Assess your own pelvic floor muscles

How often have you been told to remember to practice your pelvic floor exercises? How often have you nodded and said that you do them every day but wondered if you’re actually performing them correctly.

These muscles are hidden inside which makes it very difficult to work out exactly what is happening and lots of women are not able to tighten their pelvic floor muscles at all.

So why is it so important to make sure you are doing your pelvic floor exercises properly and can you assess your own muscles in the comfort of your own home?

This post will answer these questions as well as giving you 3 simple but effective ways of checking your own muscles. You will then be in a better position to decide if there are any treatments that might help strengthen your muscles as well as working out your own unique exercise plan.

Why are strong pelvic floor muscles so important?

Pelvic floor muscles play a vital role in supporting the both the bladder and bowel as well as helping to improve sensation during sex.

We tend to think that bladder leaks mostly effect older women but that’s not really true.  Many women who have had a baby experience the occasional leak when coughing, sneezing or running after a toddler. These leaks can continue to be a bit of a nuisance but then become much worse around the menopause.

Advertisements on the TV encourage us to laugh at these ‘whoops’ moments and to accept them as something that’s an inevitable part of being a woman and a mum. The reality is any type of bladder leak is not amusing but really very embarrassing. No-one feels feminine and sexy when they are wearing a pad and are concerned that they could leak at any moment! I have treated many women in my role as pelvic floor physiotherapist and the reality is that bladder leaks seriously effect a woman’s confidence and her quality of life. Exercising, going to the gym, wearing sexy underwear and light coloured trousers suddenly aren’t options anymore.

It’s a proven fact and research shows that many women who practice pelvic floor exercises effectively can either cure or significantly improve their bladder and bowel problems. These exercises can also reduce symptoms that come from certain types of prolapse.

Women often ask about surgery instead of exercises in the hope of a faster result. Sometimes surgery is needed but national guidelines recommend only considering this approach after trying conservative treatments (that means pelvic floor exercises) first.

This is because any type of surgery carries possible risks and if conservative treatment can be so successful it’s really worth giving it a try to begin with.

Why do I need to check if I am able to do a pelvic floor muscle contraction correctly?

1. A few women are unable to perform pelvic floor exercises correctly. Instead of doing a ‘pulling in’ movement they ‘bear down’ putting more strain and load on the pelvic floor structures. This type of downward pressure can make both bladder, bowel and  symptoms of prolapse worse.
2. You may be able to exercise correctly but you may not be working the muscle hard enough to make it stronger. If your pelvic floor muscles do not get stronger it’s unlikely any of your symptoms will improve. Women often give up on the exercises presuming they are a waste of time.
3. By assessing your own muscles you can personalise and progress your pelvic floor exercise routine so it continues to be effective for you.

3 simple ways to assess your pelvic floor muscles correctly.

Have a look

The simplest way to check these muscles is by using a mirror to look from the outside. Although you will not be able to see the muscles working directly you may be able to see the movement they produce.

Sit on the floor with your back supported so you are propped up with your knees and hips bent. Use a mirror to get a clear view of the vaginal and anal area. Imagine you are trying to stop yourself breaking wind or passing urine. As you try this you should see the whole area between your legs draw inwards and upwards. The opening to your back passage can be seen to close.

The correct movement should be a pulling in away from the mirror. The most common mistake women make is to bear down and push as if they are trying to have a bowel movement.

Feel from the outside through your clothes or underwear

Take your 4 fingers and gently lay them on the line of skin that lies between the base of your spine and your back passage. You can do this laying on your back with your knees bent. Another good position is lying on your side with one pillow supporting your head and another between your knees.

Relax first and then gently tighten your pelvic floor muscles again as if you are trying to stop yourself breaking wind. As the muscle contracts correctly you may be able to feel the area under your fingers tighten, lift and pull forwards. You should not feel a bulging or downward pressure onto your fingers.

Feel from the inside

A more accurate way of  assessing pelvic floor muscles is by feeling inside the vagina. This can be done in a lying position on your back or on your side. A small amount of lubricant can help. It’s very similar technique to inserting a tampon.

If you are right-handed very gently insert the right index finger (just up to the level of your second knuckle) into your vagina and press on to the left side of the vaginal wall. If you are left-handed insert your left index finger and press onto the right vaginal wall.

Once your finger is in the correct position attempt to perform a pelvic floor muscle contraction as explained above. If you are tightening the muscle correctly you will feel a squeezing and lifting sensation around your index finger.

There are no dangers in assessing your own muscles however some women do not like to touch this area. If you have dry vaginal tissue or some degree of prolapse self assessment may be more difficult.

After reading this post you may find it helpful to watch the video about “How to assess your own pelvic floor muscles”. (available soon on this site)

Don’t worry if you are not able to tighten your pelvic floor muscles. Women who find it really difficult to activate or visualise the action in their pelvic floor muscles can benefit from using;

• Electrical stimulation devices can be used to assist in activating weaker muscles improving endurance and strength
• Biofeedback units can be used to check if you are doing the exercises correctly. The unit will give you a reading when you tighten your muscle correctly and can help you to progress your exercises effectively.
• Alva units use vibration as a means of enhancing pelvic floor muscle contraction.

If you want professional advice speak to your GP who should be able to refer you to a specialist women’s health physiotherapist or a continence nurse advisor.