Looking after your Pelvic Floor

We all know we should be doing our Pelvic Floor (or Kegel) Exercises, but how exactly do we do them? Helen Hodder, Women’s Health Physio, who is one of our 10 specialists at Bump to Cradle Antenatal Classes clears things up with some advice for pregnant women and mums.  

Pelvic floor dysfunction can lead to incontinence, constipation and prolapse to name a few. Most of us start the exercises and then get bored. Here's some tips on how to do them...

If you are unsure about how to recruit your pelvic floor muscles try to do them in a sitting position, leaning forward with your elbows on your knees: imagine you are trying to stop yourself from having a pee or breaking wind. Tighten and close your anus, then your vagina and lift up your internal muscles.  As you become more confident, it is beneficial to progress to exercises to include some when you are standing, as this is when gravity takes a toll and your muscles are more challenged.

When exercising your pelvic floor, it is as important to fully relax your muscles before and after each exercise – this ensures that each muscle is allowed to work through it’s full range of movement and helps to prevent areas of increased muscle tension.  Functional coordination is more important than isolated muscle strengthening exercises – a short, tight muscle is a weak muscle.  Pelvic floor muscle relaxation feels like an expansion and stretching of the muscles, it is not pushing or bearing down on the muscles – it happens most easily with the inhalation or in-breath during diaphragmatic breathing.  As the diaphragm descends, the abdomen expands and relaxes and connective tissue supporting the pelvic floor also drops and promotes full relaxation of the muscles (the movement is a combined abdominal ‘flop’ and pelvic floor ‘drop’)

1. Slowly tighten and pull up the pelvic floor muscles as hard as you can. Try lifting and squeezing them for as long as you can. Rest for 4 seconds and then repeat the contraction. Build up your strength until you can do 10 slow contractions at a time, holding them for 10 seconds each with rests of 4 seconds in between.

2. Your pelvic floor muscles also need to react quickly to sudden stresses from coughing, laughing or exercise that puts pressure on the bladder. So practise some quick contractions, drawing in the pelvic floor and holding it for just one second before relaxing. Try to achieve a strong muscle tightening with up to 10 quick contractions in succession.

Aim to do a set of slow contractions (exercise 1) followed by a set of quick contractions (exercise 2) 3-4 times each day if you can.

To learn more about exercise and your health in pregnancy as well as the birth and postnatal care of your baby, take a look at our unique courses at www.bumptocradle.com.


Dr Miriam Walsh