Kilcock Therapy 087 2848409 Pelvic Floor Exercises

Pelvic Floor exercises are indicated to prevent and reverse both urge Incontinence and Stress incontinence.

Incontinence = Involuntary leaks of urine. Affects both genders though women have a greater risk of developing.Prevalence:Monthly – 46.7% of cohort of midlife women, Several Days a week or more: 15% (1). Men: 34% for older, 5% for younger

Stress Incontinence: Involuntary leaks that occur on effort or exertion, coughing or sneezing.

Urge Incontinence: Involuntary leaks accompanied by a strong sudden desire to pass urine which is difficult to defer.

Mixed Incontinence is a mix of both stress and urge incontinence.

Urinary Incontinence can seriously affect physical function, psychological wellbeing and quality of life.

Week 1
Become aware of your pelvic floor. Practice contracting posterior (anus), middle (vagina) and anterior (urethra) sections – you won’t be able to fully contract each separately but you can begin a contraction anterior and then pull up middle and posterior or vice versa. (Imagine stopping a pee, holding something in your vagina, stopping a fart).
30 (10 morning, 10 afternoon, 10 evening) short 3 second contractions at sub max(i.e strong but not as hard as you can.
3 x 15 second contractions at sub max.
Week 2
45 (15 morning, 15 afternoon, 15 evening) x 3 second contractions at sub max
3x 20 second contractions at sub max
Begin to Contract muscles before cough, sneeze, laugh, lifting heavy object
Week 3-6
60 (20 morning, 20 afternoon, 20 evening) x 3 second contractions at sub max
3x 30 second contractions at sub max
Continue to Contract muscles before cough, sneeze, laugh, lifting heavy object
eek 6-12
60 (20 morning, 20 afternoon, 20 evening) x 3 second contractions at sub max
15 at max x 8 seconds
3x 60 second contractions at sub max
Build in doing contraction during movements such as: during sit to stand, stepping forward, backward, sideways, going up stairs, running on the spot.

Top Tip: ‘knack manoeuvre’ – 3 quick strong pelvic floor contractions at max – great for urge incontinence – gives you time to safely get to the toilet avoiding any leakage.

How do pelvic floor exercises work?

Reduces stress urge incontinence by improving urethral closure and pelvic organ support. A properly timed pelvic floor muscle exercise can stop stress urge incontinence by compressing the urethra against the symphysis pubis,(3).

How do we know it works?

Research shows very good evidence that this works – The highest Level of evidence (Level 1)

1.Guccione A, Wong R, Avers D; Geriatric Physical Therapy, 2012, Elsevier, Chapter 20.

2.Waetjen LE, Liao S, Johnson WO, et al: Factors associated with prevalent and incident urinary incontinence in a cohort of midlife women: a longitudinal analysis of data: study of women’s health across the nation. Am J Epidemiol 165(3):309-318, 2007.Medline abstracts

3.DeLancey JOL, Fowler CJ, Keane D, et al: Pathophysiology. In Abrams PKS, Wein A, editors: Incontinence, first international consultation on incontinence. Plymouth, UK, 1999, Health Publication Ltd., pp 227-294.

4.Burns PA, Pranikoff K, Nochajski TH, et al: A comparison of effectiveness of biofeedback and pelvic muscle exercise treatment of stress incontinence in older community-dwelling women. J Gerontol 48(4):M167-M174, 1993.

5.Bo K, Talseth T, Holme I: Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. BMJ 318(7182):487-493, 1999. Medline abstracts

6.Henalla SM, Hutchins CJ, Robinson P, et al: Non-operative methods in the treatment of female genuine stress incontinence of urine. J ObstetGynaecol Can 9:222-225, 1989

7.Berghmans LC, Hendriks HJ, Bo K, et al: Conservative treatment of stress urinary incontinence in women: a systematic review of randomized clinical trials. Br J Urol 82(2):181-191, 1998. Medline abstracts

8.Shamliyan TA, Kane RL, Wyman J, Wilt TJ: Systematic review: randomized, controlled trials of nonsurgical treatments for urinary incontinence in women. Ann Intern Med 148(6):459-473, 2008. Medline abstracts

9.Dumoulin C, Hay-Smith EJC: Pelvic floor muscle training versus no treatment, or inactive control treatments for urinary incontinence in women. Cochrane Database Syst Rev (1):CD005654, 2006.

10.Goode PS, Burgio KL, Locher JL, et al: Effect of behavioral training with or without pelvic floor electrical stimulation on stress incontinence in women: a randomized controlled trial. JAMA 290(3):345-352, 2003. Medline abstracts

11.Herbison P, Plevnik S, Mantle J: Weighted vaginal cones for urinary incontinence. Cochrane Database Syst Rev (1):CD002114, 2002.