Never had children, Pregnant or Postnatal? – well in any scenario it’s a really good idea to be doing daily pelvic floor exercises. Think of it like brushing your teeth to keep decay away – Pelvic floor exercises will help to prevent the impact and strains of everyday life that effect our pelvic floor, bladder and bowel health. Which is something we all want to prevent (even if it’s not necessarily top of our to do list!)
Throughout my career I have spoken to hundreds (actually probably thousands) of ladies and one things for sure – I don’t think many are confident they are doing them correctly.
So first things first - the best way you are going to get advice specific to you – (and the gold standard recommendation) is to of course see a pelvic health physio and have a pelvic floor assessment. A pelvic floor consultation looks at lots of factors that when assessed and coached can help you master your best pelvic floor squeeze. But many ladies don’t even know what a pelvic health physio even does let alone what they are actually assessing during an internal assessment.
What a Pelvic Floor Assessment by a Pelvic Health Physio tells you:
How powerful your squeeze is?? – we grade this from 0-5 (0 is when someone is unable to elicit a squeeze and 5 is excellent super strength!!)
How Many Seconds you can hold for? – This assesses the endurance of the muscle to see if you can hold on for the Gold Standard of 10 x 10 seconds
How quick the muscle can contract? – can the muscle contract quickly - for example its no good having a super strong grade 5 strength contraction that has good endurance of 10 seconds but cant squeeze quick enough to stop you leaking with a quick sneeze, fast exercise like double unders, or even a fall off a curb. We need the pelvic floor to react and squeeze quickly in these scenarios.
Can it elevate up and around the Bladder neck? – We will check the muscle strength in different locations of the muscle to be confident the muscle is working to the left right back and front.
Co-Contraction - Are your core muscles joining in synergy together? – are you squeezing your gluts adductors or abs to compensate?
Timing - Is everything firing in the right order?
Are you holding your breath? I am passionate about the effect of breath and the pelvic floor – holding your breath while doing a pelvic floor contraction will limit its potential. Its really common and I see it a lot – when we are working hard, or concentrating on something new, or stressed it’s so common to holding your breath! But it’s really important to contract as you breathe out!
When you can't access a women’s health physio?
“Lift and Squeeze the Pelvic Floor as if stopping yourself passing wind or water”
This common phrase gets used a lot, it sounds so simple but many ladies say I have read up so much and I’m totally confused. Some ladies are trying to do breath and a squeeze, imagining a lift going up and down, imagining your pelvic floor is a jelly fish.. the list goes on! All these analogy’s can be really useful for specific ladies but also can just further confuse other. And if we should be doing these every day then they should be easy right?
Keep it simple
If you are getting confused and finding it all a bit complicated research suggests thinking of contracting your back passage will give you the best chances of recruiting a good pelvic floor squeeze. So if your getting stressed about how to do it, or losing your confidence– then just think about “stopping yourself passing wind” or “squeezing the anus” and statistically that should work best for most of us!
If you are still unsure other ways that you can self-assess are:
1) Use a Rolled up Towel – sitting on a rolled up towel will give your pelvic floor contact and feedback so you should be able to feel the pelvic floor lift and relax against the towel if the pelvic floor is working. It will also help you to self-assess how many seconds the pelvic floor can hold on for. For example if you lift and squeeze – then hold on for ten seconds – the relax – you SHOULD feel the pelvic floor drop back down to the towel – if you cant then its likely the pelvic floor has given up before you!
2) Use a Mirror – have a look at the perineum and if your pelvic floor is working you should see it lift up as your squeeze. This isn’t for everyone – many ladies have even looked “down there”. But on that note – we really should be looking regularly so we know what is normal for us and recognise and changes.
3) Use a thumb or finger – place your thumb or finger inside the vagina to see if you can feel the muscle squeeze and tighten against our finger
How Many and How long?
Aim for 10 lots of ten second squeezes and 10 one second squeezes . Some people will talk about long squeezes and fast squeezes. If you cant manage that straight away then start with what you can do and slowly build up .
Ideally try 3 time a day. Don't give yourself a hard time if you can manage this but its certainly a good aim.
What Position is best?
Side lying is easiest, then lying on your back, Then we usually progress to sitting and then standing. Once you are confident you can then combine your squeeze with functional activities and by that we mean squatting bending lifting etc :)
It doesn’t have to be complicated – because it isn’t ( I promise). However it’s an area of our body that doesn’t move like our knees or elbows, and an area of our body that can hold feelings such a shame and embarrassment. But doing a few squeezes everyday will certainly help them become more familiar. If you are still feeling confused or it doesn't feel right then get in touch or book in online for a specialised assessment to assess and optimise your pelvic floor squeeze!
To find a specialist physiotherapist locally to you then you can look on the Squeezy app or the POGP website to find someone local to you who can help :)
As always I love to hear your comments and more than happy to answer any questions DM call or Email. Details on the website 😊
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