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Coached Pelvic Floor Muscle Exercise

The pelvic floor muscles are important because they help you keep control over your bladder and bowel functions and to stay continent.

Before you beginning you can self-assess your urinary incontinence with the International Consultation on Incontinence Questionnaire.

In this step, we are going to coach you through two ways of doing Pelvic Floor Muscle Exercises; slow squeezing and fast squeezing.

We have included two videos below to help you.

How to use the coached pelvic floor exercise

How to find your pelvic floor muscles

A quick reminder about how to find your pelvic floor muscles. Think about the three openings in the pelvic floor, the back passage, the vagina in the middle and the small bladder opening at the front called the urethra.

Begin by lifting and squeezing around the back passage as if you are stopping wind, then bring this feeling forwards around the vagina as if you are tightening around a tampon, and forward again as if you are stopping the flow of urine.

Ways of doing a pelvic floor squeeze

There are two ways of doing a pelvic floor squeeze, either a slow or a fast squeeze.

Slow squeeze

The slow squeezes build up strength and endurance by working the muscle hard. To do this, you must keep the squeezing and lifting going throughout the squeeze up to a count of 10 seconds.

Don't just squeeze once and hold it and hope that it will get to 10 seconds as you may not feel that you have let the squeeze go. Instead, keep squeezing until the muscle is tired and then release completely for a few seconds and repeat.

Fast squeeze

The fast squeezes help to get the muscle reacting quickly. You need the muscle to squeeze quickly to prevent a leak when you cough or sneeze without much warning. For the fast squeezes, squeeze as hard as you can, followed by an immediate release and let the muscle relax.

Where to do the exercises

For this coached task, we suggest you sit upright on a firm chair and with your lower back supported. Or you can try leaning forwards with a straight back and your knees apart with your elbows resting on your knees.

In this forward lean position, your pelvic floor will be in contact with the chair so that you may have more sensation and you can think about lifting the pelvic floor up from the seat of the chair.

Keep your buttocks relaxed and breath throughout the task. If you find it easy to complete the task in sitting, then you can progress to standing. However, if you find it difficult to do them in sitting, try the coached task again in lying.

When to do these exercises

Exercises to strengthen the pelvic floor are most effective when you do them several times per day instead of doing them little and often, so you should set aside a few minutes to complete the programme of exercises. If you have tried pelvic floor exercises before or you feel that they may not be helping you, check that you are doing them correctly as we explained in the video or you that are progressing your programme. If you are not sure, you may need to seek further help from your health care provider or see a women's health physiotherapist

Breathing is important

To train the muscles effectively, it is important that you are able to breathe throughout your exercises and not pull up your muscles by holding your breath and sucking in your tummy. No one should know you are doing these exercises by looking at you, so don't squeeze your face or tighten your buttocks. Make sure that you are finish your exercise programme each time, so that you are challenging your pelvic floor muscles to change its strength and co-ordination, but remember to release completely between squeezes.

Challenging yourself

You can increase your programme of exercises by changing your position from lying to sitting and up to standing. Finally, you can include the pelvic floor squeeze while doing other tasks such as coughing, lifting or with exercising. This is when you will really begin to see the benefit of doing your exercises.