Its a really awkward feeling. You really want to start supercharging your pelvic floor to improve your sex life, prevent leaking of urine and prevent sagging of the bladder as you age…

BUT

There is a small problem – you are not sure about where and how…

You are not alone, only about 1 out of 4 patients do their pelvic floor exercises correctly after verbal instructions only.

Many patients contract the buttocks, thighs and hold their breath! So the first bit of advice would be to avoid working anything outside the panty line. Keep it inside and keep the movement small.

5 ways to isolate the correct muscles

  1. Go for a pelvic floor evaluation with a pelvic floor physiotherapist. Your therapist can evaluate strength, coordination, endurance and correctness of breathing during the contraction. The physiotherapist can make sure you are not bearing down/bulging downwards in stead of squeezing.
  2. At home: Take a small mirror, and view the perineum area while you do the contraction. The correct squeezing action will cause the clitoral area to “nod” and the area between the anus and vagina to lift/pull inwards into the body. Your anus opening will also close up a little. The movement should be up into your body. Don’t feel akward – remember that only 25% of women “get it right” without checking. So the majority of women need visual cues to help them get the right muscles working.
  3. Visualization: Imagine that you are “drinking water into the bladder with a straw” by sucking inward and upward.  Some patients say they visualize that a “tampon is going to fall out and they are holding it inside with the vaginal muscles”
  4. Many patients use a rolled towel to sit on, placed over the crotch. When you contract the pelvic floor, you should feel the pressure on the towel decrease as the perineum lifts.
  5. You/or your partner can insert a clean finger into the vagina, and during the contraction increased pressure/squeezing around the finger can be felt.

Many patients want to test the squeezing muscles during urination by trying to stop the flow of urine while on the toilet, but experience has taught me not to teach this as a method of checking the action of the urine. Many patients end up making a very big mistake: training EVERY TIME they go to the loo, which results in urine retention, incomplete emptying and urinary tract infections!

Do not confuse your bladder. Its in the toilet to empty itself, not hold urine back!

So, there will be a way for you to activate your pelvic floor correctly, if you are willing to try a few of the above techniques. Remember, that if you are still unable to activate these muscles, your pelvic floor physical therapist can assist you with rehabilitation.