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how to do pelvic muscle exercises

by Diane K. Newman, RNC, MSN, CRNP, FAAN

Finding The Pelvic Muscle

Without tensing the muscles of your leg, buttocks or abdomen, imagine that you are trying to control the passing of gas or pinching off a stool. Or imagine you are in an elevator full of people and you feel the urge to pas gas. What do you do? You tighten or pull in the ring of muscle around your rectum - your pelvic muscle. You should feel a lifting sensation in the area around the vagina or a pulling in of your rectum.

Exercise Regimen

One exercise consists of both "tightening and relaxing". It is equally important to control when your muscle tightens and relaxes. Therefore, you should relax for the same amount of time you tighten. Be sure to relax completely between each muscle tightening. Tighten your pelvic muscle and hold for a count of 3 seconds, then relax the muscle completely for a count of 3 seconds. Over time you will increase tightening the muscle to 5 - 10 seconds and even longer.

Where To Practice

You can practice these exercises anywhere and anytime. You should do the exercises in these positions:

• Sitting.
  Sit upright in a firm seat and straight-back chair, knees slightly apart, feet flat on the floor or legs stretched out in front and crossed at the ankles.
• Lying Down.
  Lie on your back, flat or with your head on a pillow, knees bent and feet slightly apart. It is helpful to support your knees with a pillow.
• Standing.
  Stand by a chair, knees slightly bent with feet shoulder width apart and toes slightly pointed outward. You can also lean on the kitchen counter with your hips flexed.

When To Use The Muscle

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If you experience urine loss in one specific position only, like when you stand then follow these steps:

• Increase the number of exercises for that position only, or
• Add an additional set of exercises per day with the focus on doing all the exercises in that position only.

Common Mistakes

• Concentrate and tighten (lift) only the pelvic floor muscle. DO NOT tighten leg muscles (thighs), buttocks or abdomen. If you feel your stomach move, then you are also using these muscles.
• DO NOT hold your breath. Breathe normally and/or count out loud.

Can They Be Harmful?

No, these exercises cannot harm you in any way. You should find them easy and relaxing. If you get back pain or stomach pain after you exercise, you are probably trying too hard and using your stomach muscles. If you experience headaches, then you are also tensing your chest muscles and probably holding your breath.

When Will A Change Be Seen?

After 4 to 6 weeks of daily exercise, you will begin to notice less urine leakage. Make the exercises part of your daily lifestyle. Tighten the muscle when you walk, as you stand up, and on the way to the bathroom.

Activities of Daily Living

In addition to doing your sets of exercises, you should start doing your exercises during activities of daily living (activities you do on a daily basis).

1. Any activity that increases pressure in your abdomen may cause you to lose urine. Examples of such activities are: coughing, sneezing, laughing, bending/lifting, carrying objects, sitting down, standing up, going up/down stairs. During these activities, pressure is placed on the bladder, forcing it to empty.
   • To prevent urine loss, tighten your pelvic muscles just before these activities.
   • For short activities like a cough, tighten your muscles until you finish, then relax.
   • For prolonged activities, tighten during the most stressful moments, or tighten them on and off during the entire activity.
   • Contract your pelvic muscle prior to rising and keep muscles contracted till you are in an upright position.
2. Do your exercises when:
   • standing at the sink and brushing your teeth
   • washing dishes
   • putting on your make-up
   • sitting in the car at a stop light
   • sitting and having dinner
   • reading a book in bed
   • going for a walk
   • talking on the phone
3. Try to always tighten your muscle when you get a strong urge that you cannot control. Tighten your muscle on the way to the bathroom.
4. Do both types of exercises, short and long holds, during your activities of daily living. You do not have to keep a formal count of the number of times you do each exercise -- just do it several times in a row. Do them often enough to make them a habit.

Remember, the more exercising you do:

• the stronger your pelvic muscles will get
• the faster they will get stronger
• the easier it will be to maintain muscle strength

References

Newman, DK. Managing and Treating Urinary Incontinence. Health Professions Pr. 2002.

Posted April 2003

26 South Main Street, PMB #162 . Concord, NH 03301 . Phone: 603 397-0103