Pelvic Floor Assessment and Exercise Programs
Assessment of the pelvic floor can be via real time ultrasound, visual or internal vaginal or rectal assessment.
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Your physio will only assess your pelvic floor in a way you feel comfortable with. The assessment helps your physiotherapist diagnose and then treat your pelvic floor issue, usually via education and an exercise program.
How do I know if I have a weak pelvic floor?
If you can’t laugh, sneeze or cough without urine leaking, you aren’t alone. Problems with controlling the pelvic floor muscles are common, especially if you have had children, are overweight, have a history of constipation, lift heavy loads, cough excessively, are older or are transitioning into menopause.
How can I strengthen my pelvic floor?
It is recommended that women exercise their pelvic floor muscles daily throughout their life. Exercising weak muscles on a regular basis can help build strength over a period of time and enable them to work well again. To switch on your pelvic floor muscles (kegel exercises) see below:
- Relax your thighs, bottom and tummy muscles
- Squeeze the muscles around the front passage as if you are trying to stop a wee
- Squeeze the muscles around the vagina as if you are trying to suck upwards into the pelvis
- Squeeze the muscles around the back passage as if you are trying to hold in wind
Your physio can assess your technique with contracting your pelvic floor and give you a specific exercise program.
Pelvic floor exercises for incontinence
The pelvic floor is a group of muscles that sit like a hammock in the base of the pelvis. The pelvic floor supports the pelvic organs and controls the bladder and bowel. The pelvic floor muscles also help with sexual sensation and function. If the pelvic floor muscles are weak it can lead to leakage of urine and faeces. To find the right muscles see above (How can I strengthen my pelvic floor) or when you go to the toilet you can try and stop or slow down the flow of urine mid way through doing a wee. If you can do this, you are contracting your pelvic floor correctly. Do this once a week to check your technique.
Pelvic floor exercises for prolapse
When your pelvic floor is strong it supports your pelvic organs to prevent prolapse. Doing pelvic floor exercises regularly can improve symptoms of pelvic organ prolapse. Vaginal pessaries can also help, but aren’t suitable for everyone. In mild to moderate cases of prolapse, surgery can often be avoided or delayed with pelvic floor exercises and lifestyle modification. In studies, between 3 and 10 women out of 100 ended up needing to have surgery to correct their prolapse.
Pelvic floor exercises for pregnancy
Pelvic floor exercises are important during pregnancy to provide strength, as these muscles are under alot of strain at this time and during birth. Pelvic floor strengthening will help the body cope with the weight of a growing baby and helps to reduce or avoid any symptoms of incontinence while pregnant or postpartum. All pregnant women should do pelvic floor exercises, regardless of age, to lower their risk of incontinence after delivery of their baby.
Pelvic floor exercises for women
Women need to do pelvic floor exercises throughout their life to support their pelvic organs and maintain continence. They are more at risk of pelvic floor issues around pregnancy, childbirth, menopause and aging. See above strategies for correctly identifying your pelvic floor muscles.
Pelvic floor exercises for men
Pelvic floor exercises can help improve bladder and bowel control and may assist with achieving and maintaining erection. They can help if you have incontinence or dribble after urination (usually after you have left the toilet). Many factors can contribute to men having weak pelvic floor muscles including surgery for the prostate (radical prostatectomy), diabetes, overactive bladder and aging. See the section on physiotherapy and prostate surgery for more information.