Weakened pelvic floor, not only after birth

The problem which many women face. During pregnancy your pelvic floor muscles usually tend to get weaker. It is happening mainly because the body of the woman has to widen and prepare for the birth. (more informations in our article: Physiological changes during pregnancy). Because of these reasons, it is possible that you may deal with urine discharge during or after birth, which is happening as a result of increased intra-abdominal pressure (sneezing, coughing, …). In case your problem is „only” in weakened muscles, there is an easy technique which can directly help you.

Try out exercises created and developed by american gynecologist Dr. Arnold Kegel. It is ideal for strengthening the muscles of the pelvic floor, which are levator ani muscle and coccygeus muscle. Main function of these exercises is played by the levator ani muscle, to be more specific the part of it which is attached to the pelvic bone (os pubis) and rectum. This part of the muscle is helping to effectively stop the urine by pressing on the urethra during increased intra-abdominal pressure. In a relaxed state, the urine is held by the urethral sphincters (two muscles which control the exit of the urine from the urinary bladder), but during laughter, sneezing or coughing the involvement of the pelvic floor muscles is needed. If these muscles are weakened, it results in an inadequate tightening of the urethra, which leads to urinary discharge.


  • For women before and after birth
  • Women who suffer from stress incontinence
  • Women with sexual function disorders

Kegel exercises are made of 4 parts:

  • Visualisation and realization
  • Relaxation
  • Isolation
  • Exercising

From the start it is optional to find a peaceful place where you can have privacy. Relaxing music can help you as well.


Use a mirror, so you could assure yourself that you are clenching correct muscles. Look at your own body and try to contract your vagina and rectum. Try to realize which muscle is working and remember it.


In the starting stages of the exercise, start with position where you lie down, so the exercise would be easier for you. The tension of the muscles is lower and you can concentrate. Place your feet below your knees and try to completely relax the abdominal muscles. Focus your concentration of the pelvic floor.


It is important to learn to isolate the contraction of the rectum and vagina. For better isolation try to hold the urine during urination, in order to realize which muscle do you use. Alternatively use two fingers, and place them into your vagina and keep them slightly apart, with adequate contraction they should join. Don’t forget to breath regularly. Avoid holding breath. You should breath with your diaphragm. Be careful to the change of the contraction of the pelvic floor muscles after the contraction of the buttocks and abdominals!


First, try to exercise in a position on your back. After you master that, you can do it into different positions - sitting, standing. Keep your muscles clenched for about 1-7 seconds, and gradually increase the time. From the beginning try to do at least 80 contractions. Gradually increase the number to a total 300 contractions per day. It’s not only important to clench your muscles, you need to learn how to relax them by your will.

Despite that the exercises are very simple, it is important to exercises them correctly, in order to see the effect of it. Therefore it would be optional to consider whether training the exercises with physiotherapist to increase the effectivity, would be ideal for you.

Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic

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