One of the most important muscle groups in humans is located in the lower pelvic area: the pelvic floor. It is located between the pubic bone and the coccyx and is bordered laterally by the ischial tuberosities. Its multi-layered network of muscles and connective tissue keeps the bladder, intestines and uterus in place and stabilizes the abdomen and back. It also envelops the vagina, rectum and urethra.
Its first of three main functions is tensing to protect the lower part of the urethra, the sphincter of the urinary bladder and the anus against incontinence. The second function of the pelvic floor is to relax for urination, defecation, orgasm and erection of the man. The third function is to counter external loads.
The pelvic floor muscles are involved in the interaction with other muscle groups; it works with respiratory, abdominal and back muscles. All this happens involuntarily, but can also be trained consciously. This is especially important in cases where stability decreases.
Why is it important to train the pelvic floor?
Early pelvic floor training without external cause prevents later impairments and diseases. In old age, the pelvic floor can weaken and the very unpleasant urinary incontinence occurs. The intestines can also be affected by incontinence.
The dreaded pelvic floor prolapse occurs especially after pregnancies. That’s why it’s important to practice and perform pelvic floor exercises, especially during pregnancy and after childbirth. The earlier you start here, the easier it will be after birth and after surgery to rebuild the weakened muscles and counteract uterine prolapse.
In women and men, the pelvic floor can also weaken after prostate surgery. Incontinence, erection problems and organ prolapse can be a consequence here. With targeted training, it is also possible to prevent this and build up and strengthen the muscles after the procedure.
Strengthen the pelvic floor muscles
The particular difficulty of strengthening this type of musculature lies in the fact that it is barely noticeable. If you want to strengthen the pelvic floor muscles, it is first important for the exercise effect to feel the region exactly and to know where the tension must lie. With a simple tactile exercise, you can easily find out how it feels and what you need to focus on in all the exercises.
In a comfortable supine position, men can feel the perineum between the scrotum and the anus. In women, the region lies between the vagina and the anus. Now it is necessary to pull this perineum as high as possible towards the body. If tension can be felt here, the right muscles have been hit. Once the patient has consciously noticed the pelvic floor muscles, it becomes easier from exercise to exercise to tense them and maintain this tension.
Exercises for strength, endurance and speed train the pelvic floor very effectively:
- For strengthening , it is used to tighten the muscles firmly, hold them for five seconds and then let go. This exercise should be repeated 15 times.
- During the endurance exercise , the pelvic floor is slightly tensed so that the tension is just noticeable. This position is held for 25 seconds.
- During the exercise for speed strength , 10 times is briefly and firmly tensed and relaxed again.
Combine these exercises as you like to strengthen the pelvic floor. They can be done two to three times a day, in any place and on any occasion, without the need for special aids.
Relaxation and relief for the pelvic floor
A tight pelvic floor can be painful and lead to an annoying urge to urinate. That’s why targeted exercises to relax the pelvic floor are also important.
Exercises for pelvic floor relaxation:
- Sitting comfortably on the seat of a chair and alternately pushing your knees forward out of the pelvis helps your muscles relax.
- In a relaxed supine position, tighten your legs and let them slowly tilt to the side, placing the soles of your feet together as much as possible, exerting light pressure on the perineum with your hand, holding for 30 seconds and relaxing.
Stretching the muscles also serves to train tension and relaxation:
- Sit on a chair with a folded towel under one half of your buttocks, sit like this for about five minutes, and then slide the towel under the other half of your buttocks.
- Placing a hot water bottle on your stomach not only relaxes, but also promotes blood circulation in the pelvic floor.
Tips and exercises to strengthen the pelvic floor
To support the pelvic floor muscles, it is helpful to have well-trained abdominal and back muscles. It is also useful to adopt the correct posture when picking up and carrying objects, consciously tensing the pelvic floor. In addition, it relieves the pelvic floor if the head and upper body are turned sideways backwards when coughing and sneezing.
exercises on exercise balls and seat cushions make it easier to feel the pelvic floor; a hula hoop strengthens the muscles around the abdomen. Endurance sports such as swimming, jogging, walking or cycling also help to train and strengthen your muscles.
Two other popular pelvic floor exercises:
- One-sided legstand
Stand upright and extend both arms to the sides, bend the right leg and pull towards the chest, this position is held for a couple of seconds, then performed with the left leg. This exercise automatically tenses the pelvic floor and also promotes coordination and a sense of balance.
- Two-legged pelvic lift
In the supine position, with heels firmly placed in the ground and the pelvic floor tense, the pelvis is raised. It is ideal if the thighs and upper body form a straight line. The tension is held for a few seconds, then the pelvis is slowly lowered again. If you are already a little more advanced in gymnastic exercises, you can intensify the effect and alternately lift your legs and stretch them horizontally into the air. This exercise also strengthens the hamstrings, buttocks and lower back.
Discover more pelvic floor exercises.
Pelvic floor aids for training
Women have the opportunity to strengthen their pelvic floor muscles from the inside with special aids. For this purpose, balls, cones or similar aids (vaginal cones) are inserted into the vagina. These increase the training effect of the exercises.
Vaginal cones are weights of different sizes that are inserted like a tampon. They sit properly when they can no longer be felt. Training starts with the lightest cone. If this can be held for more than a minute without effort while walking or standing, the next heavier cone can be inserted. Exercise time should be 15 minutes twice a day.
Some versions can be connected to the smartphone and give biofeedback on the training success.
Mothers can also incorporate pelvic floor exercises with balls or vaginal cones in a postnatal program immediately after giving birth, but only carefully and gently for the first eight weeks.
Pelvic floor trainer for Android and Apple
In the meantime, there are also pelvic floor trainers with an app that can be connected to the smartphone via Bluetooth and offer various training programs for practicing. The trainers are made of medically safe silicone, waterproof and easy to clean. They are offered as cones and are only slightly larger than a tampon. They can be adjusted in size by means of different attachments.
After insertion, pressure sensors measure the contractions of the muscles and provide real-time feedback via the app. For example, the workouts last between 5 and 20 minutes and consist of different exercises and levels of difficulty that are completely tailored to the needs of the practitioner. Some devices now offer exercises that are combined with games, so that the entire training is done in a more playful way. Through regular updates, new exercise variations can occasionally be called up.
Some providers of pelvic floor trainer apps cater to the individual needs of the practitioners. For example, they can choose a preventive program, a program for the time before and after pregnancy, an urge incontinence program, a stress incontinence program or an intimate well-being program for their training.
Pelvic floor trainer as therapy
Pelvic floor trainers in physiotherapy
In physiotherapy practices, special equipment for pelvic floor training is available, with which patients can train fully clothed. They are instructed by the physiotherapist on the pelvic floor trainer and then test their muscle strength.
Such a device can determine which areas need special training. From this, a suitable training plan is created. On the monitor, the patients track their training successes during the course of the treatment. For this type of training, the family doctor or gynecologist can, if necessary, issue a prescription for physiotherapy with pelvic floor training.
Pelvic floor trainer on prescription
Diagnosis of incontinence – this is unpleasant and the suffering of those affected is great! In some cases, reaching for an adult diaper can be avoided altogether or delayed for years by pelvic floor training.
If the doctor makes the diagnosis of “stress urinary incontinence” or “stress incontinence”, then there are various options for therapy. Among other things, there is then the possibility to get a pelvic floor trainer on prescription for home, and to pay only a small additional payment yourself.