Pelvic floor exercises and bladder retraining for women

Pelvic Floor Exercises

Pelvic floor exercises retrain and strengthen the muscles and sphincters of the pelvic floor. They are easy to perform, are not time consuming, and can be done virtually anywhere.

Technique:

The aim is to strengthen the muscles and sphincters of the pelvic floor by exercise as you would strengthen other muscles of the body.

Squeeze the muscles tightly around the front and back passages lifting the pelvic floor up. Initially, the contraction should be held for two seconds, gradually increased for ten seconds with ten second intervals. Ten contractions in one "set" is the ideal. 

- It may take months to reach this level of muscular strength so do not expect immediate results.

- To achieve more effective contractions imagine you are trying to stop wind, or attempting to prevent a tampon from falling out, or are stopping your flow of urine mid-stream.


Frequency:

The above set of exercises is best repeated as often as possible, but at least ten times per day.

This can easily be achieved if you do them:

  • When you finish going to the toilet
  • On answering the phone
  • During the commercial breaks on television
  • At the red lights when driving

Testing:

During the strengthening period, you can test the improvement in the strength of your pelvic floor by:

  • Inserting two clean fingers into the vagina and contracting the muscles as in the exercise "set"
  • Stopping mid-stream while urinating
  • Noting an improvement in your symptoms.

Important Notes:

During your exercise program or at any other time, you should ensure that you:

  • Do not bear down
  • Only use your pelvic floor muscles, not your abdominal, thigh or buttock muscles
  • Do not hold your breath.

You may find easier to remember to do those exercises if you place reminders in conspicuous locations around your house e.g. a red adhesive dot placed on the bathroom mirror, the fridge door, the TV remote, the dashboard of your car etc.

Bladder Retraining exercises for women with bladder problems

The technique involves increasing the amount of fluid the bladder can hold by gradually 'stretching' it. Instead of going to the toilet as soon as you get the desire to void, you should wait 5 minutes every time. At first this may be difficult and you may only be able to achieve 2-3 minutes, but persist!

Slowly increase the period of deferment from 5 to 10 minutes, and then from 10 to 20 to 30 minutes. Keep a time and volume chart (Please see example below) of how your bladder is working every day. During the time you are putting off going to the toilet you are learning how to suppress bladder contractions. By filling the bladder with more urine its wall is being stretched and so will hold more. Set yourself a higher target bladder capacity to aim for each week or so.

It is also vital to stop going to the toilet 'just in case'. This encourages your bladder to hold only small volumes. You should only empty the bladder when it is full and you have done your 'hold-on' exercise.

Techniques:

One or more of these techniques may be helpful in controlling the bladder when the urge is there and allow voiding to be delayed. They all require practice and can also be used together.

PELVIC FLOOR CONTRACTION: This helps prevent urine leakage when there is an urgent desire to void and suppress the unwanted bladder contraction by a spinal cord reflex. Works best if applied early on in an unstable contraction.

PERINEAL PRESSURE: Pressure on the perineum (area between the vagina and rectum) by reflex suppresses unwanted bladder contractions, e.g. sitting on the arm of a chair or the edge of a firm chair.

MENTAL DISTRACTION: When the bladder contracts at inappropriate times try to distract your mind by concentrating on something other than the toilet and emptying your bladder - anything will do, e.g. mental arithmetic, the shopping list. Breathing exercises or other relaxation techniques can also be good distractions. 

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