Five ways to strengthen your pelvic floor

Does your pelvic floor needs strengthening?
Not everyone’s does. Suzanne Hagen, professor of health services research at Glasgow Caledonian University, says there is little research to show the effectiveness of pelvic floor exercises as a preventive measure, although they did help to reduce symptoms in women with early stages of prolapse. Pregnant women should do strengthening exercises, and so should peri- and postmenopausal women, even if they don’t have symptoms. But if you haven’t given birth (either vaginally or by C-section), or had pelvic or abdominal surgery (male or female) and you don’t have symptoms of a weak pelvic floor such as incontinence or prolapse, you may not need to do them, says Lucy Allen, a pelvic health physiotherapist. Overworking the muscles can lead to pain. “We see issues in people whose pelvic floor doesn’t fully relax,” she says.

Do kegel exercises
New guidelines from the National Institute for Health and Care Excellence recommend training pelvic floor muscles as the first point of treatment for women with urinary incontinence and pelvic organ prolapse. Pelvic floor exercises are similar for men and women.

“Ideally, you should sit or lie down, with your body relaxed,” says Allen. “Tighten the back passage as if trying to stop yourself passing wind, and imagine that lifting up and forward. Hold it and relax.” The aim is to hold it for 12 seconds, repeating 10-12 times, but you may find you are unable to manage that long to start with. Do this three times a day.

As you get stronger, you will be able to do the exercises while standing up and doing everyday tasks, says Allen. She says 70% of women are doing the exercise incorrectly, suggesting it is worth getting your technique checked by a specialist physiotherapist.

Apps and devices can help
The NHS Squeezy app, which reminds and guides users to exercise their pelvic floor muscles, is well regarded and has versions for men and women. For women, there are also devices that can help with the exercises. Allen recommends those made by Elvie and Kegel8’s electronic toners.

Avoid damage to your pelvic floor
“Keep a healthy weight,” says Hagen. “If you are overweight, it puts extra pressure on the abdominal muscles.” She says learning to lift heavy weights – even toddlers and shopping bags – correctly can protect the pelvic floor, while a chronic cough can weaken it (another reason not to smoke).

Allen says it is important to avoid constipationA. “If you are straining to empty your bowels by pushing down, you are weakening the pelvic floor. Ensuring a good fibre intake, drinking plenty of fluids, exercise and keeping your weight healthy all help to avoid constipation.”

Take an exercise class
Pilates classes often incorporate pelvic floor exercises. “Weight training can be a great addition to regular pelvic floor strengthening if you have been taught how to correctly breathe and engage the core system during movement,” says Allen. “Squats, bridges and lunges can help.”