Kegels!!!! How do I train my pelvic floor if it's weak!?!
Updated: Jan 13
What are pelvic floor muscles?
Pelvic floor muscles are the layer of muscles that support the pelvic organs and span the bottom of the pelvis. The pelvic organs are the bladder and bowel in men, and bladder, bowel and uterus in women. The diagram below shows the pelvic organs and pelvic floor muscles in women (right) and men (left).
The pelvic floor muscles stretch like a muscular trampoline from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other sitting bone (side to side). These muscles are normally firm and thick.
Imagine the pelvic floor muscles as a round mini-trampoline made of firm muscle. Just like a trampoline, the pelvic floor is able to move down and up. The bladder, uterus (for women) and bowel lie on the pelvic floor muscle layer.
The pelvic floor muscle layer has hole for passages to pass through.There are two passages in men (the urethra and anus) and three passages in women (the urethra, vagina and anus). The pelvic floor muscles normally wrap quite firmly around these holes to help keep the passages shut. There is also an extra circular muscle around the anus (the anal sphincter) and around the urethra (the urethral sphincter).
Although the pelvic floor is hidden from view, it can be consciously controlled and therefore trained, much like our arm, leg or abdominal muscles.
How do I find my pelvic floor muscles?
The first thing to do is to find out which muscles you need to train.
· Sit or lie down with the muscles of your thighs, buttocks and stomach relaxed.
· Squeeze the ring of muscle around the back passage as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Try not to squeeze your buttocks.
· When sitting on the toilet to empty your bladder, try to stop the stream of urine, then start it again. Do this to learn which muscles are the right ones to use – but only once a week. Your bladder may not empty the way it should if you stop and start your stream more often than that.
If you don’t feel a distinct “squeeze and lift” of your pelvic floor muscles, or if you can’t slow your stream of urine as talked about in Point 3, ask for help from your doctor, physiotherapist, or continence nurse. They will help you to get your pelvic floor muscles working right. Women with very weak pelvic floor muscles can benefit from pelvic floor muscle training.
How do I do my pelvic floor muscle training?
Now that you can feel the muscles working, you can:
· Squeeze and draw in the muscles around your back passage and your vagina at the same time. Lift them UP inside.
Imagine there is a straw in your vagina or you penis is a straw, and you are trying suck a smoothie up and in without using your butt!
· You should have a sense of “lift” each time you squeeze your pelvic floor muscles. Try to hold them strong and tight as you count to 8. Now, let them go and relax. You should have a distinct feeling of “letting go”.
· Repeat “squeeze and lift” and let go. It is best to rest for about 8 seconds in between each lift up of the muscles. If you can’t hold for 8, just hold for as long as you can.
· Repeat this “squeeze and lift” as many times as you can, up to a limit of 8 to 12 squeezes.
· Try to do three sets of 8 to 12 squeezes each, with a rest in between.
Do this whole training plan (three sets of 8 to 12 squeezes) each day while lying down, sitting or standing.
While doing pelvic floor muscle training:
· keep breathing;
· only squeeze and lift;
· do NOT tighten your buttocks; and
· keep your thighs relaxed.
Who should do pelvic training?
For pregnant women, pelvic floor muscle training will help the body cope with the growing weight of the baby. Healthy, fit muscles before the baby is born will mend more easily after the birth.
After the birth of your baby, you should begin pelvic floor muscle training as soon as you can. Always try to “brace” your pelvic floor muscles (squeeze up and hold) each time before you cough, sneeze or lift the baby. This is called having “the knack”.
As women grow older, the pelvic floor muscles need to stay strong because hormone changes after menopause can affect bladder control. As well as this, the pelvic floor muscles change and may get weak. A pelvic floor muscle training plan can help to lessen the effects of menopause on pelvic support and bladder control. This is also true for cancer survivors suffering from pelvic floor changes due to oncology treatments.
Pelvic floor muscle training is also helpful for men with pelvic floor weakness, urinary incontinence, LUTS, constipation and post prostatectomy.
Pelvic floor muscle training may also help women who have the urgent need to pass urine more often (called urge incontinence).
Before attempting to begin a pelvic floor muscle program, follow up with a license clinician/ provider prior to starting. Each program should be individualized to you after having a comprehensive full body including pelvic examination. Sometimes Kegels are not the answer and could make your condition worse.
For more information or you want to discuss what is best for you schedule a virtual consultation today!