Doorstepping (an uninvited intrusion on your doorstep)

Doesn’t it always happen when you’ve been out on the shop and just as you reach your front door, hands full of parcels, your phone starts ringing while your rummaging to find your keys at the bottom of your bag and suddenly you need to cross your legs urgently because you need to wee now! 

I know it’s not just me, because I’ve heard the same story from so many other women, and not just older women.  In spite of having two children and too many stiches with the first one, a premature breech birth, I was always rather proud of my pelvic floor muscles.  But back in the day I was very fit and exercising all my muscles regularly until I started a new, office-based career where I spent an awful lot of time sitting on my bottom and exercising my brain.  It must have crept up on me slowly, but some twenty years later there came a day when holding on was not working like it used to and there were occasions where that doorstep moment led to a flood of embarrassment!  Particularly embarrassing for me as in my previous career in teaching and writing about health and fitness I had always championed the pelvic floor muscles and so had no excuse to have let them go, but that’s just what I did.

So wherever you are when you’re reading this please give your pelvic floor muscles a little squeeze because they are absolute stars.  If you’ve lost touch, let me remind you that your pelvic floor muscles are the layers of muscles that run between across your pelvic basin between your pubic bone and your coccyx.  They hold your abdominal contents in place and through them pass your urethra, vagina and anus.  These are surrounded by sphincter muscles, which are configured in a figure of eight, and which keep a grip on things.  Your pelvic floor muscles are like Atlas holding up the world, but when you cough, laugh, sneeze or jump about it’s like someone giving the world a big shove from above, so Atlas has to brace himself to stop his knees from buckling! I hope you get the picture.

If your pelvic floor muscles are truly shot I can’t promise you they will ever fully regain their former glory days, or restore full control if you have stress incontinence (would be better named distress incontinence), but you can certainly help prevent them from getting weaker and hopefully gain some extra strength in them.

Like all exercise, to be effective you have to work your muscles regularly – remember the old adage, use it or lose it!  But here’s the thing, your pelvic floor muscles are also your pleasure muscles, so rather than being a chore you could think of these exercises as being a bit more like fun – see exercise 4…

You can do these exercises sitting, standing, or lying down with your knees bent.   It’s no longer recommended to practice these exercises sitting on the lavatory and trying to stop your wee flow mid-stream.

Exercise 1 – the basics:  If you’re out of practice I would recommend stating lying on you back with your knees bent.  First, relax and take a deep breath in.  Breath out slowly to a count of three as you tighten your vagina and your wee muscle (urethra) as if you were holding back your wee.  Hold for a couple of seconds, still breathing out, and then breath in as you slowly release the muscles.  Repeat, building up to ten repetitions.  Don’t worry if you can’t coordinate with your breathing and squeezing at first, just focus on activating the muscles, but don’t hold your breath!  Repeat this sequence several times a day.

Do any of you remember an exercise called, The Lift?  The lift involves starting at the opening of your vagina and then slowly tightening upward from there until you reach the top floor (up towards the top of your vagina). Hold for a couple of seconds and then – and here’s the hard part – slowly release downwards floor by floor.  Try not to let your lift go into free-fall!  If you’ve neglected your pelvic floor muscles for years this is going to take practice, but please persevere.  It’s better to do a few sets of exercises throughout the day, than to try and do too many all in one go until you have muscle fatigue.  If you persevere you will soon start to build up strength.

Exercise 2 – back to front: In this exercise focus on your back passage and tighten the area around your anus (back passage).   Same breathing, same trying to close from the outside and squeeze in and upwards, then releasing slowly.  Repeat a few times. 

Best to try the next bit lying down at first.  Starting at your back passage squeeze in and then forwards towards the front of your pelvis (pubic bone), via your vagina and wee muscle, pulling in and up through the full length of your pelvic floor muscles.  Try it also in reverse, going from front to back.

Exercise 3 – side to side: This one may need a bit of mental imaging to help you squeeze inwards from sitting bone to sitting bone, pulling in from the sides of your pelvic basin.  Same breathing and repetitions as above.

The brilliant thing about the basic pelvic floor exercises is that you can do them anywhere and at any time, at home, at work or even on the bus, because no one can see!  Some people find it helpful to set themselves reminders throughout the day, such as before meals.

Exercise 4 – get a grip:  For those of you of a more sensual nature or who would like some biofeedback, you might want to test your strength by inserting one or two fingers into your vagina and squeezing.  You can also try this with your partner…Another of my favourite exercises is to imagine you are chewing soft fruit in your vagina using a gentle squeezing and releasing motion.

Whatever exercises you choose to work your pelvic floor don’t end with everything slack and relaxed; always finish off with a little pull up. 

If you’re worried about any form of incontinence, please don’t be shy about seeking help from your doctor.  It is a hugely common problem and, depending on the cause, there are medical interventions that can help.  In the meantime, keep up exercising your pelvic floor muscles – oh, and my final tip is to have your front door keys in your pocket for quick access when you’ve been out and about!