How do you exercise the pelvic floor in the elderly? A Comprehensive Guide

It is estimated that up to 50% of older women experience pelvic floor disorders, but effective exercises can significantly improve quality of life. Learn how do you exercise the pelvic floor in the elderly to safely strengthen these vital muscles, addressing common issues like incontinence and prolapse. This guide offers practical, gentle routines designed for seniors.

Quick Summary

Engaging the pelvic floor in older adults involves gentle, focused exercises like Kegels, diaphragmatic breathing, and modified yoga poses, which can be performed while seated or lying down. Consistency is vital for strengthening these muscles and improving bladder and bowel control over time.

Key Points

• Start Simple: Begin with gentle exercises while lying down, as gravity is less of a factor and it's easier to isolate the correct muscles.

• Consistency is Key: Daily practice is more important than intense, infrequent workouts. Aim for short, frequent sessions throughout the day.

• Avoid Straining: Never hold your breath or use your abdominal, thigh, or buttock muscles. The focus should be entirely on the pelvic floor muscles.

• Coordinate with Breathing: Link your muscle contractions with your breath, tightening on the exhale and relaxing on the inhale to maximize effectiveness.

• Know When to Get Help: If you can't feel the right muscles or experience pain, consult a pelvic health physiotherapist for personalized guidance and support.

• Integrate into Daily Life: Tie your exercises to daily habits like brushing your teeth or watching television to make them a routine part of your day.

Understanding the Importance of Pelvic Floor Health in Seniors

As we age, the muscles of our body naturally lose some of their strength and tone. The pelvic floor muscles, which support the bladder, bowel, and uterus, are no exception. For many elderly individuals, this weakening can lead to a range of challenging conditions, most notably urinary and fecal incontinence. Beyond the physical discomfort, these issues can lead to social anxiety and a significant decrease in quality of life. By understanding the importance of pelvic floor exercises and incorporating them into a daily routine, seniors can regain confidence and independence.

Identifying Your Pelvic Floor Muscles

Before beginning any exercises, it is crucial to properly identify the pelvic floor muscles. For many, this is the most difficult step. A common way to feel these muscles is to imagine you are trying to stop the flow of urine midstream. The muscles you use to do this are your pelvic floor muscles. However, it is important not to make a habit of stopping urination midstream as this can disrupt normal bladder function. Another method is to imagine you are holding back gas. The squeezing sensation around your anus engages the same set of muscles. For women, the feeling is often described as a lifting or tightening sensation around the vagina and anus. For men, it is a tightening sensation around the anus and the base of the penis. If you struggle to feel these muscles, it can be beneficial to consult a pelvic health physiotherapist.

Preparing for Your Exercise Routine

Starting any new exercise regimen requires preparation. For seniors, this means prioritizing safety and comfort. Choose a quiet, private space where you will not be interrupted. Lie down on a firm, comfortable surface, such as a carpeted floor or a firm bed, with your knees bent and feet flat. As you become more confident, you can also perform the exercises while seated in a supportive chair with good posture. Always wear loose, comfortable clothing that does not restrict movement. Finally, remember to breathe normally throughout the exercises. Holding your breath can increase abdominal pressure and put unnecessary strain on the pelvic floor.

Step-by-Step Pelvic Floor Exercises

Pelvic floor training is not about intensity, but rather consistency and proper technique. Here are some basic exercises suitable for most seniors:

1. Slow Kegel Contractions:

   • Assume a comfortable position, lying on your back or sitting in a chair.
   • Squeeze your pelvic floor muscles as if you are stopping urination or holding back gas.
   • Hold the contraction for 3 to 5 seconds. Avoid using your buttocks, thighs, or abdominal muscles.
   • Slowly release the contraction and relax completely for 3 to 5 seconds.
   • Repeat this process 10 times. Gradually increase the hold time as your strength improves.

2. Quick Kegel Contractions:

   • In the same comfortable position, perform a quick, strong squeeze and release of the pelvic floor muscles.
   • Do not hold the contraction. Focus on the swift, powerful engagement and release.
   • Repeat 10 to 15 times, resting for a few seconds if you feel your muscles fatiguing. These quick contractions are important for immediate support during activities like coughing, sneezing, or lifting.

3. Diaphragmatic Breathing:

   • Lie down and place one hand on your chest and the other on your stomach.
   • Inhale deeply through your nose, allowing your belly to rise. Feel your pelvic floor muscles naturally relax and lengthen.
   • Exhale slowly through your mouth, gently pulling your navel towards your spine. This subtle movement will help engage your pelvic floor muscles.
   • Repeat for 5 to 10 minutes. This exercise helps coordinate your breathing with your pelvic floor movement, promoting relaxation and awareness.

4. Pelvic Tilts:

   • Lie on your back with knees bent and feet flat on the floor.
   • Flatten your back against the floor by tightening your abdominal muscles. Your hips will tilt slightly upward.
   • Hold for a few seconds, then release and return to a neutral position. Repeat 5 to 10 times. This strengthens the lower abdominal muscles, which work with the pelvic floor for core stability.

Comparison of Exercise Positions

Different positions can affect how you perform pelvic floor exercises. Finding what works best for you is key to maintaining a routine. Below is a comparison of common positions.

Feature	Lying Down	Sitting	Standing
Starting Difficulty	Easiest for beginners due to gravity's assist.	Moderate, requires balance and good posture.	Most challenging, as you are working against gravity.
Muscle Awareness	High, as it's easier to isolate the pelvic floor muscles without engaging others.	Moderate, can be hard to avoid tensing buttocks or thighs.	Low initially, requires significant practice to isolate the muscles.
Convenience	Can be done in bed before sleep or upon waking.	Can be done at a desk, watching TV, or in the car.	Can be integrated into daily activities like waiting in line.
Progression Level	Excellent starting point for building foundational strength.	Good for advancing the exercises and building functional strength.	Advanced, builds strength for real-life movements and support.

Incorporating Pelvic Floor Exercise into Daily Life

Making pelvic floor exercises a habit is the most effective way to see lasting results. Here are some tips for integrating them into your routine:

• Link with Existing Habits: Pair your exercises with something you already do every day, like brushing your teeth, doing the dishes, or sitting down to watch the news. This makes them easier to remember.
• Set Reminders: Use a smartphone alarm or a sticky note to remind you to do your exercises a few times a day.
• Focus on Posture: Maintain good posture throughout the day. Sitting or standing up straight helps align the pelvic floor and core muscles, taking pressure off the area.
• Breathe Correctly: Remember to engage in diaphragmatic breathing throughout the day. This simple practice helps prevent straining and reinforces the pelvic floor muscles' natural movement.
• Don't Overdo It: Starting with a small number of repetitions is better than overdoing it and getting discouraged. As with any muscle, a little bit of consistent effort goes a long way.

When to Seek Professional Guidance

If you have difficulty identifying the muscles, experience pain during exercises, or have specific health concerns, it is wise to seek professional help. A pelvic health physiotherapist can provide personalized guidance, offer biofeedback to help you identify the right muscles, and create a tailored program. They can also determine if there are other underlying issues contributing to pelvic floor dysfunction. For more information on finding a qualified professional, the National Institutes of Health offers resources and guidance on various health topics.

Conclusion

Exercising the pelvic floor is a safe and effective way for elderly individuals to manage and prevent issues like incontinence. By learning how to exercise the pelvic floor in the elderly, and with consistent practice of simple techniques, seniors can significantly improve their comfort, confidence, and overall well-being. Start slow, focus on proper technique, and don't hesitate to seek expert advice if needed. Your efforts will contribute to a healthier, more active, and independent life.

Frequently Asked Questions

Are pelvic floor exercises safe for elderly people?

Yes, when done correctly and gently, pelvic floor exercises are safe and highly beneficial for elderly individuals. They are a low-impact form of exercise that can significantly improve continence and quality of life.

How often should an elderly person do pelvic floor exercises?

For best results, aim for two to three sets of exercises per day. Consistency is more important than intensity, so starting with shorter, more frequent sessions is more effective than doing long, strenuous workouts.

How long does it take for elderly individuals to see results from pelvic floor exercises?

Results can vary based on the individual and the severity of the issue. Some people may notice improvement in as little as a few weeks, while for others it may take several months. Continuing the exercises is key to maintaining results.

What is the best position for a senior to start with pelvic floor exercises?

Starting while lying down is often best. Lying on your back with your knees bent and feet flat on the floor reduces the effect of gravity, making it easier to identify and contract the correct muscles without involving others.

Can men exercise the pelvic floor in old age?

Yes, men can and should exercise their pelvic floor muscles in old age, especially those experiencing incontinence or post-prostatectomy issues. The technique is similar to women's and can be very effective.

What if an elderly person cannot feel their pelvic floor muscles?

If you cannot feel the muscles, try practicing the 'stop and start' urination technique (briefly, as a test only) to identify them. If you still have trouble, consider consulting a healthcare provider or a pelvic health physiotherapist for professional help, which may include using biofeedback devices.

Do I need any special equipment to exercise the pelvic floor?

No special equipment is needed for basic pelvic floor exercises. They can be performed anywhere and at any time. For those with difficulty, a healthcare provider might recommend biofeedback tools or other devices, but these are not necessary to begin.