Physiotherapist Jennifer Frangos discusses pelvic floor issues with a client.
Physiotherapist Jennifer Frangos discusses pelvic floor issues with a client. Barry Leddicoat

Pelvis muscles a hidden mystery

HIDDEN from view and far from a comfortable conversation topic, the workings and importance of the pelvic floor muscles often remain a mystery.

The pelvic floor muscles attach to the pubic bone and run underneath the body like a muscular trampoline, inserting into the tailbone and stretching from the sit bones on either side of the body. It supports your bladder to help it stay closed and actively squeezes when you cough or sneeze or exercise.

But these muscles often become weak after childbirth or excessive exercising and this can lead to women facing urinary incontinence or bladder leakage.

One-in-three women over 35 experience some form of urinary incontinence, so it's important to get clued up and strengthen these muscles.

Sunshine Coast Private Hospital Medical Centre uro-gynaecologist Dr Peta Higgs said that while weak pelvic floor muscles were often the result of childbirth, women of all ages needed to strengthen their pelvic floor.

“If the muscles are weak when you cough or sneeze or jump around, urine can leak out,” she said.

“If you strengthen the muscles, often you can cure it.

“It mainly starts with childbirth but I do see a lot of young women with urinary incontinence caused by playing sport.

“I encourage all ladies to do pelvic floor exercises.”

Childbirth often does the most damage. More than half of pregnant women on average report symptoms of urinary incontinence. Strengthening the muscles can decrease the chance of this.

“We hope pelvic floor exercises before, during and following pregnancy can decrease urinary incontinence,” Dr Higgs said.

Pelvic floor training is effective, with studies showing cure rates up to about 85%. Pelvic floor and continence physiotherapist Jenny Frangos warned that if the exercises were not done correctly, they could do more harm than good.

She stressed the importance of getting an individually tailored set of exercises and seeking an assessment of whether you are doing them correctly.

“You often can't really tell if you are doing the exercises correctly and actually engaging the pelvic floor muscles,” she said.

“A study showed that 30-35% of women thought they were doing the exercises correctly and they were actually bearing down rather than contracting up which does more harm than good.”

Jenny said tailored pelvic floor exercises including maximal contractions as strong as possible were ideal. She said the strength would not happen overnight but with continuous training, women would see results.

If you would like more information, visit: or call the National Continence Helpline on 1800 330 006.

Exercise 1

SQUEEZE and draw in the muscles around your back passage, vagina and front passage and lift up inside as if trying to stop passing wind and urine at the same time.

Try to hold the muscles strong and tight as you count to eight. Let them go and relax. You should have a distinct feeling of letting go.

Repeat the squeeze, lift and hold movement and let go. Repeat up to a limit of eight to 12 contractions.

Try to do three sets of eight to 12 squeezes each, with a rest in between. Do this each day while lying down, sitting or standing.

Try to vary the positions you use so that your muscles get used to working in different situations.

Exercise 2

THE ability to work these muscles quickly helps them react to sudden stresses from coughing, laughing or exercise.

Practise some quick contractions, drawing in the pelvic floor and holding for just one second before releasing the muscles.

Do these steadily, aiming for a strong muscle tightening up to a maximum of 10 times. Repeat a set of quick contractions after three sets of squeeze, lift and hold (exercise 1). When exercising, you may sense a gentle drawing in of the lower abdominal area.

These deep, lower abdominal muscles can also work with the pelvic floor muscles. However, you should not strongly and intentionally draw in your general abdominal area while you contract your pelvic floor muscles.

If you do pelvic floor exercises regularly, you will see optimum results within three to six months, but you should continue them for life.

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