Learn how to do pelvic floor exercises correctly with this Pelvic Floor Physiotherapist self examination guide.
Two self examination techniques are described below to help women find and feel their pelvic floor muscles working with the correct technique:
- How to do pelvic floor exercises using external self examination; and
- How to do pelvic floor exercises using internal self examination.
Please note: physiotherapist video instructions in both these techniques are also freely available by accessing our complimentary pelvic floor exercises video on the upper right side of your screen now
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How to do Pelvic Floor Exercises Correctly?
Correct pelvic floor exercises involve lifting and squeezing all the pelvic openings together (i.e. anus, vagina and urethra or opening to the urine tube). Ideally you should feel a lifting and squeezing sensation in and around the area where you sit.
Try not to feel disheartened if this is difficult to feel, especially when first starting out, some women feel only a small flicker of movement or nothing at all. Many women find they have more sensation of correct pelvic floor muscle exercise when they start this technique by lifting and squeezing in and around the anus (as if trying to stop wind from escaping).
Technique 1: How to do Pelvic Floor Exercises (External Examination)
This technique is ideal for feeling how to do pelvic floor exercises, particularly if you feel uncomfortable with internal self examination (outlined next).
Position: Lay on your side with a pillow between your legs and your knees slightly bent. With clean hands, use your index and third fingers to locate the area of skin between your vaginal opening and your anus. This area of skin is called the perineum shown in Diagram 1.
Your perineum can be felt through your underwear or by directly placing your fingers on your skin. Reach your arm either in front or behind your body to access your perineum.
- Step 1 – Have a small cough and feel your perineum push down or bulge out slightly against your fingers. This is the exact opposite of what you should feel with correct pelvic floor exercise.
- Step 2 – Try to lift and squeeze your pelvic openings with your fingers touching your perineum. You should feel the skin under your fingers move inward, rather than bulging outward as it did when you coughed. Try to maintain the lift and squeeze of your pelvic floor muscles as you breathe normally for up to 10 seconds.
- Step 3 – Fully relax your pelvic floor muscles. You may feel your perineum lower down slightly and it should return to its original resting position. Take a rest and recover fully before your next attempt. Wash your hands when you finish your session.
Technique 2: How to do Pelvic Floor Exercise (Internal Examination)
This is an excellent technique for feeling your pelvic floor muscles working correctly.
Avoid this technique:
- During pregnancy;
- During the first 6 weeks following childbirth;
- With active pelvic infection; and
- During early recovery from gynaecological surgery.
Position: As for Technique 1. Wash your hands before you commence and position yourself lying on your side rather than on your back.
Step 1: Use a small amount of lubricant if required and insert either your index finger or your index and third fingers to a depth of approximately 2cm.
There are two groups of pelvic floor muscles that you may be able to feel working within your vagina as you perform your pelvic floor exercises. Refer to Diagram 2 to help you find and feel your pelvic floor muscles within your vagina.
Step 2: Feel the back wall of your vagina at a depth of 1-2cm as you use the correct technique for activating your pelvic floor muscles already discussed (i.e. lift and squeeze all your pelvic openings). As you lift and squeeze your anus, you should feel the back wall of your vagina move your finger inwards and slightly forward. You may need to try a couple of times and move your finger a little to get the best position for feeling these muscles. These pelvic floor muscles are your Puborectalis or PR muscles. These are often the easiest of the pelvic floor muscles to self examine.
Step 3: Move one or two fingers a little further into your vagina to approximately 2-3 cm and feel one of the side walls of your vagina. Once again lift and squeeze your pelvic openings. This time you should feel the side wall under your finger move your finger inwards as if squeezing your finger and upwards. If your pelvic floor muscles are in good condition you may even feel both side walls of your vagina squeezing inwards against your finger at the same time. These are your Pubococcygeus pelvic floor muscles and are commonly known as the PC muscles.
Step 4: Try to maintain the lift and squeeze of your pelvic floor muscles while feeling your pelvic floor muscles.
Step 5: Fully relax your pelvic floor muscles back to their original resting position. Wash your hands thoroughly when you have completed your session immediately following internal examination.
Regardless of the technique you choose to use, remember that learning how to do pelvic floor exercises correctly takes time involving regular practice and perseverance. With practice using the techniques described above, you will become much more familiar with the feeling of correct pelvic floor exercise. As your confidence and strength improve, you will learn to activate your pelvic floor muscles without having to self examine. Then you can use these techniques to occasionally monitor pelvic floor muscles becoming stronger.