What is the best way to exercise the pelvic floor muscles?
The pelvic floor muscles play an important role in posture and movement, and respond by activating whenever we change our posture or move a limb. Therefore, you could say that any movement we do throughout the day is actually a pelvic floor muscle exercise!
We know that muscles get stronger and maintain their strength through repeated use and progressive overload, and this is no different for your pelvic floor. This is why we encourage all women to be and stay active whenever possible!
When most of us think about “exercise” though, we envision going to the gym and getting sweaty by doing squats, lunges or even joining in on a class. What many of us don’t know, is that even going for a simple walk will help the muscles of your pelvic floor! What is most important is that movement and exercise is tailored to you and your level of experience/fitness.
Should you perform general or isolated pelvic floor exercises?
This is quite an interesting topic, and there have been many debates in the professional world around the role and benefits of isolated strength work for the pelvic floor. Some feel that walking, moving and general exercise is enough for good pelvic floor function (and we agree that this should be promoted regardless!), however there is some good research available to also suggest that supervised pelvic floor strengthening is beneficial in helping women who suffer from incontinence and can even help to prevent incontinence in pregnant women.
Ideally we want to combine both of these models of exercise! It may be useful to learn how to perform a sustained pelvic floor contraction by itself initially, but once appropriate, we would want to combine that with an activity. The reality is we really want these muscles to learn to work when you need them, like whilst performing activities like lifting or carrying your baby!
Pregnancy and Postpartum Pelvic Floor Exercises
Pregnancy and childbirth increase the risk of weakening as well as injury to the pelvic floor muscles, and it has been estimated that approximately half of postpartum women may lose some of the supporting function of the pelvic floor muscles after delivery. Sadly, many women do not know that pelvic floor muscle exercises can be initiated during pregnancy and is not something that you need to wait for after giving birth.
Research suggests that even if women know about the muscles of the pelvic floor and that exercise relating specific to them as well as the muscles surrounding them are important, they are less likely to perform them unless they have had individualised training and education for it. The impact of performing pelvic floor muscle exercises after receiving individualised training is that it can reduce a lot of the symptoms of a weak pelvic floor such as incontinence (discussed further below). Many women believe that these type of symptoms are out of their control or is just something that happens with pregnancy, however we are passionate about helping pregnant women understand the link between pelvic floor muscle training and a healthy mum and bubs.
It is true that incontinence is common after pregnancy, however we want women to know that it is not “normal” and can be improved with the right care and advice around pelvic floor muscles exercises from a physiotherapist.
Pelvic Floor Muscle Training and Urinary Incontinence
The pelvic floor has important role not only in terms of supporting the pelvis, but also in maintaining continence. For pregnant clients we recommend doing pelvic floor exercises as this can reduce the rate of urge incontinence later in pregnancy as well as after the birth. Unfortunately being able to hold and contract the correct muscles is not as simple as it sounds (well not without pelvic floor muscle training). Ideally what we look to teach women who are pregnant or postpartum is how to contract their pelvic floor muscles with support of the deep abdominal muscles (such as transverse abdominis) without over emphasising the use of their superficial abdominal muscles (like the muscles that form our “6 pack”). There are many strategies to help learn these contractions, however finding the right one that makes sense to the individual is our most important factor. As we said previously, if women understand what to do and feel confident in performing pelvic floor exercises, they are much more likely to complete them and benefit from the support it provides!
Studies have shown that performing pelvic floor muscle exercises reduces the rate of incontinence and also improves the quality of life experienced by the individual. Although simply performing the exercises showed improvements, the groups which improve most have been those who conduct their exercise under supervision of an allied health professional. So although medical advice alone is very helpful to understand what and why we perform pelvic floor muscle exercises, taking part in a Physiotherapist led Supervised Exercise Group Class is our best recommendation until you feel you confident to continue them alone.
It is important to get assessed and have a program tailored to you so that you can gain the knowledge and receive the guidance to best help you! Our team loves helping women, whether they are currently pregnant or have recently given birth, to feel strong and empowered to get back to doing what they enjoy again.