Pelvic Floor Recovery

For pelvic floor strengthen exercises to be effective it is VITAL that you make sure you are performing a PFC (Pelvic Floor Contraction) properly. The muscles have a drawing/lifting up effect. You can check this by using a mirror or inserting a clean (or gloved) finger or two into the vagina and then pulling up.

Secondly you must make sure you are only using your pelvic floor. The stomach, legs and buttocks should all be relaxed. Otherwise you will increase your intra-abdominal pressure and place some strain on your pelvic floor

PFC (Kegels) can be done in any position but try sitting on a chair with your legs slightly apart and your elbows resting on your knees. This position will give you some good feedback as you lift your PF off the chair.

To correctly Kegel, pull up the muscles around your bladder/vagina/anus. You should feel a lifting up effect as you do this. DON’T HOLD YOUR BREATH and count how many seconds you can sustain this before you feel it letting go. As soon as you feel the muscles fatiguing let them go. Make a mental note of how long you could hold for. This will be different for all women – it may be 2, 5, 8 or even 10 seconds. After 10 seconds the muscles will be fatigued even in young women with excellent pelvic floor strength. Rest for about 5-10 seconds between each PFC. Now repeat, holding for the same length of time you held the first one for. Keep doing this rest, contract, rest, contract until you are no longer able to hold the PFC for the same amount of time.

For example, you may have held the first PFC for 8 seconds, and you did 5 of them for 8 sec, but the 6th one you could only hold for 6 sec before it tired (and if you tried another maybe only held it For 4 sec) Then your exercise regime would be to do 5 PFC holding each for 8 sec. Also see how many quick PFC you can do before you notice fatigue. Say you can do 6 of these. Then you full ex routine would be: 5 PFC holding for 8 secs and 6 quick PFC.

You then do this at least 3 times per day. Trying to find several times per day to do them well WILL be much more effective than trying to do them all day with other activities. Over the next weeks you will find that now you can still hold for 8 seconds, but instead of doing 5, you can now do 7 of them. Then you might find that after a few more weeks you can still manage 7 of them, but you can now hold for 9 sec. And so it goes on.

PF rehabilitation takes many months. Most women show considerable improvement within 6 months. It is also worth learning to brace the PF by tightening the muscles every time you go to cough, sneeze (even laugh) or pick up anything heavy (more than about 10lbs.) This becomes very automatic after a while.

Ideally to really get some good feedback it is worth measuring your PF with a perineometer. Then you can see when your muscles are fatiguing. Most of my patients find this very helpful and cues them into the quality of their PFC. We can do this for you at the clinic once a month or so if you wish.

The important thing is to work you PF like any at muscle you want to build up – at your own pace. Whether you can hold for 2 seconds or 10 seconds, work at your own pace and don’t overdo it. If you end up being sore after doing Kegels, then you HAVE overdone it.

Also, be aware that women who are breastfeeding can have some lower PF tone than those who have weaned. I do not advocate early weaning to improve PF tone, but some women may find that when their hormonal levels return to normal that their PF tone improves somewhat naturally.


Source Credit: Dr. Trevor A. Wing, The Women’s Natural Health Clinic

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