The importance of pelvic floor exercises before, during and after pregnancy 

The pelvic floor muscles are those which are attached to the pelvis, and they support the bladder, bowel, uterus and genitals. Problems with these muscles, known as pelvic floor dysfunction, is a common issue for women of all ages. 

The National Institute of Clinical Excellence (NICE) highlighted in their 2021 guidelines on the prevention and non-surgical management of pelvic floor dysfunction, that up to 50 per cent of women were identified as having some degree of pelvic organ prolapse when examined.

Pregnancy and labour in particular can put huge strain on the pelvic floor muscles over a relatively short period of time. They are also affected by the hormone relaxin, which allows the muscles and ligaments to elongate. This is essential to creat new space for the growing fetus and allow natural delivery to happen. However, it can lead to weak muscular structure, leading to a number of issues. These include:

• Organ Prolapse

• Incontinence – including leaking urine when you cough, laugh or sneeze

• Pelvic and lower back pain and discomfort

• Bowel issues

• Pain and discomfort during sex

Nevertheless, pelvic floor dysfunction can be prevented with lifestyle changes and simple exercises. These are important for women at all stages of life, but none more so than during and after pregnancy.

For most people, adding specific pelvic floor exercises into their daily routine both pre and postnatally is a simple way to strengthen these muscles and maintain overall pelvic health. Some of the key exercises, known as Kegels, you can do to help include:

• Long squeezes – sit or lie comfortably and squeeze your pelvic muscles tight. Try to hold it for a few seconds, increasing the hold time as your muscles strengthen. Repeat until the muscles fatigue.

• Short squeezes – sit or lie comfortably; this time quickly tighten your pelvic floor muscles and relax them straight away. Repeat until the muscles fatigue.

With both exercises, avoid holding your breath or tighten your abdomen, buttock or thighs, and fully relax the pelvic floor muscles after each squeeze. Aim to be able to do 10 long squeezes, holding each squeeze for 10 seconds, followed by 10 short squeezes and you should try to repeat the sequences three times a day.

You can find more information about pelvic floor exercises on the Pelvic Obstetric and Gynaecological Physiotherapy (POGP) website here. You can also download the Squeezy App, which comes pre-set with an exercise plan recommended by a pelvic health physiotherapists. You can then set reminders to help you remember to do your exercises throughout the day. 

For some patients, pre and postnatal physiotherapy can also be hugely beneficial to both treat and prevent pelvic floor weakness and the issues that come with it.

At Physiomove, our women’s health specialist will assess you establish a treatment program, helping to rehabilitate and strengthen the weakened muscles, as well as advising you on lifestyle changes. Including diet and fitness, as well as good bowel and bladder habits. Assessments are also beneficial for the preventative stage such as early pregnancies.

If you think you would benefit from speaking to one of our physiotherapists about preventing or treating pelvic floor dysfunction, contact us today.