Pregnancy Pelvic Floor Muscle Exercise

Pregnancy Pelvic Floor Muscle Exercise

 

This information is provided as a general information and a guide only and clients are advised to consult with their own caregiver for further advice.

-The ups and downs of the pelvic floor muscles-

having a baby

 

Congratulations! Expecting a baby is exciting! While the outward change of a growing belly is obvious it does mean that your body will go through a lot of more subtle changes over the next 9 months often including weakening of the pelvic floor muscles. Now is the time to focus on improving and maintaining pelvic floor muscle health, strength, relaxation and function. Be aware that many women find these exercise difficult to understand and 1/4 perform them incorrectly. 1/2 ladies perform ineffective contractions. It is essential to have your technique checked.

Note, Pilates may assist in awareness of the pelvic floor but does not necessarily strengthen or improve continence (leaking from urine or bowel). Most women are aware of the function of the pelvic floor muscles to help control bladder and bowels(continence) but the muscles have many different functions. Continence issues may even occur with an overactive pelvic floor and strengthening the muscles or performing Pilates without full understanding of the pelvic floor muscles in this situation may even make the problem worse. Any symptoms of pelvic floor dysfunction must be thoroughly assessed by a Pelvic Floor Physiotherapist. Strengthening the pelvic floor is not always the answer. 

 Pelvic floor muscles are the funnel shaped trampoline like group of muscles under your bladder, uterus and bowel that help with bladder and bowel control ie stopping leakage, and they give support of these pelvic organs. Pelvic floor muscles also have important sexual functions and help support the back and pelvis.

 In pregnancy many women leak urine especially as the baby gets bigger. This is common but we do know that these women are more likely to go on and continue to leak urine after the baby is born. Also women who have had a baby are around 3 times more likely to wet themselves as women who haven’t had a baby.  Descent or prolapse of the pelvic organs (bladder, uterus and or bowel) may also affect women post natally.  These problems tend to become more common as women grow older. 

Ensuring you perform exercises regularly now will help to lessen the risk of having pelvic floor weakness later. All women as a general rule, must perform pelvic floor muscle exercises regularly even if they have no symptoms. Women who have had 3 or 4 pregnancies or more are more at risk even if they have had caesarean sections. 

Pelvic floor muscle training has been shown to be effective in preventing and reducing incontinence if performed effectively and frequently. It is even more effective to train with a Physiotherapist trained in management of the PF area and do specific PF classes. Physiotherapists with a special interest in this area can assist you in learning pelvic floor exercises. Current research is looking at the role of the Pelvic floor Physiotherapist in teaching every pregnant women about their pelvic floor muscles. So please book an appt now!

pelvic floor

This is your pelvic floor area. You can see the bladder which stores urine, and its corresponding tube, the urethra; the uterus and vagina below; and the bowel finishing at the anus. The urethra, the vagina and the rectum/anus pass through the pelvic floor muscle layers. The layers also include supporting structures such as ligaments and ligament type tissue called fascia. The muscles run from front to back and support or hold up the pelvic organs and they more or less wrap around these 3 openings too, so as to pull them and close them off when the muscles contract.

  •  To exercise the pelvic floor start in a side lying position or sitting and think about where those muscles are.
  • Imagine you are squeezing around the sphincter muscle of the anus to stop passing wind. Relax.
  • Do this again and squeeze around the vagina opening too. Then relax.
  • This time squeeze around the anus, vagina and this time the urethra as if you are stopping wind and stopping urine flow. Relax. A healthy muscle is also able to relax fully so this part of the exercise is just as important as the squeezey part.
  • Lastly squeeze all openings quickly tighter and lift up the pelvic floor up and inside, away from your pants.
  • Try to feel the muscles lifting slightly forward as well towards your navel. Relax. Relax fully, don't forget!
  •  Now, squeeze and lift up and forward again and start with a  5 second hold up, relax and rest completely for 10 seconds and repeat 5 times.  Do this 3 x daily.
  • As you get better, then hold up to 8 seconds, rest for 10 seconds then repeat up to 12 times. When confident, also add in strong quick squeezes at the final few seconds of your lift.

 If you feel a letting go when you stop squeezing or a deliberate lift on the initial tightening then you probably have the technique correct. But many women find it hard to feel these muscles and are unsure whether they are performing them correctly. A Physiotherapist can show you how to correctly use your abdominals and your pelvic floor muscles. As time goes by you will aim to squeeze and lift more intensely. it is essential that you let go as well as squeeze and lift.

When you cough, sneeze, laugh, blow your nose, or lift baby or anything else, squeeze and lift up inside and also gently activate your low, deep abdominals. Avoid lifting anything heavy during pregnancy or minimize lifting toddlers etc, and then continue to avoid heavy lifting for at least 3 months postnatally.

 Exercise the pelvic floor in different positions especially as you are getting stronger. Continue to exercise 3 x daily in pregnancy and then after birth until you have no symptoms of pelvic floor weakness, and can hold strongly for at 10 seconds, 8 -12 times. This may take several months. All women must continue to exercise the pelvic floor muscles to fatigue 1 x daily and continue to use them in every day activities. Use it or lose it!

 Studies looking at learning pelvic floor muscle exercises from a handout or verbal instruction show that 50% of women use incorrect muscle action and 25% actually use straining action that can weaken the pelvic floor.

 Individual assessment is thus essential for pregnant women and even more so if you are experiencing any difficulty with the exercises or problems with bladder, bowel or sexual function.