Pelvic-floor exercises are a simple, effective way to combat incontinence. They help to restore pelvic muscle tone through exercise, and should initially be carried out under guidance from your GP, nurse or physiotherapist.

Both men and women can benefit from these exercises.

The exercises

When carried out correctly, pelvic-floor exercises improve bladder control and prevent leakages. The more you stimulate these muscles, the stronger they become.

The exercises can be carried out anytime, anyplace and should be a lifetime commitment.

The success of the exercises depends on being able to identify the correct muscles and becoming aware of the feeling of the pelvic floor rising upwards and backwards towards the spine.

Identifying the muscles

It is important to learn how to do the exercises correctly to gain maximum benefit; this is where advice from your physiotherapist or nurse should be sought.

Firstly, stopping the flow of urine mid-stream helps in identifying and isolating these muscles, and exercises them at the same time.  The second part of identification and exercise is to tighten the anal area as though holding back a bowel movement, or preventing breaking wind.

If you find that you are pulling your tummy in, squeezing your legs together or tightening your buttocks, then the chances are you have not successfully isolated the pelvic-floor muscles.

If you are in doubt as to whether you are doing the exercises correctly, do a quick self-test.

For women, put one or two fingers in the vagina and try the exercises - you should feel a gentle squeeze if you are exercising the pelvic floor.

For men, place a finger on the skin between the scrotum and the anus.  You should be able to feel the skin lift slightly, as if being pulled up into your body.  The ring of muscle around the anus should contract.

A large number of people give up due to the initial difficulty in isolating the muscles or by forgetting to do the exercises.  

Bladder retraining may assist in providing positive feedback that the condition is improving, therefore encouraging persistence and ensuring you make the exercises a part of your daily routine.

Exercise routine

Putting the exercises into practice involves establishing an exercise programme.  You will be advised on your own personal programme, which may well start along the following lines, as recommended by The Continence Foundation:

Over a period of time, your muscles will become stronger and you will be able to steadily increase the length of the hold and the number of repetitions.  It can be useful to do the pelvic-floor exercises in different positions, sitting, standing or lying, so that the muscles are exercised using a full range of movements.

A degree of patience is required, as full muscle strength is only regained after several months.

Kegel weights

For women, there are special cones that can be inserted into the vagina for those who find it difficult to focus on the tightening routine.  The cones,of varying heaviness, are known as Kegel weights.

The aim is to keep the cones in place using muscle contractions, so increasing the strength of the tightening action and of the pelvic-floor muscles.  Your doctor should be consulted prior to their use.

For other self-management methods that supplement pelvic-floor exercises, please see the Self-management section.

Exercise once more

A sedentary lifestyle causes weakening of the pelvic-floor muscles.  Hence regular exercise such as walking, cycling and swimming is important not only to help prevent incontinence but for all sufferers of incontinence.  Many people find exercise difficult, as body movements are often the trigger of leakage.  There are protection products that can be worn during exercise whilst you continue to strengthen the pelvic-floor muscles.

Once you have regained control, don't then neglect your pelvic floor.  Continue to do a few pelvic floor exercises a day to prevent a recurrence of the problem.

With renewed confidence, remember that regular exercise such as walking is then an invaluable means to maintain muscle strength - and all-round good health.

20/05/2009