Advice and exercises for abdominal and pelvic floor muscles following gynaecological surgery
Stomach and pelvic floor - women
After surgery it is very important to train the pelvic floor, to maintain and strengthen muscles. A weak pelvic floor can lead to;
- Involuntary passing of urine, stools and wind
- Unsatisfactory sex life
- Pains in the lower abdomen and uterus
- Prolapse of the pelvic organs, bladder or intestines.
Side view of a woman’s bladder and related structures
The pelvic floor muscles are about 1 cm thick and wrap around the base of your pelvis, keeping your pelvic organs (uterus, bladder and rectum) in the correct position. The pelvic floor has openings to the urinary tract, vagina and rectum. The pelvic floor has to resist rises in pressure from the stomach. To oppose this pressure, the pelvic floor must be strong and durable. It is therefore important to tighten the pelvic floor muscles before:
- You get up or sit down
- You lift objects
- You laugh or cough or sneeze
- Exerting yourself physically ex when hopping.
Training the pelvic floor
The pelvic floor muscles function as all other muscles in our bodies and become stronger by exercise. Concentration is required to tighten the pelvic floor - this is called ”squeezing”.
When weakened the muscles must be tightened. It is best to start training with an exercise lying on your back.
Try to squeeze the rectal muscles, as if you were trying to stop passing wind. This will close the vagina and urinary tract, but you won´t really feel much around this area. Keep your buttocks still, and refrain from sucking your tummy in or holding your breath. Furthermore do not push your knees together. You should be able to make these squeezes for 2-3 seconds, then they will naturally reside and you can repeat this 4 to 6 times before you start tightening all the other areas - then take a break.
Training the pelvic floor in different positions
- Lie on your back with bent legs
- Lie on your side with bent legs
- Sit on a chair or stool and lean slightly backwards.
- Sit on a chair and lean forwards.
- Stand up with your legs a little bit apart.
How can you test if the pelvic floor is tightened?
There are 3 ways to test if you are tightening the pelvic floor:
- Try to stop the flow of urine when you go to the toilet. In the beginning it’s easier to achieve near the end of the flow. Do not repeat this too often, as it can cause problems with emptying your bladder and result in urinary infections.
- Lie on your back with bent legs and place a couple of fingers on the perineum, the flesh between the vagina and rectum. Push your fingers upwards and make a pelvic floor contraction. Feel the area contracting upwards and becoming tighter. Relax and feel the area returning to the starting position.
- Lie on your back with your legs bent and place your index and middle fingers inside your vagina. Tighten and feel how the pelvic floor, which is the lowest third of the vaginal canal, pushes on your fingers and lifts them a little upwards (remember the pelvic floor is only about 1 cm thick). Relax and feel how everything softens.
How often should you exercise?
You should do the exercises 2-3 times a day. The contractions or squeezes should last a maximum of 6-8 second and then relax for 10 seconds.
Repeat the contractions at least 5 times and a maximum of 20 times alto-gether. Depending on the type of surgery you have undergone, it can take up to 3-6 months to train the pelvic floor back to normal.
Recovery depends on:
- The strength of the pelvic floor when you begin exercising.
- How committed you are to the exercises.
- Exercise at the same time every day, so the exercises fit in with your daily life.