Pelvic floor exercises – are you doing them right and are you doing enough?
If you think about your pelvic floor like any other muscle in your body, doing an exercise for a few seconds, a few times, once a week, is not going to strengthen these muscles. Physiotherapist Jaclyn Thurley explains what your pelvic floor training program should include.
“Are you doing your pelvic floor exercises?”
The common response is either, “No” or, “Yes, here and there”.
How many times a week do you do them? “Maybe once.” How many contractions do you do? “About 5, then my mind veers off to my to-do list!”
How long are you holding the contractions for? “Probably a few seconds.”
The above is a common conversation pelvic health professionals have with their clients. For the record – kudos to those women doing any form of pelvic floor exercise! Please keep it up! But, unfortunately, doing a few contractions here and there is not enough to strengthen your pelvic floor.
Think about your pelvic floor like any other muscle in your body, for instance your tummy muscles. Holding a plank for a few seconds, a few times, once a week, is not going to strengthen your core – and the same can be said about your pelvic floor.
To strengthen your pelvic floor there are two main principles:
- Correct Technique
Many women incorrectly contract their pelvic floor. Research shows that 60% of women do not turn on their pelvic floor correctly when verbally cued, and 40% bear down when asked to contract their pelvic floor (Thompson & O’Sullivan, 2003). Therefore, it is important to have your muscles checked by a Women’s Health Physiotherapist to ensure you are contracting them correctly.
- Sufficient Training Load
To strengthen a muscle, you need to perform an exercise at the right intensity/level of difficulty and you need to perform enough reps and sets to achieve muscular fatigue. The pelvic floor literature suggests 6-12 reps, 3 sets a day or twice a week at a bare minimum (Bø, 2006).
But it’s not just about pelvic floor strength. It’s also about pelvic floor endurance and being able to turn the pelvic floor on quickly when you need it. To explain this further lets discuss the two main functions of the pelvic floor.
- Stop urine leakage when you cough and sneeze
To prevent leakage, the pelvic floor needs to turn on fast enough to catch the leakage. It also needs to turn on strongly enough to prevent anything escaping the bladder. Therefore, your pelvic floor exercises need to not only improve your strength, but also your ability to turn the muscles on quickly.
- Allow you to hold on to a full bladder for as long as you need
To prevent leakage when your bladder is really full and you’re walking to the toilet OR to enable you to delay the need go (perhaps you’re in a meeting and can’t go for another 30 minutes – arrhh!), the pelvic floor must have great endurance.
Therefore your pelvic floor training program needs to include: a) strengthening exercises, b) speed exercises, and c) endurance exercises.
The problem lies in the fact that everybody’s pelvic floor is different. No two pelvic floors are the same. That means that no two pelvic floor programs should be the same.
How long you hold it for, at what intensity, how many reps and sets your do, and what position you do them in, will differ from person to person. However, the following can be used as a general guide:
- Strengthening exercises (Strong 80-100% effort contractions), 6-12 reps
- Speed exercises (Quick on/off contractions), 6-12 reps
- Endurance exercises (5-20 second holds at 50% effort), 6-12 reps
Your pelvic floor contractions are preferably performed in sitting and standing, but you can start in lying if you find this easier.
To strengthen a weak pelvic floor the literature suggests 3-5 months of regular and progressive pelvic floor exercises (Bø, 2006). To make sure you’re not wasting your precious time by either doing your exercises incorrectly or by doing an incorrect dosage, it is best to see a Women’s Health Physiotherapist as they can prescribe a tailored exercise program for you.
A lot of women find it hard to do their pelvic floor exercises – your mind veers off, you get distracted. If this is the case, get your physiotherapist to record a pelvic floor audio for you. This audio will take you rep by rep and set by set through your specific pelvic floor program. All you need to do is press play and follow the prompts. Audios can be a great way to improve your compliance with your exercises.
Hopefully you can take away from this article that when it comes to your pelvic floor exercises:
- You need to do them right; and
- You need to do enough!
Good luck and enjoy!
Jaclyn Thurley is the founder and principal physiotherapist at The Pelvic Studio in Salamanca Place, Hobart. She is a friendly, fun-loving and passionate physiotherapist with years of experience treating complex pelvic and musculoskeletal/sports conditions.
If you are a new mum returning to exercise and are not sure where to start check out our FREE Safe Return to Exercise for New Mums program to learn all you need to know.
– Bø, K. (2006). Can pelvic floor muscle training prevent and treat pelvic organ prolapse? Acta Obstetricia et Gynecologica Scandinavica, 85(3), 263-268. doi:10.1080/00016340500486800
– Thompson, J., & O’Sullivan, P. (2003). Levator plate movement during voluntary pelvic floor muscle contraction in subjective with incontinence and prolapse; a cross-sectional study and review. Int Urogynecol J Pelvic Floor Dysfunct, 14(2), 84-86