The Pelvic Floor Exercise Programme

Start the exercise by sitting in a comfortable and relaxed position in a chair. Squeeze and lift your back passage as if you are stopping yourself from passing wind. You should be able to feel your pelvic floor muscles move and lift away from the chair. Your legs and bottom muscles should not move and you should try not to hold your breath.

After each squeeze, let your muscles fully relax before squeezing again. There are two variations of the basic exercise to help strengthen and improve the function of your pelvic floor muscles; long and short contractions.

Long contractions

Tighten your pelvic floor muscles as hard as you can. Count to see how long you can hold this position for before your muscles start to relax. Make sure you continue to breathe normally during this exercise.

How many seconds can you hold this position for? _____

Relax for a few seconds and repeat this exercise as many times as you can (up to a maximum of 10 repetitions).

How many times can you repeat this exercise? _____

Build up the time you can hold this position for and the number of repetitions. Try to aim for a 10 second hold and to be able to repeat this 10 times.

Short contractions

Tighten your pelvic floor muscles as quickly as you can and then let go straight away. Count how many short contractions you can do in a row before your muscles become tired (up to a maximum of 10 repetitions). Always let your muscles fully relax before the next repetition. How many short contractions can you do? _____

Try to build up the number of repetitions you can do. You should aim for 10 short ones.

Now that you can do the basic exercise you can build up the endurance of the muscles so that will work harder and longer.

Firstly, you need to determine your ‘starting block’.

Tighten your pelvic floor muscles as previously described and hold for as long as you can (maximum = 10 seconds).

How many seconds can you hold for?

Relax the contraction and rest for 5 – 10 seconds.

Then repeat the ‘tighten, hold and relax’ movement as many times as you can (maximum = 10).

How many times can you repeat this?

This is your ‘starting block’.

ow perform the basic exercise but squeeze and lift more firmly, and let go straight away. This is called a quick contraction and will help your muscles react quickly when you cough, sneeze or lift, etc.

How many quick contractions can you do?

Aim to increase this to a maximum of 10.

You should try to repeat your starting block and quick contractions at least 3 times a day.

Your starting block will change as the muscles get stronger; therefore re-assess this every few weeks

Also try to remember to tighten your pelvic floor muscles before you cough, sneeze or lift. Try and tighten your pelvic floor muscles with any functional activity e.g. sit to stand, bending to pick something up from the floor. If you feel your upper abdominals working hard and pushing down towards your pelvic floor muscles, tighten your pelvic floor muscles to counter balance and to prevent the pelvic organs from being pushed in a downward movement.

Pelvic floor muscles are like any other muscles. You need to practise exercising them to get full strength. The muscles may get tired at first and it may take time to progress the exercises.

Don’t worry. Do as much as you can. Try to do a little more each time

You would expect fewer leaks in your underwear after about 3 months of exercising. Get help if there has been no improvement after 3 months. You may need to exercise up to 6 months before you see an improvement. If you were able to feel a lump in your vagina (symptom of a prolapse) you may not feel it at all or it may be not as uncomfortable

It can be hard to remember. Choose something that you do 4 times a day and do your pelvic floor exercises every time you do this activity. For example whenever you switch on the kettle or meal times. Wear a watch on the other wrist or a ring on a different finger. You can put reminders on your mobile phone or computer. You must still do the workout at least once a day for the rest of your life and contract your pelvic floor muscles with functional activities or the muscles will become weak again.

Some people do need more help. It is very easy to get treatment and advice from a continence advisor or specialist physiotherapist.  You may need a referral to Women’s Health Physiotherapy Department from your Doctor.

In the Physiotherapy clinic you would be asked questions such as:

• How often do you pass urine?
• How often do you leak?
• When do you leak?
• What do you normally drink?

After you have been assessed there may be other things to try such as:

• Pelvic floor physiotherapy sessions
• Electrical stimulation of the muscles
• Vaginal weights
• Bladder training
• Bio-feedback of the muscles