can be improved with exercises. Pelvic floor
exercises can also help to reduce the severity of your symptoms.
Pelvic floor exercises should be a ‘healthy habit’. Daily pelvic floor
exercises need to be done for life.
How Do I Contract My Pelvic Floor?
How do I contract my Pelvic Floor?
When you contract your pelvic floor, it feels like trying to ‘hold in your urine & wind’. You should feel a
When you
contract
your pelvic
‘squeeze
and
lift’ around
your floor,
front
Your lower
tummy can very
gently draw in.
it feels like trying to ‘hold in your
urine and wind’. You should feel a
‘squeeze
and lift’
around
The
lower tummy
will also
very your
gently front
draw
vagina
passage.
in passage,
as if pulling
away and
from back
the zip
of tight
passage, vagina and back passage.
trousers.
The lower
tummy will also very
gently draw in as if pulling away
Nobody should be able to tell when you are
from the zip of tight trousers.
exercising your pelvic floor. Your
bottom
A gentle squeeze & lift
around your front passage,
vagina & back passage.
thighs & upper tummy muscles should stay relaxed. Also, you should not have to hold your breath when
contracting your pelvic floor.
4
It may take time and concentration to learn to correctly contract your pelvic floor.
Pelvic floor exercises can be performed in:
Your lower
tummy can very
gently draw in.
in as if pulling away from the zip of tight
in as
if pulling away from the zip of tight
passage, vagina
and back passage.
trousers.
trousers.
The lower Nobody
tummy should
will also
verytogently
draw
be able
tell when
you are
Nobody should be able to tell when you are
A gentle squeeze & lift
A gentle squeeze & lift
around your front passage,
around your front passage,
vagina & back passage.
vagina & back passage.
exercising
your pelvic
floor. of
Your
bottom
in as if exercising
pulling
away
tight
your from
pelvic the
floor.zipYour
bottom
thighs
&
upper
tummy
muscles
should
stay relaxed.
Also,
you should notyour
have to hold your
breath
when
trousers.thighsNobody
shouldmuscles
be able
to tell
you
are
floor.
Your
& upper tummy
should
staywhen
relaxed.
Also,
youexercising
should not have topelvic
hold your
breath
when
contracting
your pelvic
floor.
bottom
thighs
and
upper
contracting
your
pelvic floor.
A gentle squeeze & lift
tummy muscles
should stay relaxed. Also, you should
around your front passage,
Nobody should
able to
when
you
are when contracting your pelvic floor.
notbehave
to tell
hold
your
breath
vagina & back passage.
It may take time and concentration to learn to correctly contract your pelvic floor.
It may
time and
concentration
to learn to correctly contract your pelvic floor.
exercising
yourtake
pelvic
floor.
Your bottom
It may take time and concentration to learn to correctly contract your pelvic floor.
thighs & upper tummy muscles should
stay relaxed.
Also, youcan
should
not have to in:
hold your breath when
Pelvic
floor exercises
be performed
Pelvic floor exercises can be performed in:
Pelvic
floor
exercises
can
be
performed
in:
contracting your pelvic floor.
It may take time and concentration to learn to correctly contract your pelvic floor.
floor(easiest)
exercises 4-point
can kneeling
be performed
Crook-lying (easiest) Pelvic
Side-lying
Sittingin:
(convenient)
Crook-lying (easiest)
Side-lying (easiest)
4-point kneeling
Sitting (convenient)
Standing (hardest)
Standing (hardest)
HowDo
doI Know
I know
I am
doing
the
exercises
correctly?
How
If if
I Am
Doing
The
Exercises
Correctly?
How Do I Know If I Am Doing The Exercises Correctly?
Holdsoayou
mirror
sothe
you
can
see the
M Mirror
irror
Hold a mirror
can see
area
between
yourarea
legs. between your legs.
M irror
Hold a mirror so you can see the area between your legs.
Tighten your
pelvic your
floor; the
skin between
yourskin
anusbetween
and vaginayour
(perineum)
Tighten
pelvic
floor; the
anus should
and
Tighten
the
between yourSitting
anus (convenient)
and vagina (perineum)
should
Crook-lying (easiest)
Side-lying
(easiest)
4-point
kneeling
Standing
(hardest)
moveyour
awaypelvic
from floor;
you in
theskin
mirror.
vagina
should move away from you in the mirror.
move
awayor
from
you (perineum)
in theyour
mirror.
Palpation
In lying
sitting,
place
hand gently on the perineum. You
Palpation
In lying
orfeel
sitting,
place your
hand
on thewhen
perineum.
You your
should
away
fromgently
your hand
yougently
contract
Palpation should
Inmovement
lying or
sitting,
place
your
hand
feel
movement
away
from
your
hand
when
you
contract
your
floor.Doing The Exercises Correctly?
How Do I Know pelvic
Ifpelvic
Ifloor.
Am
on
the
perineum.
You
should
feel
movement
Digital palpation Gently insert your index finger into your vagina to feel tightening &
Digital palpation Gently
insertyour
your
index as
finger
into
youryour
vagina
toyou
feel
tightening
away
your
hand
when
contract&your
around
finger
contract
pelvic
floor.
M irror
Hold a mirror
so you
canfrom
see you
the
area
between
your
legs.
around your finger as you contract your pelvic floor.
Sex
During
sexual
intercourse,
your
pelvic
floor
and
ask your
partner if they
can feel
pelvic
floor.
Tighten your
pelvic
floor;
the skincontract
between
your
anus
and
vagina
(perineum)
should
Sex
During
sexual
intercourse,
contract your pelvic floor and ask your partner if they can feel
you
tightening
the
muscles.
move away from you in the mirror.
you tightening
the muscles.
Digital palpation
Gently
insert your index finger into your vagina to feel
Palpation
In lying or sitting, place your hand gently on the perineum. You
Avoid Stopping Urine Mid-flow
tightening and around your finger as you contract your pelvic
shouldUrine
feel movement
Avoid Stopping
Mid-flow away from your hand when you contract your
floor.
It can bepelvic
a helpful
prompt floor.
to visualise yourself stopping urination over the toilet in order to
It
can
be
a
helpful
prompt
visualise
stopping
urination
theurination
toilet& in whilst
order over
to
Digital palpation
Gently
insert floor.
yourtoHowever,
index
finger
vagina
feelover
contract
your pelvic
ityourself
is into
not your
advisable
totostart
&tightening
stop
Sex
During
sexual
intercourse,
contract
your
pelvic
floor
and ask
contract
your
pelvic
floor.
However,
it
is
not
advisable
to
start
&
stop
urination
whilst
over
the toiletaround
as a way
of doing
floorcontract
exercises.
Thispelvic
is because
your
fingerpelvic
as you
your
floor. your bladder may start to
the toilet as a way of doing pelvic
floor
exercises.
because
may start
your
partner
if This
theyiscan
feelyour
youbladder
tightening
the to
muscles.
Sex
During sexual intercourse, contract your pelvic floor and ask your partner if they can feel
Women’s Health Physiotherapy/ Continence Advisor. Review Date: May 2018
you tightening
the muscles.
Women’s Health
Physiotherapy/
Continence Advisor. Review Date: May 2018
Avoid stopping urine mid-flow
Avoid Stopping Urine Mid-flow
It can be a helpful prompt to visualise yourself stopping urination
It can be a helpful
prompt
yourself
stopping
overHowever,
the toilet in
to
over the
toilettoinvisualise
order to
contract
your urination
pelvic floor.
it order
is
contract yournot
pelvic
floor. However,
it isand
not stop
advisable
to start
& stop
whilst
over
advisable
to start
urination
whilst
overurination
the toilet
as a
the toilet as a way of doing pelvic floor exercises. This is because your bladder may start to
way of doing pelvic floor exercises. This is because your bladder may
startPhysiotherapy/
to retain old Continence
urine. ThisAdvisor.
can lead
to bladder
and
urinary tract
Women’s Health
Review
Date: May
2018
infections.
5
to do
s?
pelvic
es with
activity
g your
ng your
lvic
es
general
tine
What Are The Exercises I Need To Do?
1. Long Holds for endurance:
What Are The Exercises I Need To Do?
Trouble
rememberi
your exerci
Trouble
rememberi
Try:
your exerc
Contract your pelvic floor and hold it for up to 10 seconds; relax
5 seconds.
Repeat
times.to do?
What 1.
arefor
the
exercises
I10
need
Long
Holds
for
endurance:
If you can’t achieve this, then just hold and repeat for as
Contract
your pelvic floor and hold it for up to 10 seconds; relax
1. Long Holds
for endurance:
long/many as you can before your muscles tire. Your muscles
forpelvic
5 seconds.
Repeat
10 times.
Contract your
hold
for up to 10 seconds; relax for 5 seconds. 1. Timing yo
may
also floor
need and
longer
toitrest.
If
you
can’t
achieve
this,
then
hold
repeat
for as for as long/ Try:floor exer
Repeat 10 times. If you can’t achieve this,just
then
justand
hold
and repeat
a particul
as you muscles
can before your
muscles
tire. Your
muscles
many as youlong/many
can before
tired.
muscles
may
also need
1. Timing y
x 10
forYour
5 secs
Holdyour
for 10 secs getRest
(eg. brus
may also need longer to rest.
longer to rest.
floor exe
teeth, wa
a particu
face)
x 10
Rest for 5 secs
Hold for 10 secs
(eg. brus
2. Quick Flicks for resisting stress on bladder cause by
2. Complete
teeth, wa
coughing etc.:
floor exer
face)
Contract
pelvic floor
strongly
for 1 second,
then relax etc:
it
2. Quick Flicks
foryour
resisting
stress
on bladder
cause and
by coughing
during yo
2. Quick Flicks for resisting stress on bladder cause by
2. Complete
immediately.
Repeat
up for
to 10
times (rapidly)
unless
muscles
Contract your
pelvic floor
strongly
1 second,
and then
relaxyour
it immediately.
exercise r
coughing
etc.:
floor exe
tire
beforehand.
Repeat up to
10 times
(rapidly)
unless
your muscles
tire beforehand.
3. Set a rem
Contract
your
pelvic floor
strongly
for 1 second,
and then relax it
during yo
your pho
immediately. Repeat
up to 10 times (rapidly) unless your muscles
1 sec hold
exercise
download
tire beforehand.
3.
Set a rem
x 10
‘Squeezy
your pho
sec rest
1 sec 1hold
your sma
download
x 10
‘Squeez
Complete
set ofholds
long1 (exercise
holds
1) followed
by of
a set
of flicks
Complete
one setone
of long
1) followed
by a set
quick
sec rest(exercise
your sma
quick2)flicks
(exercise
2) at daily.
least 3-4 times daily.
(exercise
at least
3-4 times
It takesIt
time
exercise
to long
strengthen
your pelvic
floor.
You
won’t
notice
Complete
onefor
setexercise
of
holds
(exercise
followed
byYou
a set
takesfor
time
to
strengthen
your1)pelvic
floor.
areof things
gettingunlikely
betterflicks
for
a
few
weeks,
but
keep
going.
To
improve
your
pelvic
quick
(exercise
2)
at
least
3-4
times
daily.
to notice any improvement for several weeks, so persist! To
floor function,
at least
3-6floor
months
of regular
pelvic
floor exercises
are
improve your
pelvic
function,
at least
3 months
of
It takes time for exercise to strengthen your pelvic floor. You are
required.
regular pelvic floor exercises are required.
unlikely to notice any improvement for several weeks, so persist! To
3. Theimprove
“Knack”:your pelvic floor function, at least 3 months of
3.
The
“Knack”:
regular
pelvic
floor
exercises
are required.
Contract
your pelvic
floor
before
you cough,
sneezeAdvisor.
or lift & Review
keep your
pelvic
Women’s
Health
Physiotherapy/
Continence
Date:
Mayfloor
2018
Contract your pelvic floor
contracted until the event is over. This will help minimise urine leakage and/or the
before you cough, sneeze
feeling of pelvic heaviness.
orWomen’s
lift & keepHealth
your pelvic
Physiotherapy/
Continence Advisor.
Cough
floor contracted until the
event is over. This will
help minimise urine
Rest
leakage and/or the
feeling of pelvic
heaviness.
How Do I Progress My Exercises?
6
Your pelvic floor needs to be exercised to fatigue in
order to improve strength. If you only just managed
to complete the last 1-2 repetitions of your exercises,
Review Date: May 2018
floor exercises
during your general
exercise routine
3. Set a reminder on
your phone or
download the NHS
exercises? ‘Squeezy app’ to
your smart phone
Contract your pelvic floor strongly for 1 second, and then relax it
immediately. Repeat up to 10 times (rapidly) unless your muscles
tire beforehand.
1 sec hold
x 10
Trouble remembering to do your
Try:
1 sec rest
2.exercise
Make to
pelvic
floor exercises
part
of your
general
It takes time for
strengthen
your pelvic
floor.
You are
exercise
routinefor several weeks, so persist! To
unlikely to notice any
improvement
Women’s Health Physiotherapy/ Continence Advisor. Review Date: May 2018
How do I progress my exercises?
Your pelvic floor needs to be exercised to fatigue in order to improve
strength.
you only My
just Pelvic
managed
to complete the last 1-2 repetitions of your
How
Do I If
Contract
Floor?
exercises, finding them very difficult, then your pelvic floor will gradually build
When
you contract your pelvic floor, it feels like trying to ‘hold in your urine & wind’. You should feel a
strength.
and
lift’
around
your
passage,
vaginayour
and back
passage.
Finding
exercise
front
Your lower
tummy can very
programme too easy? gently draw in.
The
lower
tummy
gently draw
Then
alter
onewillofalso
thevery
following:
in as if pulling away from the zip of tight
• Increase the amount of time you contract by 1-2 secs
trousers.
OR
Nobody should be able to tell when you are
• Decrease
the amount
of time
you
exercising
your pelvic
floor. Your
bottom
A gentle squeeze & lift
around your front passage,
vagina & back passage.
rest by 1-2 secs
thighs
& upper tummy muscles should stay relaxed. Also, you should not have to hold your breath when
OR
contracting your pelvic floor.
• Increase the number of repetitions by 1-2
It may take time and concentration to learn to correctly contract your pelvic floor.
OR
floorposition
exercises
can
be performed
in:standing)
• Try exercising in aPelvic
different
(i.e.
lying
to sitting to
Crook-lying (easiest)
Side-lying (easiest)
4-point kneeling
Sitting (convenient)
Standing (hardest)
How Do I Know If I Am Doing The Exercises Correctly?
M irror
Palpation
7
•
•
NHS ‘Squeezy app’ to your smart phone
then alte
•
improve your pelvic floor function, at least 3 months of
3. Set a reminder on your phone or download the
regular pelvic floor exercises are required.
If you a
•
your (exercise
pelvic floor1)exercises
activity (eg. brushing
Complete one 1.
set ofDoing
long holds
followed with
by a a
setparticular
of
quick flicks (exercise
2) teeth,
at least
3-4 times
your
washing
yourdaily.
face)
‘squeeze
order to
to comp
finding t
graduall
Hold a mirror so you can see the area between your legs.
Tighten your pelvic floor; the skin between your anus and vagina (perineum) should
move away from you in the mirror.
In lying or sitting, place your hand gently on the perineum. You
How do I protect my Pelvic Floor from weakening?
How DoAvoid
I Protect
Myon
Pelvic
Floor
From Weakening?
straining
the toilet
(constipation):
Pelvic floor
•exercises:
Eat at least 30g of fibre daily to bulk
•
your
it soft
to pass.
Exercise
yourstool
pelvicand
floorkeep
muscles
regularly
to
Eg,
wholemeal
maintain
their
strength. bread, oats, fresh fruit
and vegetables.
Healthy Toilet Position
Avoid straining on the toilet (constipation):
•
•
•
•
• Drink at least 1.5-2L (3-4 pints) of
Eat at least 30g of fibre daily to bulk your stool and
water daily to nourish your body and
keep it soft to pass.
the risk
constipation.
Drink atreduce
least 1.5-2L
(3-4 of
pints)
of water daily to
nourish your body and reduce the risk of constipation.
• If you have issues with straining, have
If you have issues with straining, having a stool under
a footrest
under
yourcan
feet
and
your feet
and leaning
forwards
help
youleaning
open
forwards
your bowels
easiercan help you open your
It is normal
to open
your bowels between 3 times a
bowels
easier.
day to 3 times a week.
• It is normal to open your bowels
Liaise with your
GP:
between
3 times a day to 3 times a week.
•
•
•
•
Cease
Smoking:
Smoking
causes chronic coughing straining the pelvic floor, as well as the buildLiaise
with your
GP:
up of toxins which adversely affect the pelvic tissues.
Maintain
a healthy
weight: Extra
abdominal
weight
places
extra pressure
on your
floor.
• Give
up smoking:
Smoking
causes
chronic
coughing
straining
thepelvic
pelvic
Local Oestrogen
(Menopausal
Women):
If
this
is
a
suitable
option,
increasing
oestrogen
floor, as well as the build-up of toxins which don’t help the pelvic tissues. in the
tissues can help improve your pelvic floor integrity.
• Maintain
a healthy
weight:
abdominal
places
pressure
Constipation:
If you
are still having
issues Extra
with straining
on theweight
toilet, you
may extra
need advice
regarding
and stool softeners.
on fibre
yoursupplements
pelvic floor.
• Local Oestrogen
Women):
If this is a suitable option,
How Important
Is It To (Menopausal
Do Pelvic Floor
Exercises?
increasing oestrogen in the tissues can help improve your pelvic floor integrity
by applying a cream to the area.
The pelvic floor is like any other muscle, it needs to be exercised to maintain its strength and function.
•
•
1 in 3 women will experience incontinence and/or prolapse at some
• Constipation: If you are still having issues with straining on the toilet, you
point in their lives.
may
advice
fibre supplements
stool softeners.
Females
are need
more at
risk of regarding
incontinence/prolapse
than males and
as our
pelvic floors and tissues will undergo more weakening due to
Pelvic floor exercises:
pregnancy, childbirth and menopause.
• Exercise your pelvic floor muscles regularly to maintain their strength.
It is essential that pelvic floor exercises become routine and are done for life!
What If I Can’t Contract My Pelvic Floor?
A Women’s Health physiotherapist specialises in treating Women’s Health problems including incontinence,
prolapse and pelvic pain. They can help you activate your pelvic floor using verbal instruction, positioning,
biofeedback and electrical stimulation as required.
8
Your gynaecologist or GP will refer you for these services if appropriate.
•
•
Local Oestrogen (Menopausal Women): If this is a suitable option, increasing oestrogen in the
tissues can help improve your pelvic floor integrity.
Constipation: If you are still having issues with straining on the toilet, you may need advice
regarding fibre supplements and stool softeners.
How Important Is It To Do Pelvic Floor Exercises?
How
important
it to
doit my
Floor
exercises?
The pelvic
floor is like anyis
other
muscle,
needs Pelvic
to be exercised
to maintain
its strength and function.
• 3
1 women
in 3 women
willexperience
experience incontinence
and/or and/or
prolapse at
some
• 1 in
will
incontinence
prolapse
point in their lives.
at some point in their lives.
•
Females are more at risk of incontinence/prolapse than males as our
pelvic
floors
and tissues
more weakening due to
• Females
are
more
at riskwillofundergo
incontinence/prolapse
than
pregnancy, childbirth and menopause.
males as our pelvic floors and tissues will undergo more
Itweakening
is essential due
that pelvic
floor exercises
becomeand
routine
and are done for life!
to pregnancy,
childbirth
menopause.
If I Can’t
My
Pelvic Floor?
It What
is essential
that Contract
pelvic floor
exercises
become routine and are done
forA life!
Women’s Health physiotherapist specialises in treating Women’s Health problems including incontinence,
prolapse and pelvic pain. They can help you activate your pelvic floor using verbal instruction, positioning,
biofeedback and electrical stimulation as required.
What
if I can’t contract my Pelvic Floor?
Your gynaecologist or GP will refer you for these services if appropriate.
A Women’s Health physiotherapist specialises in treating Women’s Health
problems including incontinence, prolapse and pelvic pain. They can help you
Common
Myths
About
& Exercises
activate
your pelvic
floor
usingPelvic
verbal Floor
instruction,
positioning, biofeedback and
Women’s Health Physiotherapy/ Continence Advisor. Review Date: May 2018
electrical stimulation as required.
Your gynaecologist or GP will refer you for these services if appropriate.
Common myths about Pelvic Floor and exercises
“It’s normal to have a bit of a leak after a baby or with age.”
Pregnancy, childbirth and age make women vulnerable to incontinence, but it
is not normal. You would not put up with a leaking tap in your house for long.
“My incontinence will resolve on its own.”
It is possible to do nothing about incontinence and have it get better on its
own. However, incontinence is a symptom of pelvic floor weakness, sometimes
your body may compensate temporarily before the symptoms come back.
“I had a caesarean. I don’t need to do pelvic floor exercises.”
You are still at risk of incontinence and prolapse, as your pelvic floor had to
support your growing baby for 9 months, which weakens your pelvic floor. You
still need to complete your exercises.
9
“You need electrical stimulation or vaginal cones to do pelvic floor
exercises.”
Most women do not need electrical stimulation or vaginal cones to do pelvic
floor exercises. However, for some women who are not sure how to contract
their muscles, these treatments can be useful.
“I already have a prolapse, pelvic floor exercises will not help me now.”
If you have a severe prolapse, your gynaecologist will counsel you on whether
pelvic floor exercises will benefit you. Whilst, pelvic floor exercises cannot
reverse a prolapse, they may still reduce the severity of your symptoms.
“I can’t do pelvic floor exercises straight after giving birth or pelvic
surgery.”
Gentle pelvic floor exercises can shift swelling and promote healing of your
pelvic tissues if you have a perineal tear or surgery. Try a few gentle squeezes.
If you have a catheter, then wait until it is removed before you start your
exercises.
“Men do not suffer from incontinence.”
Males and females both have a pelvic floor. Men can and do suffer from incontinence, however they are at less risk as their pelvic floors are not subjected to pregnancy, childbirth or menopause.
10
Useful resources and acknowledgements
Bladder & Bowel Foundation (UK):
Pelvic Floor Exercises for Women. https://www.bladderandbowelfoundation.org
Quit 4 You:
Isle of Man Smoking Cessation Service. Quit4You 01624 642404 or email
[email protected]
Weight Loss Advice:
https://www.bda.uk.com/foodfacts/Want2LoseWeight.pdf
NHS Weight Loss Guide:
http://www.nhs.uk/Livewell/weight-loss-guide/Pages/weight-loss-guide.aspx
11
This document can be provided in large print
or audio format on request.
The contents are the property of the Department of Health and Social Care
and should not be copied without its permission.
Department of Health and Social Care
Health Visiting Service, Crookall House, Demesne Road, Douglas
Telephone: 01624 642650 www.gov.im/dhsc
Printed: July 2016
Review: July 2018
printed by Mannin Group
Origination: Uro Gynae Team
12