It's rarely too late to start.
Strengthening your pelvic floor muscles can reduce incontinence, and you can begin during pregnancy, or well before it. Whether you are dealing with bladder control issues or simply want stronger pelvic muscles, there are exercises that can help, done on your own or with a physical therapist's guidance. It is best to check with your health care provider before starting any new exercise routine.
How pelvic floor exercises work.
Pelvic floor muscles sit deep in the groin, hold the bowels in place, and help prevent gas from escaping the body; they are also the muscles you engage to stop urine mid-stream. They can weaken with age or become injured during childbirth. Pelvic floor exercises can be done lying down, sitting, or standing, and if you are doing them seated, breathing properly matters, since improper breathing makes the exercises harder to perform correctly. One approach: lie on your back, bend your knees, engage your core, and lift your buttocks off the floor for about a minute, holding for a count of eight. If you cannot hold it that long yet, work up to it gradually. Aim for three sessions a day, and if you have difficulty, check in with your doctor or physical therapist.
Pregnancy is a good time to start.
During pregnancy, the pelvic floor works overtime to support a growing baby, which makes it a good time to raise any concerns with your doctor before they worsen, and to start a regular postpartum care plan. Pelvic floor physical therapy can help strengthen the pelvic floor and also help manage constipation, sciatica, and pelvic pain that can occur during pregnancy or postpartum. A pelvic floor physical therapist can teach safe exercises, including perineal massage, which may help with urinary incontinence, along with movements like deep squats, the butterfly stretch, the happy baby stretch, and the bridge stretch. This kind of therapy is considered safe during pregnancy, and it helps women better understand their own bodies. A therapist can assess muscle tone and function, palpate the pelvic floor to locate problem areas, and recommend which exercises, and which modifications, are right for you.
Treating incontinence.
Continence problems, including urinary incontinence, incomplete voiding, and straining, can be treated in several ways: medication, surgery, behavior modification, and pelvic floor physical therapy, which is often the first line of treatment. A physical therapist can help strengthen and tone the pelvic floor muscles while also improving posture and core strength. Treatment typically includes exercises like Kegels, active contractions of the pelvic floor that work similarly for men and women and can reduce the frequency of stress incontinence episodes. When incontinence is severe, surgical options may be considered, sometimes combining pelvic floor therapy with a minimally invasive midurethral sling, a short in-clinic procedure that supports the urethra.