Let's get you feeling good again

Help & Advice

Let's get you feeling good again

Pelvic floor exercises

Exercising your pelvic floor should be as important a part of your daily routine as brushing your teeth. Read more

/professionals/news/looking-after-your-bladder/

Retrain your bladder to develop good habits by practising the Bladder Drill. Read more

When are pelvic floor exercises not enough?

Not everyone can get their pelvic floor to work by exercises alone. 

A woman and a child

If your muscles are very weak or you have lost some sensation in your pelvic floor due to childbirth, surgery or long-term constipation, then it can be difficult to feel if you are doing the right thing. Some women find that they can only feel something happening if they hold their breath or clench their buttocks or tummy muscles at the same time. This often means that you mistake the action of these bigger muscles for your pelvic floor muscles and think that you are strengthening your pelvic floor when you’re not.

If you cannot feel anything happen, are not getting any better after a few weeks, or can’t tighten without your buttock or tummy muscles holding on too, then it is time to seek some extra help.

The Educator can be a useful starting point. This is an inexpensive device that you place inside your vagina, like a tampon, and attach a long stick to. The stick can be seen on the outside and moves in response to your pelvic floor muscles working. When you tighten your pelvic floor muscles, the stick moves towards your body and when you relax them, it moves down. This can enable you to see if something is actually happening. If you simply tighten your buttocks then the stick won’t move. Many women find that this is all they need to find their pelvic floor.

If you can see or feel your muscles working but don’t seem to be able to get them any stronger then Aquaflex cones can often help. These cones are inserted into your vagina and the idea is that you use your pelvic floor muscles to hold them in place. You begin with a light but large cone and then gradually progress to heavier and smaller cones. Even if you can feel your pelvic floor muscles working, these cones can work wonders for your motivation and make it easier for you to stick to a regular regime.

For some women, some extra help is required to get the pelvic floor muscles working. If the muscles are very weak then some help from a health professional is required. The e-PAQ (an on-line pelvic floor assessment questionnaire) lets you fill in a questionnaire that helps to diagnose your pelvic floor problem to print off and take to your GP. Your GP will then refer you to a specially trained Women’s Health Physiotherapist or Continence Advisor who will assess you and find out why you are not getting better or are having difficulties in exercising your pelvic floor.

If the muscles are very weak then your health professional will advise the use of a biofeedback or pelvic floor stimulator. These are devices that attach to a small probe that you place inside your vagina. Probes like the Periform and Anuform have been designed to make insertion easy but also to ensure that the part of the machine that stimulates or picks up messages from the vaginal muscles is in full contact with your body. The Peritone biofeedback machine enables you to see when your muscles are contracting. The Pericalm stimulator actually provides gentle stimulation to the nerves and muscles so that it is easier for you to tighten those muscles. The sensation is similar to a TENS machine – a light pins and needles type feeling.  Biofeedback and stimulation have both been shown by research to be effective in the treatment of urinary incontinence and pelvic floor weakness. 

By Alison Bourne MA (Cantab) BSc MCSP ACPWH