Pelvic Floor Exercises: Understanding, Benefits, and Correct Techniques

How Do You Do Pelvic Floors?

Engaging your pelvic floor muscles involves a specific contraction and relaxation technique, often referred to as Kegel exercises, crucial for supporting internal organs, maintaining continence, and enhancing core stability.

Understanding Your Pelvic Floor Muscles (P.F.M.)

The pelvic floor muscles are a group of muscles, ligaments, and connective tissues that form a sling or hammock-like structure at the base of your pelvis. They stretch from the pubic bone at the front to the tailbone (coccyx) at the back, and from side to side across the ischial tuberosities (sit bones).

These muscles play a vital role in several bodily functions:

• Support: They support the pelvic organs, including the bladder, bowel, and uterus (in women) or prostate (in men), preventing them from prolapsing or dropping.
• Continence: They control the opening and closing of the bladder and bowel, helping to prevent leakage of urine or feces.
• Sexual Function: They contribute to sexual sensation and orgasm in both men and women.
• Core Stability: They work in conjunction with the deep abdominal muscles (transversus abdominis), diaphragm, and multifidus (deep back muscles) to form the "inner core" unit, providing stability to the spine and pelvis.

Why Pelvic Floor Exercises (Kegels) Matter

Regularly exercising your pelvic floor muscles, commonly known as Kegel exercises, can significantly improve or prevent various conditions. A strong, functional pelvic floor is essential for overall health and well-being.

Key benefits include:

• Urinary Incontinence: Preventing or reducing stress incontinence (leakage during coughs, sneezes, jumps) and urge incontinence (sudden, strong need to urinate).
• Fecal Incontinence: Improving bowel control.
• Pregnancy and Postpartum Recovery: Preparing the body for childbirth and aiding recovery from vaginal delivery, reducing the risk of prolapse and incontinence.
• Pelvic Organ Prolapse: Helping to support organs and reduce symptoms of mild prolapse.
• Sexual Health: Enhancing sensation, improving erectile function in men, and potentially improving orgasmic function in women.
• Prostate Health (Men): Assisting recovery and continence after prostate surgery.
• Core Stability: Contributing to a stable torso, which can indirectly help with back pain and improve athletic performance.

Weakness in these muscles can lead to issues like urinary leakage, pelvic organ prolapse, or reduced sexual sensation. Conversely, muscles that are too tight (hypertonic) can also cause problems like pain or difficulty emptying the bladder.

Identifying Your Pelvic Floor Muscles

Before you can effectively exercise your pelvic floor, you must correctly identify the muscles. This is the most crucial step, as many people mistakenly engage other muscles like the glutes, abs, or inner thighs.

Here are a few common methods to help you locate them:

• Stopping Urine Flow (Identification Only): While urinating, try to stop the flow mid-stream. The muscles you use to do this are your pelvic floor muscles. Do not make this a regular practice as an exercise, as it can interfere with bladder emptying. Use it only for identification.
• Tightening Around a Tampon or Finger (Women): If you use tampons, try to squeeze and lift one inside your vagina. Alternatively, insert a clean finger into your vagina and try to squeeze around it. You should feel a gentle grip and an upward lift.
• Preventing Gas Release (Both Sexes): Imagine you are trying to prevent passing gas. The muscles you engage to "hold it in" are part of your pelvic floor. You should feel a tightening and lifting sensation around the anus.
• Visual/Tactile Cues: For men, when contracting, you might notice the base of your penis move slightly closer to your body. For both sexes, avoid any visible movement in your glutes, thighs, or abdominals. The movement should be internal and subtle.

If you struggle to identify these muscles, consider seeking guidance from a pelvic floor physical therapist.

How to Perform Pelvic Floor Exercises (Kegels) Correctly

Once you've identified your pelvic floor muscles, you can begin to exercise them. Consistency and correct technique are paramount.

1. Preparation:

• Empty your bladder before you start.
• Find a comfortable position: Begin by lying down, as gravity is less of a factor. You can progress to sitting and then standing as you become more proficient.
• Relax your body: Ensure your glutes, abdominal muscles, and inner thigh muscles are relaxed. Focus solely on your pelvic floor.

2. The Basic Contraction (Slow Lifts):

• Inhale: Take a gentle breath in, allowing your abdomen to relax.
• Exhale and Contract: As you exhale, gently contract your pelvic floor muscles. Imagine you are trying to stop both urine flow and passing gas simultaneously, drawing everything up and in towards your belly button. Think of it as an internal "lift."
• Hold: Hold the contraction for 3-5 seconds initially. The goal is to feel the lift, not to strain.
• Relax: Slowly and completely release the contraction. Allow the muscles to fully relax back to their starting position. This relaxation phase is as crucial as the contraction. Take the same amount of time to relax as you did to hold (e.g., 3-5 seconds).

3. Repetitions and Sets:

• Start with 5-10 repetitions per session.
• Aim for 3 sessions per day.

4. Quick Flicks (Fast Contractions):

• In addition to slow lifts, incorporate some quick contractions.
• Contract: Rapidly squeeze and lift your pelvic floor muscles.
• Release: Immediately and fully relax them.
• Perform 10-20 quick flicks per session, after your slow lifts. These help with reactive strength, crucial for preventing leakage during sudden movements like coughing or sneezing.

Progression and Integration into Your Routine

As your pelvic floor muscles get stronger, you can gradually increase the challenge:

• Increase Hold Time: Slowly work up to holding the slow lifts for 10 seconds.
• Increase Repetitions: Aim for 10-15 repetitions per set for both slow lifts and quick flicks.
• Vary Positions: Once comfortable lying down, practice Kegels while sitting, standing, and even walking.
• Integrate into Daily Activities: Consciously engage your pelvic floor before and during activities that put pressure on it, such as lifting heavy objects, coughing, sneezing, or jumping. This is often called "The Knack."
• Consistency is Key: Pelvic floor exercises are not a quick fix. They require daily, consistent effort to see and maintain results. It may take several weeks to a few months to notice significant improvement.

Common Mistakes to Avoid

Performing Kegels incorrectly can be ineffective or even detrimental. Be mindful of these common errors:

• Bearing Down: Do not push down or bear down as if having a bowel movement. The action should always be a lift up and in.
• Holding Your Breath: Breathe normally throughout the exercises. Holding your breath increases intra-abdominal pressure, which can counteract the benefits.
• Using Other Muscles: Do not squeeze your buttocks, tighten your abdominal muscles excessively, or clench your inner thighs. The movement should be isolated to the pelvic floor.
• Overdoing It: More is not always better. Excessive or forceful contractions can lead to muscle fatigue or hypertonicity (overly tight muscles), which can cause pain or difficulty with function.
• Not Fully Relaxing: The relaxation phase is just as important as the contraction. The muscles need to lengthen and release fully to avoid becoming chronically tight.

When to Seek Professional Guidance

While Kegel exercises are generally safe and beneficial, some situations warrant professional guidance:

• Difficulty Identifying Muscles: If you cannot feel the correct muscles contracting, a professional can help with biofeedback or manual techniques.
• No Improvement or Worsening Symptoms: If your symptoms don't improve after consistent practice for several weeks, or if they worsen, consult a specialist.
• Pain During Exercises: If you experience any pain during or after performing Kegels, stop and seek advice.
• Specific Conditions: Individuals who are pregnant, postpartum, recovering from prostate surgery, dealing with chronic pelvic pain, or experiencing significant prolapse should consult a pelvic floor physical therapist.

A Pelvic Floor Physical Therapist (PT) or Women's Health PT is a specialized healthcare professional who can provide a comprehensive assessment, personalized exercise program, and advanced techniques to address specific pelvic floor dysfunctions.

Conclusion

Mastering pelvic floor exercises is a fundamental aspect of maintaining optimal health and function for both men and women. By understanding the anatomy, correctly identifying the muscles, and consistently practicing the proper technique, you can significantly improve continence, enhance core stability, and contribute to overall well-being. Remember, like any muscle group, the pelvic floor responds to consistent, correct training. If in doubt, always seek professional guidance to ensure you're on the right path.