What are pelvic floor muscles?
Your pelvic floor muscles stretch inside your pelvis like a hammock or sling. They attach on the pubic bone at the front of your pelvis, on the tailbone (the coccyx) at the back of your pelvis and on the two bones you sit on (ishial tuberosities).
In women, the pelvic muscles support the bladder, bowel and womb (the uterus). Having strong pelvic muscles helps women to stop uncontrolled leakage of urine or faeces. The muscles also help to hold the organs in place inside the pelvis and help with sexual sensation.
In men, the pelvic floor muscles support the bladder and the bowel and weak pelvic muscles can lead to urine or bowel incontinence. Strong pelvic floor muscles also play an important role in a man’s sexual function.
What causes weak pelvic floor muscles?
Weak pelvic muscles can be stretched or too tight and can be affected by a range of activities and situations.
Causes of weak pelvic floor muscles include:
• age – changes in your body as you become older
• menopause – changes in women’s hormones during and after menopause
• heavy lifting – constant heavy lifting at work or in the gym
• high-impact exercises – for example, running or aerobics
• body weight – maintaining a healthy weight helps to lessen the strain on your pelvic floor muscles
• pregnancy and childbirth
• straining on the toilet – being frequently constipated
• surgery –women who have had a hysterectomy to remove parts or all of the uterus (womb) or men who have had prostate surgery or radiation treatment for prostate cancer
• prolapse – organs such as the bladder can drop lower in the pelvis and cause pressure or a bulge in the pelvic area
• constant coughing – your pelvic floor muscles may be affected if you have a ‘smoker’s cough’, or a cough because of bronchitis or asthma.
How do I know if I have a weak pelvic floor?
Your pelvic floor muscles may be weak if you:
• accidently leak urine when you sneeze, cough or laugh (also called stress incontinence )
• accidently leak urine when you exercise or play sport
• accidently leak urine before you reach the toilet
• accidently empty your bowels at the wrong time and before you reach the toilet
• feel pain in the pelvic area or have a bulge in your pelvis
• feel pain when you are having sex.
Training your pelvic floor is an effective and simple way to strengthen your pelvic floor and treat incontinence.
What are pelvic floor exercises?
Pelvic floor exercises (Kegel exercises) help you to strengthen your pelvic floor muscles. Kegel exercises can be done anywhere – at home, lying down, standing or waiting in a queue to buy coffee.
If you are a woman, these exercises involve squeezing the muscles around your anus and vagina, holding them for a few seconds and then releasing or relaxing the muscles. You should feel a ‘squeeze’ and then a ‘lift’ when you relax. If you are having trouble trying to figure out where your pelvic floor muscles are located, try stopping the stream of urine when you are on the toilet. After a few seconds, start urinating again.
Men can also benefit from doing pelvic floor muscle exercises, especially if they are facing or recovering from surgery (e.g. prostate surgery). Strengthening your pelvic floor may also help you to manage incontinence . To locate your pelvic floor muscles, try to stop the stream of urine when you are standing at the toilet. After a few seconds, start urinating again.
To train your pelvic floor, squeeze the muscles around your anus as if you are trying to stop a bowel movement or trying to stop yourself from passing wind. You should feel a ‘lift’ or ‘pull’ on your anus. To focus the exercise on the pelvic floor, try not to tighten your buttocks or use your stomach muscles when you are doing the exercises.
After practicing these exercises for three months, most people notice a difference in the strength of their pelvic floor.
You can try doing the exercises by yourself, but if you need help you can find pelvic health physiotherapists who specialise in teaching you how to do them correctly.
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