Are you doing your pelvic floor exercises?

It is extremely important that you exercise these muscles correctly to regain muscle tone and strength after having a baby to prevent problems now and in later life.

WHAT ARE THE PELVIC FLOOR MUSCLES (PFM)
PFM are a sling of muscle running from your pubic bone at the front to your coccyx at the back. They form your perineum and give the support to your
bladder, bowel and uterus from below; allowing the passage for the urethra, anus and vagina.
In pregnancy there is an increase in pressure on this area due to the growth of your womb and of your baby. The hormonal changes that occur also cause a weakness of the muscles.
In a vaginal delivery it is PFM which are stretched, torn or cut (episiotomy)THE ROLE OF PFM
To support the pelvic organs, to prevent a prolapse which can occur after childbirth or in later life.
To control the flow of urine-to stop you leaking
To control wind and bowel motion-to prevent incontinence.
To enhance sexual enjoyment.
To give support to the growing baby , then guide its head during the delivery.WHEN TO DO THE EXERCISES
It is important to start the exercises when you are pregnant to maintain as much strength in the muscles as possible, and to teach you how to feel the contraction so you know what you are doing postnatally when the area may feel numb, sore and out of control!
Antenatally you may go through good and bad stages of control of your continence. This can be due to the hormonal changes and also the position of the baby-it may be resting on your bladder giving you less control and making you want to wee more frequently.
Postnatally -contracting the muscles helps increase the blood supply to the area which helps with the healing and also with the swelling. The PFM exercises help to regain control and strength and the whole function and stability around the pelvic area.THE EXERCISES
There are 2 ways to exercise the muscles, so as to work the different muscle fibres .
Slowly tighten the muscles around the vagina and front passage, pulling up inside you as if trying to stop the flow of urine mid stream. Hold this contraction for as long as you can ( 4 seconds at first increasing to 10 seconds) then relax taking twice as long as you did to contract. Repeat this up to 10 times if possible.
2.Fast-Quickly and strongly contract the muscles holding for 1second, then relaxing for 2. Repeat 10 times. Do 5 sets of each a day
As a test only, you can try to stop the flow of urine mid stream, but do not do this as the exercise. The PFM are anti-gravity muscles, therefore working in any upright position, but are also under voluntary control. As with any muscle strengthening programme you should feel the muscles working, the feeling should be deep inside not just superficial. You may feel your lower abdominals working at the same time, this is fine, but you should be able to contract PFM without the buttocks, thighs or upper abdominals coming and without holding your breath. Breathe out whilst exercising.
Position to do the exercises in- Postnatally you should first do the exercises lying down and progress to sitting and standing up. Contract the muscles whilst you are moving, from sit to stand, lifting, going up the stairs and pushing the pushchair. Exercise regularly and frequently, progressing as you improve.
Coughing and sneezing -Sometimes you loose the natural reflex which should come in when coughing . this results in an increase in downward pressure from the abdominals not counteracted by the upward toning of PFM and you therefore leak. Try a ‘small’ cough whilst maintaining the PFM contraction. Increase the strength of the cough as you improve.
Sneezing is more difficult to control but try to contract quickly before you sneeze.RETURNING TO SPORT
You should not return to aerobic(high impact-running, jumping, pounding) exercise until you gain control and do not leak on these movements. This may be at least 3 months, and longer if still breast feeding. Low impact exercise can be started earlier.If you continue to have problems. Contact your Doctor or a Physiotherapist specialising in Women’s Health. The Physiotherapist would do a vaginal examination to test whether you are doing the contractions correctly, then give you specific exercises for your problem. A biofeedback machine may be used to test the strength and stamina of the muscle or a machine for muscular stimulation. Physiotherapy will give you a better perception and awareness of the area helping the perineum to work with the whole body functionally.

Do not let the problem linger on. Many women do suffer from some sort of incontinence, which can be easily helped with the correct techniques and advice

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