How To Strengthen Pelvic Floor Muscles 101

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How to strengthen pelvic floor muscles? The short answer is exercise.

But first things first. Let’s look at what is the pelvic floor, followed by what makes the pelvic floor muscles loose, how to identify it, and how to use Kegels exercises to strengthen pelvic floor muscles.

What is the Pelvic Floor?

The pelvic floor is a group of muscles, rather like a small muscle hammock that runs between the pubic bone in the front, and the tailbone at the back.

A woman’s pelvic floor muscles support her womb (uterus), bladder, and bowel (colon). The urine tube (urethra), the vagina, and the anus all pass through the pelvic floor muscles.

A man’s pelvic floor muscles support his bladder and bowel. The urethra and the anus all pass through the pelvic floor muscles.

Pelvic floor muscles help control the bladder and bowel, and are involved with sexual function.

Almost 24% women in the US have a pelvic floor disorder at some stage in their lives, usually caused by pregnancy, age, childbirth, and weight gain. In men. In men, pelvic floor disorders are most commonly caused by age, weight gain, frequent surgery, or injury.

One of the best ways to strengthen the pelvic floor with exercise, especially Kegel exercises where you contract and relax the muscles of the pelvic floor. Kegel exercises work by strengthening the pubococcygeus muscle, which supports the pelvic floor and is activated to stop the flow of urine.

What makes pelvic floor muscles loose?

• Pregnancy and childbirth for women
• Straining on the toilet
• Chronic coughing
• Heavy lifting
• High impact exercise
• Age
• Obesity

My Story

I had just had a baby, and naturally, I felt like I’d performed a miracle. Almost 24 hours of labor where the dear folks at the hospital suspected it was a false alarm when I serenely told them my water broke. Then they decided to humor me with an examination and sure enough, I was right. They decided to induce labor pain and to cut a long story short, my son was born a Cesarean baby the next morning.

When I regained consciousness, the nurse brought my little bundle of joy and placed him next to me. Love overflowed from my breasts. Hours later, when I was allowed to get up and walk, I was shocked to find me looking … not very different from the day before.

• My tummy was still large, but looser now.
• My breasts were tender and veiny…and… leaky
• I had stretch marks everywhere I saw, and am sure where I couldn’t see, as well.
• I was of course achy all over, felt weak and bruised, and not a little constipated
• My cesarean scar was painful and sore

And I was very afraid to sit on the toilet. When I eventually did, I felt a weird shift in my insides, as though they had realigned themselves. I hoped everything was in the right place!

It isn’t like I didn’t know I’d be feeling this way, but actually experiencing it was freaking me out. Clearly, I had to come to terms with these physical changes and the emotional war raging inside me. My gynecologist called it classic textbook postpartum depression. Luckily I had no time to wallow in it as I had to get busy focusing on my son. The sooner I worked on recovery, the better, I thought!

I pledged to do the following.

• Love my postpartum body, since I had to live with it until it got back into some semblance of shape
• Start maintaining a journal where I noted down questions and concerns I wanted answers to
• Watch my diet and eat well
• Resume all those exercises I had learned during pregnancy
• Strengthen pelvic floor muscles

The weirdest part was the loose feeling; I just felt all stretched out. I was lucky that my doc kept insisting on specific exercises to strengthen pelvic floor.

Women: why rebuild and strengthen pelvic floor muscles  

Pregnancy puts a lot of pressure on the pelvic floor muscles thanks to the hormones and the growing baby weight. She told me that pelvic floor exercises during pregnancy could help me avoid incontinence after delivery. In fact, she also advised me to continue doing these for long-term pelvic health.

Let me blind you with some science now about the pelvic floor muscles and what they do.

What the pelvic floor muscles do

• Support the uterus, intestines and bladder
• Maintain bladder and bowel control
• Support the spine
• Promote perineal healing
• Strengthen the vaginal muscles
• Help you enjoy intimacy
• Support the weight of the growing uterus
• Help rotate the baby’s head to the right position

Toning your pelvic muscles also helps avoid two of pregnancy’s most common and painful issues – bladder control and hemorrhoids.

So I decided to start my recovery with rebuilding and strengthening my pelvic floor muscles– because surely they had been through a lot!

The pelvic floor muscles have two types of muscle fibers:

• the fast ones for strength and
• the slow ones for stamina

Exercises help with the healing process.

Some tips while exercising to strengthen pelvic floor muscles.

1. If you’ve had a normal delivery, you can start doing them after 24 hours, as soon as you are comfortable.
2. If you have stitches, make sure you start them lying down and then gradually progress to sitting.
3. After a cesarean/ forceps delivery start after the urinary catheter is off.
4. Do consult your doc before you start anything though, for your specific health condition.

There are easy exercises to strengthen them, but my favorite is the Kegel exercise, specific for the pelvic floor. I did them both during and after pregnancy.

If you’re thinking, omg, when do I find the time to do Kegels, here’s when:

• Waiting at your doc’s clinic
• Waiting at the bank/your pharmacy/traffic lights/
• Watching TV
• After you’re done on the potty–you get the idea

Nobody will even know.

I also included walking in my regimen – the easiest thing to do, while taking baby out for a spin.

Considering it takes nine months before you hold your baby in your arms for the first time, it will probably take that long or a little longer to return to your pre pregnancy weight. Even then, you’re definitely going to look different—and gorgeous. The physical and emotional changes are quite challenging. Take your time, love yourself. It is worth it. Don’t rush it.

But as I mentioned earlier, it is not just women who need to strengthen the pelvic floor muscles. Men must do it too.

Why strengthen pelvic floor muscles

• Prevents urinary incontinence
• Improves bladder and bowel control.
• Improves recovery from childbirth and gynaecological surgery (in women)
• Protects against pelvic organ prolapse
• Improves sexual health
• Increases stamina and treats erectile dysfunction
• increase social confidence and quality of life.

How to find the pelvic floor?

Lie down or sit in a chair comfortably. Now, imagine you are squeezing your muscles to stop the flow of urine and the passing of wind. Draw these muscles inwardly tightly. This will show you where the pelvic floor muscles are located and what they do.

Another way to identify the pelvic floor muscles is to try and stop the flow of urine when you are emptying your bladder. If you are able to do this for one or two seconds, you are using the right muscles. Do not do this repeatedly as it can cause problems with emptying your bladder fully. This is just a way to identify the muscles for your Kegels exercise.

Kegels exercise for men and women

There are several types of Kegel exercises to strengthen the hips, glutes, and abdominals and the surrounding muscles. Here’s how you do the basic Kegels to strengthen pelvic floor.

How to Do Basic Kegels

Ideally, it is best to practice Kegels every day. You can do them anywhere. Start by holding your Kegels for three seconds at a time and slowly work up to eight seconds.

Here’s how to do it.

For women:

• Sit comfortably in a chair, relaxed.
• Squeeze and draw in the muscles around your anus and your vagina simultaneously.
• Lift them upwards inside.
• You will feel a sense of lifting each time you squeeze the pelvic floor muscles.
• Now try to hold them strong and tight, counting to 8.
• Next, let them go and relax.
• You will feel a sense of letting go.

For men:

• Squeeze and draw in the muscles as though you are shortening your penis and lifting the base of scrotum at the same time.
• Lift them upwards inside, to feel a sense of life every time you squeeze the pelvic floor muscle.s
• Try and hold strong and tight to a count of 3
• Now let them go and relax.
• You will feel a sense of letting go.

Steps for both men and women 

• Repeat the squeeze and lift, and let go as outlined earlier.
• Rest for 8 seconds between each lift of the muscles.
• In case you are unable to hold for 3-8 seconds, just try to do it for 2-3 seconds and work up to 8.
• Do the squeeze and lift up to 8-12 squeezes.
• Aim for three sets of 8-12 squeezes per day, resting in between.
• Can be done lying down, standing or sitting.

Some things to bear in mind while doing Kegels

While doing pelvic floor muscle training, remember to

• Don’t overdo it. It can exhaust the pelvic floor making it difficult to function normally.
• keep breathing
• only squeeze and lift
• do NOT tighten your buttocks
• keep your thighs relaxed.

When should you seek medical help?

Please seek professional medical help when you:

• Find that the pelvic floor muscles are too tight
• Cannot identify your pelvic floor muscles
• Find that the exercises are not helping
• Need to urgently and frequently visit the toilet to pass urine or motions
• Have accidental leakage of urine, motions or gas
• Find it tough to empty bladder or bowel
• Experience pain in the bladder, bowel or in the back close to the pelvic floor area while exercising or doing intercourse

Do you practice Kegel exercises to strengthen pelvic floor muscles?

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