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Expert Advice: Your Pelvic Floor Muscles Explained

EXPERT ADVICE: The pelvic floor muscles prevent embarrassing leaks, improve sensation during sex and help to hold all our bits in the right place, explains physiotherapist and eumom expert Aoibhin McGreal who specialises in helping women with pelvic floor problems.

Doing pelvic floor exercises improves up to 70 per cent of women with bladder leakage. If you have been ignoring your pelvic floor, it's time you started paying these important muscles some much needed attention.

What are the pelvic floor muscles?

The pelvic floor muscles stretch from the pubic bone at the front, to the tailbone (coccyx) at the back and form the floor of the pelvis. They are like a trampoline and work to support the bladder, vagina, womb and rectum, holding them in the correct place.

What are they supposed to do?

The pelvic floor muscles work to:

  • Support the bladder, bowel and uterus (womb), preventing prolapse
  • Help prevent leakage when you cough, laugh, sneeze, run or jump
  • Help you hold on when the toilet is not near
  • Improve sensation during sexual intercourse

Why do they stop working properly?

These muscles can become weak due to:

  • Pregnancy
  • Childbirth
  • Menopause​
  • Constipation and straining
  • Persistent heavy lifting
  • Chronic cough (from smoking, chronic bronchitis or asthma)
  • Being overweight
  • Lack of general fitness

But for some women they can also become tight and tense as a result of:

  • Constant "holding" of the tummy or pelvic floor (normally without noticing that you're doing it)
  • Poor posture
  • Excessive core exercise
  • Damage during childbirth

How do we exercise the pelvic floor muscles?

The pelvic floor muscles need to contract (tighten) and relax (release) fully. To start with, try Aoibhin's 'balloon breathing' technique to release the pelvic floor.

  1. Lie on your back with your knees bent and your hands placed gently on your tummy.
  2. Breathe in through your nose, allowing your tummy to expand gently. Make sure your chest doesn't lift – this can take practice.
  3. Hold the air in for 2 to 3 seconds.
  4. Gently let the air out through your mouth.

​Repeat this at least 10 times or for up to 10 minutes. Once you get the technique right, start to concentrate on what's happening to your pelvic floor. Think of your tummy and pelvic floor as the balloon, as your tummy expands, your pelvic floor relaxes downwards. You can view a short video demonstrating the balloon breathing technique here. Now move on to pelvic floor strengthening:

  1. Lie on your back with your knees bent or sit in an upright chair with your back supported.
  2. Imagine trying to lift your vagina up inside or imagine you are trying to hold back urine, or wind from the back passage.
  3. Build up to holding this for 10 seconds and repeat 10 times. As the muscles get stronger you will feel a stronger squeeze and lift.

When you tighten your pelvic floor muscles, try to keep breathing normally. You may notice a slight tightening of your lower tummy which is absolutely fine, but try to avoid clenching your buttocks or legs. Try to do these exercises three times every day. You can view a short video demonstrating the pelvic floor strengthening exercises here. If you are unable to feel a definite squeeze and lift action of your pelvic floor, don’t worry! Even people with very weak muscles can be taught these exercises by a chartered physiotherapist who specialises in women's health and continence. I find that up to 70 per cent of women improve with my specialised pelvic floor physiotherapy.

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