Vaginal Pelvic Floor Exercises

Vaginal Pelvic Floor Exercises

Vaginal Pelvic floor exercises
Pelvic floor exercises are a simple and effective way to combat incontinence (loss of bladder control). They help to restore muscle tone through exercise.

What is the pelvic floor?
The floor of the pelvis is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tail bone at the back to the pubic bone in the front. The pelvic floor supports the bladder, the uterus (womb) and bowel. The urethra (water pipe), the vagina (birth canal) and rectum (back passage) pass through the pelvic floor muscles. The pelvic floor muscles play an important role in bladder and bowel control and sexual sensation.

What are pelvic floor exercises?
You can improve control of your bladder and bowel by doing exercises to strengthen your pelvic floor muscles. These can also be useful when used with a bladder retraining programme that aims to improve your bladder control if you need to pass urine urgently and frequently. 

Why do the pelvic floor muscles get weak?
The pelvic floor muscles can be weakened by: 

• pregnancy and childbirth
• constipation (continual straining)
• persistent heavy lifting
• a chronic cough
• being overweight
• changes in hormone levels at menopause (change of life)

Identifying the pelvic floor muscles
This is so you can get your pelvic floor muscles working correctly: 

• Sit or lie comfortably with the muscles of your thighs, buttocks and abdomen relaxed.
• Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea or wind, and then relax it.  Practice this movement several times until you are sure that you are exercising the right muscle.  Try not to squeeze your buttocks or tighten your thighs or tummy muscles.
• Imagine you are passing water, trying to stop the flow mid-stream and restarting it.  (You can do this for real if you wish, but do so only to learn which muscles are the correct ones to use). 
• If you cannot feel a definite squeeze and lift action of your pelvic floor or are unable to slow the stream of urine, you should seek professional help.  

Doing your pelvic floor exercises
Now you can feel the pelvic muscles working, you can start to exercise them.

• Tightening and drawing in around the anus, the vagina and urethra all at once lifting them up inside. Try and hold the contraction strongly as you count to five and then relax. You should have a definite feeling of letting go.
• Repeat (squeeze and lift for a count of 5) and relax. It is important to relax for about 10 seconds in between each contraction. If you find it easy to hold for a count of 5, try and hold for longer – up to 10 seconds.
• Repeat this as many times as you are able up to a maximum of 8-10 squeezes.
• Now do five to ten short, fast, but strong contractions, pulling up and immediately letting go.
• Do this exercise routine at least 4-5 times every day. You can do it in varying positions:  lying, standing or walking.
• Whilst doing the exercises don’t hold your breath, tighten your tummy, buttocks or thighs or push down.  Instead squeeze and lift up.

Make the exercises a daily routine
Get into the habit of doing the exercises. Link doing them to some everyday activities – for example, do them after you have passed water or when you turn on a tap. You may find keeping a simple exercise diary helpful. Get into the habit of tightening these muscles prior to activities that are likely to make you leak – such as getting up from the chair, coughing, sneezing or lifting. 

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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