Pelvic Floor Exercises for Women This series of brochures has been developed and funded as part of the Australian Government’s National Continence Management Strategy (NCMS). All artwork created by Georgina Altona and Warwick Keen. Remember You are not alone. Incontinence can be prevented, better managed, treated and sometimes cured. While doing the exercises: 1. DO NOT hold your breath. 2. DO NOT push down instead of squeezing and lifting up. 3. TRY NOT to tighten your tummy, bottom or thighs. Do your exercises well The quality of your exercises is important. Fewer good exercises are better than lots of half hearted ones. Making the exercises part of your daily routine Once you have learnt how to do these exercises they should be done regularly, giving each set your full attention. It might be helpful to set aside at least 5 regular times during the day for doing the exercises. For example, after going to the toilet, when having a drink or when lying in bed. Other things you can do to help your pelvic floor muscles • share the lifting of heavy loads; • avoid constipation and prevent any straining during a bowel movement; • ask for medical advice for hay-fever, asthma and bronchitis to reduce sneezing and coughing; and • keep your weight within the right range for your height and age. If you are not sure what this should be, talk to a health worker. Ask for help Good results take time. In order to build up your pelvic floor muscles to their maximum strength you will need to work hard at these exercises. For the best results ask for help from a health worker, physiotherapist or continence adviser who will design a personal exercise program especially suited to your muscles. Diabetes warning: If you are always feeling thirsty and having to urinate (pass water or wee) all the time, tell the doctor or the health worker. It is important that you are checked to make sure diabetes (sugar sickness) is not the problem. Who can help? • Your local Aboriginal and Torres Strait Islander Community Health Service. • Doctors. • A special continence adviser. • National Continence Helpline Freecall™ 1800 33 00 66. • Visit the website at www.bladderbowel.gov.au or the National Public Toilet Map website at www.toiletmap.gov.au Other brochures in this series: • Continence Myths and Facts • Bladder Training • What is Urinary Incontinence • Good Bladder Training for Everyone • What is a Continence Assessment • Continence Products and Appliances • Pelvic Floor Exercises for Men • Bladder Problems and the Prostate • Pelvic Floor Exercises for Women • Dementia and Urinary Incontinence • A List of Ten Frequently Asked Questions • Constipation • Continence Comic What are the pelvic floor muscles? The pelvic floor is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tail-bone at the back to the pubic bone in front. A woman’s pelvic floor supports the bladder, the uterus (womb) and the bowel. The urethra (urine tube), the vagina (birth canal) and the rectum (back passage) pass through the pelvic floor muscles. The pelvic floor muscles play an important role in bladder and bowel control and sexual sensation. Why the pelvic floor muscles may weaken The pelvic floor muscles may be weakened by: • pregnancy and childbirth; • continual straining to empty your bowel (constipation – not being able to or having difficulty doing goona or cooney); Pubic Bone Anus Vagina Urethra Tail Bone Pelvic Floor Muscles Colon Uterus Bladder • constant heavy lifting; • an ongoing cough (such as a smoker’s cough or chronic bronchitis and asthma); • being overweight; • changes in hormone levels at menopause (change of life); and • being unfit. The benefits of pelvic floor exercises It is important for women of all ages to have strong pelvic floor muscles. Women with stress incontinence, that is, those who regularly lose urine (wee or water) when coughing, sneezing or exercising, will find these exercises very helpful in overcoming this problem. For pregnant women these exercises help the body cope with the increasing weight of the baby. Healthy, fit muscles before the baby is born will recover more easily after the birth. As women grow older it is important to keep the pelvic floor muscles strong because at menopause the muscles change and may weaken. A pelvic floor exercise routine helps to lessen the effects of menopause on pelvic support and bladder control. Pelvic floor exercises may also be useful with a bladder training program aimed at improving bladder control in people who have the urgent need to pass urine frequently (urge incontinence). Bladder training is explained in the ‘Bladder Training’ brochure of this series. How to contract the pelvic floor muscles The first thing to do is to correctly identify the muscles that need to be exercised. 1. Sit or lie comfortably with the muscles of your thighs, bottom and stomach relaxed. 2. Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea (soft or runny goona or cooney) or wind. Relax it. Practice this movement several times until you are sure you are exercising the right muscles. Try not to squeeze your bottom cheeks. 3. When you are passing urine try to stop the flow mid-stream, then restart it. Only do this to learn which muscles are the correct ones to use and then do it no more than once a week to check your progress. If you do it more often than this is may interfere with normal bladder emptying. If you don’t feel a definite squeeze and lift action of your pelvic floor muscles or are unable to even slow the stream of urine as described in point 3 talk to a health worker, continence adviser, doctor or physiotherapist. They can help to get your pelvic floor muscles working correctly. Even women with very weak pelvic floor muscles can be taught these exercises and will benefit. Doing pelvic floor exercises If you can feel the muscles working, exercise them by: 1. ‘Squeeze and lift’ by tightening and drawing in in the muscles around the anus, the vagina and the urethra all at once, lifting them UP inside. Try to hold this, as you count to 5, then release and relax. You should have a definite feeling of ‘letting go’. 2. Repeat ‘squeeze and lift’ and relax. It is important to rest for about 10 seconds between each contraction (tightening of the muscles). If you find it easy to hold for a count of 5, try to hold for longer – up to 10 seconds. 3. Repeat this as many times as you are able up to a maximum of 8 to 10 squeezes. 4. Now do 5 to 10 short, fast, but strong contractions. 5. Do this whole exercise routine at least 4 to 5 times every day. What are the pelvic floor muscles? The pelvic floor is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tail-bone at the back to the pubic bone in front. A woman’s pelvic floor supports the bladder, the uterus (womb) and the bowel. The urethra (urine tube), the vagina (birth canal) and the rectum (back passage) pass through the pelvic floor muscles. The pelvic floor muscles play an important role in bladder and bowel control and sexual sensation. Why the pelvic floor muscles may weaken The pelvic floor muscles may be weakened by: • pregnancy and childbirth; • continual straining to empty your bowel (constipation – not being able to or having difficulty doing goona or cooney); Pubic Bone Anus Vagina Urethra Tail Bone Pelvic Floor Muscles Colon Uterus Bladder • constant heavy lifting; • an ongoing cough (such as a smoker’s cough or chronic bronchitis and asthma); • being overweight; • changes in hormone levels at menopause (change of life); and • being unfit. The benefits of pelvic floor exercises It is important for women of all ages to have strong pelvic floor muscles. Women with stress incontinence, that is, those who regularly lose urine (wee or water) when coughing, sneezing or exercising, will find these exercises very helpful in overcoming this problem. For pregnant women these exercises help the body cope with the increasing weight of the baby. Healthy, fit muscles before the baby is born will recover more easily after the birth. As women grow older it is important to keep the pelvic floor muscles strong because at menopause the muscles change and may weaken. A pelvic floor exercise routine helps to lessen the effects of menopause on pelvic support and bladder control. Pelvic floor exercises may also be useful with a bladder training program aimed at improving bladder control in people who have the urgent need to pass urine frequently (urge incontinence). Bladder training is explained in the ‘Bladder Training’ brochure of this series. How to contract the pelvic floor muscles The first thing to do is to correctly identify the muscles that need to be exercised. 1. Sit or lie comfortably with the muscles of your thighs, bottom and stomach relaxed. 2. Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea (soft or runny goona or cooney) or wind. Relax it. Practice this movement several times until you are sure you are exercising the right muscles. Try not to squeeze your bottom cheeks. 3. When you are passing urine try to stop the flow mid-stream, then restart it. Only do this to learn which muscles are the correct ones to use and then do it no more than once a week to check your progress. If you do it more often than this is may interfere with normal bladder emptying. If you don’t feel a definite squeeze and lift action of your pelvic floor muscles or are unable to even slow the stream of urine as described in point 3 talk to a health worker, continence adviser, doctor or physiotherapist. They can help to get your pelvic floor muscles working correctly. Even women with very weak pelvic floor muscles can be taught these exercises and will benefit. Doing pelvic floor exercises If you can feel the muscles working, exercise them by: 1. ‘Squeeze and lift’ by tightening and drawing in in the muscles around the anus, the vagina and the urethra all at once, lifting them UP inside. Try to hold this, as you count to 5, then release and relax. You should have a definite feeling of ‘letting go’. 2. Repeat ‘squeeze and lift’ and relax. It is important to rest for about 10 seconds between each contraction (tightening of the muscles). If you find it easy to hold for a count of 5, try to hold for longer – up to 10 seconds. 3. Repeat this as many times as you are able up to a maximum of 8 to 10 squeezes. 4. Now do 5 to 10 short, fast, but strong contractions. 5. Do this whole exercise routine at least 4 to 5 times every day. What are the pelvic floor muscles? The pelvic floor is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tail-bone at the back to the pubic bone in front. A woman’s pelvic floor supports the bladder, the uterus (womb) and the bowel. The urethra (urine tube), the vagina (birth canal) and the rectum (back passage) pass through the pelvic floor muscles. The pelvic floor muscles play an important role in bladder and bowel control and sexual sensation. Why the pelvic floor muscles may weaken The pelvic floor muscles may be weakened by: • pregnancy and childbirth; • continual straining to empty your bowel (constipation – not being able to or having difficulty doing goona or cooney); Pubic Bone Anus Vagina Urethra Tail Bone Pelvic Floor Muscles Colon Uterus Bladder • constant heavy lifting; • an ongoing cough (such as a smoker’s cough or chronic bronchitis and asthma); • being overweight; • changes in hormone levels at menopause (change of life); and • being unfit. The benefits of pelvic floor exercises It is important for women of all ages to have strong pelvic floor muscles. Women with stress incontinence, that is, those who regularly lose urine (wee or water) when coughing, sneezing or exercising, will find these exercises very helpful in overcoming this problem. For pregnant women these exercises help the body cope with the increasing weight of the baby. Healthy, fit muscles before the baby is born will recover more easily after the birth. As women grow older it is important to keep the pelvic floor muscles strong because at menopause the muscles change and may weaken. A pelvic floor exercise routine helps to lessen the effects of menopause on pelvic support and bladder control. Pelvic floor exercises may also be useful with a bladder training program aimed at improving bladder control in people who have the urgent need to pass urine frequently (urge incontinence). Bladder training is explained in the ‘Bladder Training’ brochure of this series. How to contract the pelvic floor muscles The first thing to do is to correctly identify the muscles that need to be exercised. 1. Sit or lie comfortably with the muscles of your thighs, bottom and stomach relaxed. 2. Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea (soft or runny goona or cooney) or wind. Relax it. Practice this movement several times until you are sure you are exercising the right muscles. Try not to squeeze your bottom cheeks. 3. When you are passing urine try to stop the flow mid-stream, then restart it. Only do this to learn which muscles are the correct ones to use and then do it no more than once a week to check your progress. If you do it more often than this is may interfere with normal bladder emptying. If you don’t feel a definite squeeze and lift action of your pelvic floor muscles or are unable to even slow the stream of urine as described in point 3 talk to a health worker, continence adviser, doctor or physiotherapist. They can help to get your pelvic floor muscles working correctly. Even women with very weak pelvic floor muscles can be taught these exercises and will benefit. Doing pelvic floor exercises If you can feel the muscles working, exercise them by: 1. ‘Squeeze and lift’ by tightening and drawing in in the muscles around the anus, the vagina and the urethra all at once, lifting them UP inside. Try to hold this, as you count to 5, then release and relax. You should have a definite feeling of ‘letting go’. 2. Repeat ‘squeeze and lift’ and relax. It is important to rest for about 10 seconds between each contraction (tightening of the muscles). If you find it easy to hold for a count of 5, try to hold for longer – up to 10 seconds. 3. Repeat this as many times as you are able up to a maximum of 8 to 10 squeezes. 4. Now do 5 to 10 short, fast, but strong contractions. 5. Do this whole exercise routine at least 4 to 5 times every day. What are the pelvic floor muscles? The pelvic floor is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tail-bone at the back to the pubic bone in front. A woman’s pelvic floor supports the bladder, the uterus (womb) and the bowel. The urethra (urine tube), the vagina (birth canal) and the rectum (back passage) pass through the pelvic floor muscles. The pelvic floor muscles play an important role in bladder and bowel control and sexual sensation. Why the pelvic floor muscles may weaken The pelvic floor muscles may be weakened by: • pregnancy and childbirth; • continual straining to empty your bowel (constipation – not being able to or having difficulty doing goona or cooney); Pubic Bone Anus Vagina Urethra Tail Bone Pelvic Floor Muscles Colon Uterus Bladder • constant heavy lifting; • an ongoing cough (such as a smoker’s cough or chronic bronchitis and asthma); • being overweight; • changes in hormone levels at menopause (change of life); and • being unfit. The benefits of pelvic floor exercises It is important for women of all ages to have strong pelvic floor muscles. Women with stress incontinence, that is, those who regularly lose urine (wee or water) when coughing, sneezing or exercising, will find these exercises very helpful in overcoming this problem. For pregnant women these exercises help the body cope with the increasing weight of the baby. Healthy, fit muscles before the baby is born will recover more easily after the birth. As women grow older it is important to keep the pelvic floor muscles strong because at menopause the muscles change and may weaken. A pelvic floor exercise routine helps to lessen the effects of menopause on pelvic support and bladder control. Pelvic floor exercises may also be useful with a bladder training program aimed at improving bladder control in people who have the urgent need to pass urine frequently (urge incontinence). Bladder training is explained in the ‘Bladder Training’ brochure of this series. How to contract the pelvic floor muscles The first thing to do is to correctly identify the muscles that need to be exercised. 1. Sit or lie comfortably with the muscles of your thighs, bottom and stomach relaxed. 2. Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea (soft or runny goona or cooney) or wind. Relax it. Practice this movement several times until you are sure you are exercising the right muscles. Try not to squeeze your bottom cheeks. 3. When you are passing urine try to stop the flow mid-stream, then restart it. Only do this to learn which muscles are the correct ones to use and then do it no more than once a week to check your progress. If you do it more often than this is may interfere with normal bladder emptying. If you don’t feel a definite squeeze and lift action of your pelvic floor muscles or are unable to even slow the stream of urine as described in point 3 talk to a health worker, continence adviser, doctor or physiotherapist. They can help to get your pelvic floor muscles working correctly. Even women with very weak pelvic floor muscles can be taught these exercises and will benefit. Doing pelvic floor exercises If you can feel the muscles working, exercise them by: 1. ‘Squeeze and lift’ by tightening and drawing in in the muscles around the anus, the vagina and the urethra all at once, lifting them UP inside. Try to hold this, as you count to 5, then release and relax. You should have a definite feeling of ‘letting go’. 2. Repeat ‘squeeze and lift’ and relax. It is important to rest for about 10 seconds between each contraction (tightening of the muscles). If you find it easy to hold for a count of 5, try to hold for longer – up to 10 seconds. 3. Repeat this as many times as you are able up to a maximum of 8 to 10 squeezes. 4. Now do 5 to 10 short, fast, but strong contractions. 5. Do this whole exercise routine at least 4 to 5 times every day. Pelvic Floor Exercises for Women This series of brochures has been developed and funded as part of the Australian Government’s National Continence Management Strategy (NCMS). All artwork created by Georgina Altona and Warwick Keen. Remember You are not alone. Incontinence can be prevented, better managed, treated and sometimes cured. While doing the exercises: 1. DO NOT hold your breath. 2. DO NOT push down instead of squeezing and lifting up. 3. TRY NOT to tighten your tummy, bottom or thighs. Do your exercises well The quality of your exercises is important. Fewer good exercises are better than lots of half hearted ones. Making the exercises part of your daily routine Once you have learnt how to do these exercises they should be done regularly, giving each set your full attention. It might be helpful to set aside at least 5 regular times during the day for doing the exercises. For example, after going to the toilet, when having a drink or when lying in bed. Other things you can do to help your pelvic floor muscles • share the lifting of heavy loads; • avoid constipation and prevent any straining during a bowel movement; • ask for medical advice for hay-fever, asthma and bronchitis to reduce sneezing and coughing; and • keep your weight within the right range for your height and age. If you are not sure what this should be, talk to a health worker. Ask for help Good results take time. In order to build up your pelvic floor muscles to their maximum strength you will need to work hard at these exercises. For the best results ask for help from a health worker, physiotherapist or continence adviser who will design a personal exercise program especially suited to your muscles. Diabetes warning: If you are always feeling thirsty and having to urinate (pass water or wee) all the time, tell the doctor or the health worker. It is important that you are checked to make sure diabetes (sugar sickness) is not the problem. Who can help? • Your local Aboriginal and Torres Strait Islander Community Health Service. • Doctors. • A special continence adviser. • National Continence Helpline Freecall™ 1800 33 00 66. • Visit the website at www.bladderbowel.gov.au or the National Public Toilet Map website at www.toiletmap.gov.au Other brochures in this series: • Continence Myths and Facts • Bladder Training • What is Urinary Incontinence • Good Bladder Training for Everyone • What is a Continence Assessment • Continence Products and Appliances • Pelvic Floor Exercises for Men • Bladder Problems and the Prostate • Pelvic Floor Exercises for Women • Dementia and Urinary Incontinence • A List of Ten Frequently Asked Questions • Constipation • Continence Comic Pelvic Floor Exercises for Women This series of brochures has been developed and funded as part of the Australian Government’s National Continence Management Strategy (NCMS). All artwork created by Georgina Altona and Warwick Keen. Remember You are not alone. Incontinence can be prevented, better managed, treated and sometimes cured. While doing the exercises: 1. DO NOT hold your breath. 2. DO NOT push down instead of squeezing and lifting up. 3. TRY NOT to tighten your tummy, bottom or thighs. Do your exercises well The quality of your exercises is important. Fewer good exercises are better than lots of half hearted ones. Making the exercises part of your daily routine Once you have learnt how to do these exercises they should be done regularly, giving each set your full attention. It might be helpful to set aside at least 5 regular times during the day for doing the exercises. For example, after going to the toilet, when having a drink or when lying in bed. Other things you can do to help your pelvic floor muscles • share the lifting of heavy loads; • avoid constipation and prevent any straining during a bowel movement; • ask for medical advice for hay-fever, asthma and bronchitis to reduce sneezing and coughing; and • keep your weight within the right range for your height and age. If you are not sure what this should be, talk to a health worker. Ask for help Good results take time. In order to build up your pelvic floor muscles to their maximum strength you will need to work hard at these exercises. For the best results ask for help from a health worker, physiotherapist or continence adviser who will design a personal exercise program especially suited to your muscles. Diabetes warning: If you are always feeling thirsty and having to urinate (pass water or wee) all the time, tell the doctor or the health worker. It is important that you are checked to make sure diabetes (sugar sickness) is not the problem. Who can help? • Your local Aboriginal and Torres Strait Islander Community Health Service. • Doctors. • A special continence adviser. • National Continence Helpline Freecall™ 1800 33 00 66. • Visit the website at www.bladderbowel.gov.au or the National Public Toilet Map website at www.toiletmap.gov.au Other brochures in this series: • Continence Myths and Facts • Bladder Training • What is Urinary Incontinence • Good Bladder Training for Everyone • What is a Continence Assessment • Continence Products and Appliances • Pelvic Floor Exercises for Men • Bladder Problems and the Prostate • Pelvic Floor Exercises for Women • Dementia and Urinary Incontinence • A List of Ten Frequently Asked Questions • Constipation • Continence Comic Pelvic Floor Exercises for Women This series of brochures has been developed and funded as part of the Australian Government’s National Continence Management Strategy (NCMS). All artwork created by Georgina Altona and Warwick Keen. Remember You are not alone. Incontinence can be prevented, better managed, treated and sometimes cured. While doing the exercises: 1. DO NOT hold your breath. 2. DO NOT push down instead of squeezing and lifting up. 3. TRY NOT to tighten your tummy, bottom or thighs. Do your exercises well The quality of your exercises is important. Fewer good exercises are better than lots of half hearted ones. Making the exercises part of your daily routine Once you have learnt how to do these exercises they should be done regularly, giving each set your full attention. It might be helpful to set aside at least 5 regular times during the day for doing the exercises. For example, after going to the toilet, when having a drink or when lying in bed. Other things you can do to help your pelvic floor muscles • share the lifting of heavy loads; • avoid constipation and prevent any straining during a bowel movement; • ask for medical advice for hay-fever, asthma and bronchitis to reduce sneezing and coughing; and • keep your weight within the right range for your height and age. If you are not sure what this should be, talk to a health worker. Ask for help Good results take time. In order to build up your pelvic floor muscles to their maximum strength you will need to work hard at these exercises. For the best results ask for help from a health worker, physiotherapist or continence adviser who will design a personal exercise program especially suited to your muscles. Diabetes warning: If you are always feeling thirsty and having to urinate (pass water or wee) all the time, tell the doctor or the health worker. It is important that you are checked to make sure diabetes (sugar sickness) is not the problem. Who can help? • Your local Aboriginal and Torres Strait Islander Community Health Service. • Doctors. • A special continence adviser. • National Continence Helpline Freecall™ 1800 33 00 66. • Visit the website at www.bladderbowel.gov.au or the National Public Toilet Map website at www.toiletmap.gov.au Other brochures in this series: • Continence Myths and Facts • Bladder Training • What is Urinary Incontinence • Good Bladder Training for Everyone • What is a Continence Assessment • Continence Products and Appliances • Pelvic Floor Exercises for Men • Bladder Problems and the Prostate • Pelvic Floor Exercises for Women • Dementia and Urinary Incontinence • A List of Ten Frequently Asked Questions • Constipation • Continence Comic