Pelvic floor training

This is brief information about pelvic floor training.

We do not know for certain what is optimal when it comes to how often, for how long, and how many contractions are best for the different symptoms for which we recommend pelvic floor training. But the pelvic floor carries the weight of our bodies, apart from the legs, throughout a long life, so both with and without symptoms it is wise to train it regularly.

We know that about 40% of those who have leakage when coughing, sneezing, or during physical activity, and who train regularly with good technique, get rid of the leakage.

After childbirth, retraining the pelvic floor can help prevent leakage later. Pelvic floor training can restore some of the anatomical changes in the vagina that occur after childbirth, and it stabilizes the pelvis and lower back.

When you are building strength, it can be useful to train often over a short period. For 3 months, you can try training every day, perhaps 2-3 times daily, with 8-10 contractions each time.

Keep your full focus when training until you have good technique and notice an effect from the training.

Increase the duration of each contraction, and the rest between contractions, as you get stronger.

You can then maintain by training 3-4 times weekly, about 10 minutes each time.

It is important to find the right muscles. The pelvic floor muscles form a ring around the vaginal opening and a ring around the anal opening. Let the muscles in your buttocks, thighs, and abdomen rest. When you contract correctly, you feel the vaginal opening lift slightly upward and tightening around the anus.

Rest for as long between each contraction as the contraction itself lasts. Make sure you fully release the pelvic floor before you start counting the seconds of rest.

This will also improve circulation in the muscles and help you avoid a tight, sore pelvic floor.

If you are training the pelvic floor because of tight, sore muscles, what we call vaginismus, we recommend that you look at vulva.no -> Pasient -> Sykdommer og tilstander -> Vulvodynier -> Vaginisme -> Behandling -> Bekkenbunn for good information.

There you will also find good videos for relaxation exercises and stretching.

Repeat as many times as you can during the time you have set aside.

You can also practice the "elevator" exercise.

"Elevator": Contract as much as you can, hold for 4 seconds. Contract a little more, hold for 4 seconds. Release partially, hold for 3 seconds. Release completely and relax for 15 seconds. Repeat

Maintenance means contracting the pelvic floor 3-4 times weekly for 5-10 minutes each time, still with full focus when you contract and equal emphasis on rest and contraction.

You can vary between short, quick contractions, holding for as long as you can, the elevator exercise, and 7-second contractions.

After a pelvic floor training session, it is useful to stretch the pelvic floor for a few minutes on each side. A simple way to stretch is by stretching the inner thighs, but there are also dedicated videos with different stretches. Search, for example, for "Pelvic floor stretches".

There is an app called "Knipeøvelser" published by GynZone that is good. It costs around NOK 50.

There is also a doctor-developed pelvic floor training game, Perifit, which has received positive feedback from many patients who use it. It costs around NOK 2000. It uses a sensor inserted into the vagina that registers both contraction and relaxation of the pelvic floor. The sensor connects via Bluetooth to an app containing different games. See http://www.perifit.se for more information.

An overview of physiotherapists who can help can be found at quintet.no. Open the tab called "Behandlere" and search in your area. Some physiotherapists have public funding agreements and are part of the public health service, while others are private practitioners.