How to Do Pelvic Floor Exercises While Pregnant

Pelvic floor exercises during pregnancy – What’s all the fuss?

Without good strength and function, the pelvic floor may have difficulty adapting to the ever-changing stages of pregnancy.

The good news is that pelvic floor muscles are the same type of muscle as your biceps, gluteals, quads etc; meaning, they’re skeletal muscle. Which means that just like those muscles we train, challenge and progressively load, the same theory can be used for the pelvic floor muscles. It’s time to start thinking of your pelvic floor exercise program just like sports rehabilitation for an AFL player with hamstring issues or a footballer with calf concerns.

Did you also know that strong pelvic floor muscles stretch and adapt to labour better? They also recover faster during the post-partum period.

It is also important to acknowledge here that pelvic floor problems are common, especially during pregnancy. You are never alone and the majority of the time symptoms can be resolved with some dedicated training. Most importantly, no matter what the issue, they’re not normal, so always reach out and do something about it.

How common are pelvic floor problems?

• 1 in 3 women who have had a baby will leak urine (Therefore this is COMMON but by no means NORMAL)

• 1 in 4 women will have a prolapse

How do I know if I have reduced pelvic floor strength?

Signs of reduced pelvic floor strength include:

• Leakage of wee with cough/sneeze/laugh/jumping/running/sex

• Unable to hold on to wee

• Sudden urgency to wee

• Unable to hold in wind

• Unable to hold in poo

• Sudden urgency to poo

• Heaviness/dragging/pressure in vagina

• Feeling like something is falling out of your vagina

• Feeling a lump coming out of your vagina

• Decreased sensation with sex

What causes this?

• Pregnancy and childbirth (regardless of the type of birth

• Menopause (unfortunately that’s going to be every one of us women!)

• Constipation

• Heavy lifting

• Post hysterectomy

• High impact exercise

Do these exercises really work?

Yes. We have very high levels of evidence to show that a supervised, individualised program for a minimum of 3 months can significantly reduce symptoms, if not cure them.

How do I do pelvic floor exercise?

A correct pelvic floor contraction should feel like a gentle 'squeeze' and 'lift' at the base of the pelvis where the muscles are located. You should NOT feel a sense of straining or 'bearing down'.

It’s also easy to confuse pelvic floor exercises with other exercises involving muscles around the pelvis. Squats, bridges and other hip or ‘core’ type exercises are great in general but won’t be specific enough to target your pelvic floor. You have to pare it right back and just squeeze and relax the pelvic floor only.

Here is a great video that shows how your pelvic floor works when you squeeze and relax those muscles, see here.

When we teach a correct pelvic floor action, we often provide visual 'cues'. You might like to try the following 'cues' to help to identify your pelvic floor muscles correctly:

1. Imagine you are trying to stop the flow of urine (Don't actually do this when emptying).

2. Imagine you are trying to stop passing wind.

3. Imagine you are sitting on a silk scarf and you are trying to lift this upwards through your vagina.

When complete, don't forget to release and relax the pelvic floor muscles again.

If you're still in doubt, book an appointment with one of our experienced pelvic floor physiotherapists to have your pelvic floor assessed and technique confirmed.

I find it hard to know if I am doing them right, do most people know how to do them?

About 50% of people are doing their exercises incorrectly, while 30% of those are doing something that may cause harm. This is why individual assessment is so important.

So, I think I’ve got them right, how many do I do and how often?

Like all muscle exercises it’s so important to be specific so it’s important that your program is targeted towards your, individual, pelvic floor. The exact dosage of hold time and repeats depends on your current level of strength and function! To be effective and see results your program needs to be tailored to you!

Individual assessment by a Pelvic Floor Physiotherapist is so important so that you know you are doing you exercises correctly and that your program is at a level that is best for you. If your program is too easy or too hard it won’t work, and you may get disheartened or frustrated as your symptoms won’t improve despite your best efforts.

It's never too late to get started – the time is now! Get squeezing!

Laura Wieczorski is a senior Pregnancy and Pelvic Floor Physiotherapist at Melbourne Pregnancy and Pelvic Floor Physiotherapy. To make an appointment to see Laura please visit our website www.mppp.com.au