Pelvic floor exercises - stage one

The pelvic floor muscles sit at the bottom of your pelvis, between your legs. They are attached between the tailbone (coccyx) at the back to the pubic bone at the front and to each of your sit bones at the sides. This creates a hammock to support the pelvic organs such as the bladder, the womb and the bowel.

These muscles work to help to keep the bladder and bowel openings closed to stop leakage. They relax when you pass urine and empty your bowels. 

Pelvic floor muscles are like every other muscle in the body. They can become weak or damaged with injury, and enjoy regular exercise to stay strong and healthy.

Pelvic Floor Muscles Explained - YouTube

How to do a pelvic floor contraction

Begin by choosing the position that gives you the best awareness of the pelvic floor contraction such as:

• Lying down on your back with knees bent and feet flat on the floor
• Lying on your side with your hips and knees bent
• Sitting on the edge of a firm chair
• Sitting on a rolled up towel between your legs can help increase the sensation and awareness of the contraction.

How to find your pelvic floor? | Squeezy | Myra Robson - YouTube

Tips on Pelvic Floor Contraction

• Should feel like a gentle squeeze and lift
• Should not feel like you are pushing down or straining
• Should not be painful
• Should not need any extra muscles to contract with it (tummy muscles, buttock muscles, inner thighs)
• Always breathe while doing pelvic floor contractions. Do not hold your breath
• Make sure your tummy remains soft and doesn’t bulge outwards or suck inwards

How to contract and relax your pelvic floor muscles

Pull in your back passage (anus) as if trying to hold in wind, then draw the pelvic floor muscles forward and upwards imagining you are stopping the flow of urine at the same time.

You want to feel a squeeze and lift

Or

Think of closing anus, close vagina, hold and lift

Or

Think of closing from the back up towards the front

Follow this by a full relaxation, just let go and allow the pelvic floor muscles to release and drop again, imagining the softening and opening of the muscles within the pelvic bowl and your sit bones spreading gently apart.

Now you can begin to train your pelvic floor

Training your pelvic floor muscles involves doing a mixture of long hold squeezes and short quick squeezes, always make sure you relax fully between each one.

Long Squeezes

Perform your pelvic floor squeeze and lift and see how many seconds you can hold for (up to 10 seconds when able)

Write it down here ________ seconds

Now relax and perform some gentle belly breathing for up to 10 seconds before doing the next squeeze.

Next, see how many repetitions you can do like this (aiming for 8-12 repetitions) 

Write it down here _______ repetitions

This is where you will start, for example you may be able to do 5 repetitions with a 5 second hold and then build these up over time.

Short /quick squeezes

Try to do a quick and strong, 1 second squeeze then relax and let go fully.

Repeat this quick squeeze and see how many you can do before the muscle tires out (aiming for 10 in total when you are able).

Quick squeeze/release/relax

How many could you do? ________ repetitions

The Goal

Aim to build up over time to being able to do

10 Long squeezes with a 10 second hold on each one.

Allow yourself time to relax fully between each exercise and do some gentle belly breathing in between.

Followed by 10 of the fast/quick squeezes.

During both exercises you should:

• Feel your pelvic floor muscles ‘lift up’ inside you, rather than feel a downward movement
• Relax your thighs and buttocks
• Keep breathing normally
• Stop exercising if your muscles fatigue

What Next?

When you feel you are ready to progress to the next stage, see the Pelvic Floor Exercises Stage 2 leaflet.

Remembering to do your exercises

It can be easy to forget to do your exercises at first. Try to use daily activities such as brushing your teeth or having a shower to remind you to do your exercises. You could practice them on a daily journey such as train, car, or bus. Or use a pelvic floor app such as Squeezy below.

Pelvic Floor Exercise App

“Squeezy” is the NHS App for pelvic floor muscle exercises and is available from the App Store and Google Play. This app has been designed by physiotherapists working in the NHS. It is discreet, informative and has helpful visual and audio prompts to support your exercise programme. It can give you reminders to exercise and records the number of exercises you have completed. There are also other pelvic floor exercise apps available.