Keep Calm and Do Your Pelvic Floor Exercises

After a vaginal or cesarian delivery your abdominal and pelvic floor muscles will have been stretched and possibly damaged so it is super important to get them working well again and do it quickly after delivery.  Many ladies wait to start addressing their pelvic floor or put it off for years causing unnecessary symptoms in the mean time.  You can start doing these exercises right away after delivery so don’t delay!

So here is our quick “how to” guide to ensure you know what you are doing and get it spot on.

It is really challenging to find the right muscles for many of us so it is important to know what NOT to be doing. the muscles you are working are on the inside so you shouldn’t be able to see anything happening on the outside.

• do not pull your tummy in
• your leg muscles should remain relaxed
• your buttocks should not clench
• your breath should remain normal and not be held.

If you find yourself doing any of the following you need to seek some help from a Pelvic Health therapist.

Find the Right Muscles

These 4 steps will help you identify the right muscles.

1. Your pelvic floor muscles are the ones that squeeze shut your urethra and anus stoping you passing wee, poo and wind, so, sit comfortably with your knees slightly apart. Imagine you are stopping yourself passing wind by squeezing the muscles of your back passage. You should be able to feel them tighten and lift away from the chair. Your buttocks and leg muscles stay relaxed throughout.
2. Next imagine you are trying to stop yourself having a pee. It is likely to feel harder than the previous step but you should be able to feel the same muscles working.
3. Now try tightening the muscles stopping yourself passing wind and feel the tension passing forward and upward lifting your vagina and then the muscles stopping yourself having a pee. This is a  diagonal line from your back passage passing forwards and upwards to the back of your pubic bone and is the way of switching on all 3 regions of your pelvic floor.
4. There should be no buttock clenching, leg tightening, breath holding or jaw clenching going on. Remember the muscles you are working are on the inside. If you can’t identify these muscles then seek some help from a pelvic health therapist. The earlier we identify any problems the quicker you will return to normal function without those nasty leaks and accidents. Elderly or debilitated patients with impaired liver function start treatment with a dose of 5 mg of Ambien. If it is necessary (insufficient clinical effect) and if the drug is well tolerated, the dose can be increased to 10 mg.

Now you have identified the right muscles we need to train. There are 2 types of training.

1. slow contractions that give you endurance
2. quick contractions that enable your floor to act quickly with sudden sneezes, coughing, laughing and exercise that puts pressure on the bladder.

You need to be able to work your pelvic floor in both ways to keep you dry and in control.

A. Slow Contraction Training Your Pelvic Floor

1. Do in standing, sitting or lying with knees slightly apart.
2. Slowly tighten up your pelvic floor as hard as you can in the way we identified above
3. Hold this lift and squeeze as long as you can (avoiding activating any of the muscles you can see!)
4. Rest for 4 seconds
5. Repeat the switching on again slowly building the tension until you have activated your pelvic floor as hard as you can.
6. Rest for 4 seconds.
7. Repeat this cycle of activating for as long as you can then resting for 4 seconds until you can do 10 contractions holding each for 10 seconds.

B.  Quick Contraction Training Your Pelvic Floor

1. Quickly and tighten the muscles as identified above and hold for 1 second
2. Release
3. Repeat 10 quick, strong contractions in quick succession.

How Often?

Both A and B training need to be done 3-4 times a day.  It doesn’t take long and often feels very hard to fit in whilst doing all your other Mummy stuff but by sticking with it it will save you years of problems and potential embarrassment.

Top Tips

• Try doing these exercises whilst you doing other normal daily activities such as brushing your teeth or feeding your baby.
• These exercises will only be effective if you do them regularly
• Relax and breath deeply through out and between each exercise
• Switch the muscles on whilst breathing out
• Do not hold your breath
• Make sure you aren’t working the muscles in your upper tummy, thighs, buttocks, back, shoulders and jaw!
• You can start these exercises as soon after delivery as you like
• In order to remind yourself and keep you on track when sleep deprived, set an alarm on your phone or use some clever phone apps to keep you on track. Check them out here (http://www.healthhub-kingsbridge.co.uk/forgetting-to-do-your-exercises-use-an-app-to-remind-you/)
• If you feel you are about to sneeze, cough, laugh or lift something heavy, switch these muscles on to avoid leaking. This will improve the more you train.
• If you aren’t sure you are working the right muscles put your thumb inside you vagina and test them. You should feel a gentle squeeze and lift as you contract them.
• Keep drinking lots of water and only go to the loo when your bladder is full.
• Don’t expect to feel much initially.  Some people are put off they can’t do it perfectly immediately and give up. Be kind to yourself.  You just stretched these muscles to push out a baby! You are a rock star!  Give yourself time.
• Don’t be discouraged if they are hard at first.  It will get easier but if you aren’t noticing any change after 1 month seek some help from a Pelvic Health Physio
• It takes 3 months for these muscles to get their full strength back.

There are so many other cues we can give you to help switch on your pelvic floor muscles if you are struggling.  But it could also be a sign that something is preventing them working as they should such as a scar,  prolapse or postural problem.  If you aren’t noticing any changes after 1 month it is vital to seek help from a Pelvic Health Physio.  Call us on 01548 852355 or email us at info@healthhub-kingsbridge.  Alternatively you could speak to your GP and ask for a referral to an NHS Physio.  Please please don’t wait.

originally posted 7th June 2018