For men and women, there is no downside to having a strong pelvic floor muscle. It improves bladder and bowel control, including nocturia (having to get up repeatedly during the night to urinate). It can also improve erectile function in men and sexual function in women (libido, arousal, lubrication and pleasure). In fact, this American research paper found a positive correlation between middle-aged women with a strong pelvic floor and sexual activity.
So, let’s step through the basics of these important, but often over-looked exercises.
Locating the right muscles
It may surprise some people, but both males and females have pelvic floor muscles. Nor does it matter if you’ve given birth, if they’re very weak or if you can’t partake in other forms of exercise - you can still exercise your pelvic floor. You can read more on Common Myths about You Pelvic Floor here
The first step is to understand where these muscles are located and how to effectively ‘clench’ them.
These videos, from the Continence Foundation of Australia give a three-dimensional view of the pelvic floor and explain the sensation you should experience when clenching.
Another way to locate the correct muscles is to stop the urine flow when you’re on the toilet. The muscles you use to do this are your pelvic floor. Don’t worry if you try and can’t stop it, or even slow it down – that just means the muscles are very weak, but with persistence, they can be strengthened. Although this ‘stream stopping or slowing’ exercise is convenient to help identify the muscles to contract, regularly and repeatedly stopping your urine flow isn’t recommended.
You can do pelvic floor exercises lying down, sitting or standing up and you don’t need special clothing or equipment.
If you can’t stop or even slow your urine stream on the toilet, start the exercises lying down. This takes all pressure off the muscle and should make the clenching a bit easier. Lie on your back on a firm surface, such as the floor, with your arms loosely by your side.
If you can stop or slow the flow, sit comfortably on a chair that allows both feet to be planted firmly on the floor. A firm seat with a back is ideal, like a kitchen chair. Pay attention to your posture, which should be upright, with the shoulders relaxed back and the head in a neutral position (that is, neither looking up nor down). Imagine a thread running up your spine and through the top of your head that being gently pulled upwards. Arms can be by your side, or you can rest your hands on your thighs.
Take a couple of slow, relaxing, deep breaths.
Now, clench your pelvic floor muscles and hold for a count of two to three seconds – more if you can manage it – then release.
Don’t hold your breath or engage your buttock, thigh and abdominal muscles. Focus on using just your pelvic floor. Engaging other muscles distributes the load and reduces the effectiveness of the exercises.
If you don’t have a sensation of ‘letting go’ at the end of your count, it means that the clench slipped away before you got there. Experiment until you find a comfortable threshold, usually somewhere between two and ten seconds.
This ‘clench, hold and release’ action forms the basis of all pelvic floor exercise routines. Done in difference sequences, positions, intensity and timing, it will build both strength and endurance in these critical muscles.
Strength these muscles will allow you to squeeze hard enough to stop any leaks – even under the pressure of a sneeze, cough or laugh.
Clench and hold your pelvic floor for the count you identified as comfortable – somewhere between two and ten seconds. Then relax for ten seconds before repeating the same exercise. You’re aiming to do a set of ten.
If the muscle feels fatigued, stop and try again later.
You should be aiming to do six sets across the day.
Once you’re comfortable doing these, you might like to add some quick, intense clenches. For these, squeeze your pelvic floor as hard as you can, then let go straight away. Without resting in between, repeat this exercise up to ten times.
The benefit of building endurance is that you’ll be able to hold the clench for a sustained period. This can give you the extra time you need to get to a bathroom without leaking.
To build endurance, use the same technique as for the strength exercise, but this time instead of repeating short clenches, extend the ‘hold’ for ten or more seconds, then relax for twenty. Repeat this ‘hold and relax’ as many times as you can, aiming to get to ten in a set
Combine or alternate the strength and endurance exercises across your day.
Incorporating pelvic floor exercises into your daily routine.
For most people, mastering the basics of pelvic exercises isn’t difficult – but remembering to do them is!
Use regular daily events to trigger your memory, such as:
- Putting the kettle on
- Checking email
- When you answer the phone
- At red traffic lights when you’re out driving
- After you’ve been to the toilet
- When you send or receive a text
There are also several apps, some specifically for women, men and pregnancy. Google ‘pelvic floor reminder app’ and have a look around for one that you like.
Why it’s essential to exercise your pelvic floor
all muscles, without exercise, the tone is lost over time.
This is particularly the case for menopausal women because reduced estrogen is associated with a decline in muscle strength. However, like gaining weight during this life-stage, it shouldn’t be accepted as inevitable. Exercise – both generally and of the pelvic floor specifically – can keep weight at bay and ensure you don’t have continence issues.
Pregnancy and childbirth can both damage and weaken the pelvic floor muscles. The effects of this, such as incontinence, can be experienced straight after the birth, but can also present years later as it is compounded by weakening due to age.
Men can also suffer from weak pelvic floor muscles, simply from age. The other major contributor is any treatment for an enlarged prostate, including surgery and radiation therapy.
Lifestyle factors that can weaken the muscles that affect both men and women are:
- Being overweight or obese, which puts an additional load onto the muscles
- Smoking, or more specifically, the cough associated with it that puts regular and significant downward pressure on the muscles
- Straining on the toilet due to persistent constipation
- Repeated lifting of heavy weights (without bracing your core muscles) which again, exerts a forceful, downward pressure on these muscles located across the base of your pelvis
Even if you have no continence issues, you should still exercise your pelvic floor muscle as a preventative measure. A strong pelvic floor muscle can also help prevent a prolapse. You can read about Prolapse and Exercise here
What if the exercises don’t work?
Done correctly, you will begin to notice an improvement within two to three weeks.
If you don’t see a change, or if you’re having trouble locating or tensing the muscles, make an appointment with your doctor. They’ll be able to refer you to a continence physiotherapist, who’ll check your technique and devise a personalised plan.
As mentioned, there are many benefits to having a strong pelvic floor, so don’t give up. Once the muscle is strong and has endurance, you will need to keep exercising to maintain it.
Managing incontinence caused by a weak pelvic floor
Leaking urine is often the first indicator that people have a weak pelvic floor. This is called Stress Incontinence.
The good news is that once the muscles are strong, the leaking should stop,
In the meanwhile, you can manage leaks with TENA products. All have been specifically designed to handle the thin, fast flow, locking urine away quickly to keep you dry and prevent odours from developing. The Men’s range includes anatomically shaped Shields that are just 3mm thin and tuck into the front of your briefs. TENA Guards are similarly shaped but offer three levels of absorbency. You can read about the difference between these two products in great detail here. There’s also an article for men on using incontinence pads here
We know how important finding the right product to meet your needs is, so we developed the Product Finder Tool to assist. It will step you through a few questions and recommend products based on your answers. You can also order free samples.
Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.