Pelvic Floor Muscle Training for Women in Dinka

What are the pelvic floor muscles?

The floor of the pelvis is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in front.

A woman’s pelvic floor muscles support her bladder, womb (uterus) and bowel (colon). The urine tube (front passage), the vagina and the back passage all pass through the pelvic floor muscles. Your pelvic floor muscles help you to control your bladder and bowel. They also help sexual function. It is vital to keep your pelvic floor muscles strong.

Acuek aŋuum ye käŋö?

Na cï meth dhiëëth, ka yïn alëu ba acuek aŋuum ya duääny të lëu yen rot. aköl them ba acuek aŋumdu ya “ŋiëëc” piiny (ye nhiaaic ku muk) keya kaam bïnë ɣɔɔl, tïïm wulɛ̈ të jɔt yi’n meth. Kënë ee kë path ye cɔl “ba rot duääny”.

Acuek aŋum ë tik aa alɛ̈ɛ̈c, adhiëëth ku yäc duööt nhial. Dhël lɛc, wath ku dhël la roor aa tëëk acuek aŋuum yic. Acuek aŋuum kä kek aa yï kony ba la roor ku laac ya muk nhïïm bë käŋ cï ye wat path. Keek aya aa tik cɔl a ŋic tɔ̈u ke moc. Apath ba acuek kuun aŋuum ŋiɛc ya muk nhïïm bïk cï luär.

Why should i do pelvic floor muscle training?

Women of all ages need to have strong pelvic floor muscles.

Pelvic floor muscles can be made weaker by:

• not keeping them active;
• being pregnant and having babies;
• constipation;
• being overweight;
• heavy lifting;
• coughing that goes on for a long time (such as smoker’s cough, bronchitis or asthma); and
• growing older.

Women with stress incontinence – that is, women who wet themselves when they cough, sneeze or are active – will find pelvic floor muscle training can help in getting over this problem.

For pregnant women, pelvic floor muscle training will help the body cope with the growing weight of the baby. Healthy, fit muscles before the baby is born will mend more easily after the birth.

After the birth of your baby, you should begin pelvic floor muscle training as soon as you can. Always try to “brace” your pelvic floor muscles (squeeze up and hold) each time before you cough, sneeze or lift the baby. This is called having “the knack”.

As women grow older, the pelvic floor muscles need to stay strong because hormone changes after menopause can affect bladder control. As well  as this, the pelvic floor muscles change and may get weak. A pelvic floor muscle training plan can help to lessen the effects of menopause on pelvic support and bladder control.

Pelvic floor muscle training may also help women who have the urgent need to pass urine more often (called urge incontinence).

Yeŋö dhil ɣɛn acuek ciëën aŋuum duääny?

Diäär wɛ̈ɛ̈c ruön ken yiic aa dhil laŋ acuek aŋuum ril tör.

Käkä alëu bïk acuek aŋuum cɔl a luär nyïn:

• tɛ̈ cïn acuek aŋuum ye duääny;
• liëc ku dhiëth;
• Kuil;
• Cuai;
• Jön ka thiek;
• Ɣɔɔl këc lac kɔ̈ɔ̈c (cëmën ɣɔɔl raan math tap yäär, toŋgol wälä Adhiäma); wälä
• Dhiööp.

Diäär cï acuek aŋuum cïn lär – rööl röt läc tɛ̈ ɣɔɔl kek, tïïm kek wälä tɛ̈ tuuk kek – aa bë laŋ tɛ̈thi kek acuek aŋuum ku tɛkdä ka bë ŋiɛc ya gum tɛ̈ këc ror dööt.

Tɛ̈n tiŋ liac, duɛ̈ɛ̈ny acuek aŋuum a bë ye kony bë manh tɔ̈u yiɛ̈ɛ̈c ŋiɛc ɣääc. Na ril acuek aŋuum ka bë ŋiɛc lɔ̈k dɛm tɛ̈ le meth dhiëëth.

Na cë meth dhiëëth, ka tik apiath bë acuek aŋuum ya duääny – ku lɔc gɔl. Ye rot duut tɛ̈ ɣɔɔl yïn, tïïm yïn, wälä tɛ̈ jɔt yïn meth. Kën ee kë path ba “ŋiɛ̈ɛ̈c”.

Na la tik ka dhiɔp, ka path bë acuek aŋuöm de ya rëër ke ril rin ye guöp ye yic waar ku lär acuek nyïn ku kën a lëu bë tik cɔl ye rot läc. Acuek aŋuum aa lëu bïk nyïn lär. Na ye tik acuek aŋuum duääny, ka acuek aŋuum aa lëu bïk rëër ke ril tör – cɔk alä dhiɔp tik.

Duɛ̈ɛ̈ny acuek aŋuum aya a lëu bë diäär kony laac bïk röt cï ye läc tɛ̈ cï lɛc thiɔ̈k (bïk cï ye kööl kaam bär yic ke tït lac).

Where are my pelvic floor muscles?

The first thing to do is to find out which muscles you need to train.

1. Sit or lie down with the muscles of your thighs, buttocks and stomach relaxed.
2. Squeeze the ring of muscle around the back passage as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Try not to squeeze your buttocks.
3. When sitting on the toilet to empty your bladder, try to stop the stream of urine, then start it again. Do this to learn which muscles are the right ones to use – but only once a week. Your bladder may not empty the way it should if you stop and start your stream more often than that.

If you don’t feel a distinct “squeeze and lift” of your pelvic floor muscles, or if you can’t slow your stream of urine as talked about in Point 3, ask for help from your doctor, physiotherapist, or continence nurse. They will help you to get your pelvic floor muscles working right.

Women with very weak pelvic floor muscles can benefit from pelvic floor muscle training.

Räl acuek ciëën aŋuum tɛ̈ukä tɛ̈no?

Kë ba kaŋ looi ee ba ŋic ye räl acuek nɛn kek wïc duɛ̈ɛ̈ny.

1. Nyuööjë wälä tääjë yï taar ku päl yï ɣɔ̈ɔ̈m piny ku duk yï thar rot. Na wïc ka yï muk macaar yï thar ba acuek kuun aŋuum tïŋ tɛ̈ ye kek kë riëëc ebën miɛɛt thïn ku pälkä.
2. Rot yï thar ciët yï pën köth. Päl yic piny. Ye yï thar rot ku päl yic kë gäk yic rin ba tɛ̈ ye acuek aŋuum luui thïn deet. Duk aŋuem ye nyiith yiic.
3. Na lɔ laac, ka them ba lɛc teem kɔ̈ɔ̈th bïn bïn ye lëu, ku bɛn laac dhuök. Loi kën rin ba acuek aŋuum lac ku duut ŋic – ku ye looi kën yic tök wik yic. Aläny du a lëu bë cak tɛ̈ ye yïn lɛc teem kɔ̈ɔ̈th abak.

Na cïn tɛ̈ ye yök, “ka nyith ku rat nhial”wälä cïn tɛ̈ ye yïn lɛc teem kɔ̈ɔ̈th tɛ̈ mën wën cï ye lueel abaŋ 3 yic, wälä cuöl du ku nhian ku aa cï ye tïŋ ke jɔt röt ku kɛ̈ɛ̈ckä cëmën wën cï ye lueel abaŋ 4 yic, ka yï la tɛ̈n akiɛ̈m du, raan duun yï duääny wälä akuɔnyakïm ë thiu thar. Keek kɔɔc kä aa lëu bïk yï kony ba acuek kuun aŋuum cɔ̈k piny. Röör cï acuek aŋuum nyïn luär aa lëu bïk tɛ̈thi yök tɛ̈ duɛ̈ɛ̈ny kek acuek keen aŋuum.

Diäär cï räl acuek nyïn luär aa lëu bïk tɛ̈thi yök tɛ̈ duɛ̈ɛ̈ny kek acuek keen aŋuum.

How do i do pelvic floor muscle training?

Now that you can feel the muscles working, you can:

• Squeeze and draw in the muscles around your back passage and your vagina at the same time. Lift them UP inside. You should have a sense of “lift” each time you squeeze your pelvic floor muscles. Try to hold them strong and tight as you count to 8. Now, let them go and relax. You should have a distinct feeling of “letting go”.
• Repeat “squeeze and lift” and let go. It is best to rest for about 8 seconds in between each lift up of the muscles. If you can’t hold for 8, just hold for as long as you can.
• Repeat this “squeeze and lift” as many times as you can, up to a limit of 8 to 12 squeezes.
• Try to do three sets of 8 to 12 squeezes each, with a rest in between.
• Do this whole training plan (three sets of 8 to 12 squeezes) each day while lying down, sitting or standing.

While doing pelvic floor muscle training:

• keep breathing;
• only squeeze and lift;
• do NOT tighten your buttocks; and
• keep your thighs relaxed.

Ba acuek aŋuum duääny kadä?

Mën cïn acuek kuun aŋuum jal ŋic tɛ̈ ye kek luui thïn, yïn a lëu:

• A lëu ba lɛc ku la roor duut tök. A lëu ba yï yic ŋöp ku miɛɛt këriëëc ebën nhial. A lëu ba acuek aŋuum ya yök ke jot këriëëc ebën nhial tɛ̈ ŋöp yïn yï yic. Them ba muk nyiɛn tök ku jɔl kuen ɣet 8. Bɛn ke puöl yiic. A lëu ba gua yök tɛ̈ ye yïn yic wuu thïn tɛ̈ pɛ̈l yïn acuek aŋuum yiic.
• Beric (nyith ku rat nhial) ku päl yic. Apath ba ya lɔ̈ŋ mocmooc ka 8 ku bɛn looi. Na cï lëu ba rɔt ku ŋöp mocmooc ka 8, ka them ba kaam bär yic tɛ̈ cït tɛ̈ ba lëu.
• Beric “nyith ku rat nhial” yic arak juääc tɛ̈ cït tɛ̈ wïc ku duk cɔl want 12.
• Them ba looi kën yic 8 ɣet 12 arak tök, ku dhil ya lɔ̈ŋ kam ken.
• Ye kën looi (arak 8 ɣet 12) abak ka yï cë tɔ̈c piiny, wälä ka yï cë nyuc wälä ka yï kääc.

Ka yï loi duɛ̈ɛ̈ny räl acuek aŋuum:

• Ye wëëi;
• Ye nyith ku rat nhial;
• Duk aŋuem ye nyiith yiic; ku
• Päl yï ɣɔ̈ɔ̈m piny.

Do your pelvic floor muscle training well

Fewer good squeezes are better than a lot of half hearted ones! If you are not sure that you are doing the squeezes right, or if you do not see a change in symptoms after 3 months, ask for help from your doctor, physiotherapist, or continence nurse.

Ye acuek aŋuum ŋiɛc duääny

Na ye acuek aŋuum ŋiɛc rot ku jɔt keek arak lik yiic ka cë cït tɛ̈ yïn ye looi arak juääc ku a cï ye ŋiɛc looi! Na kuc lɔn yïn acuek aŋuum ŋiɛc rot ku jɔt keek wälä na cïn kë cë rot waar pɛ̈y ka 3 diäk yiic, ka yï cɔl rot a kony akiɛ̈m du, raan duun yï duääny wälä akuɔnyakïm ë thiu thar.

Make the training part of your daily life

Once you have learnt how to do pelvic floor muscle squeezes, you should do them often. Every day is best. You should give each set of squeezes your full focus. Make a regular time to do your pelvic floor muscle squeezes. This might be after going to the toilet, when having a drink, or when lying in bed.

Other things you can do to help your pelvic floor muscles:

• Use “the knack” - that is, always try to “brace” your pelvic floor muscles (by squeezing up and holding) each time before you cough, sneeze or lift anything.
• Share the lifting of heavy loads.
• Eat fruit and vegetables and drink 1.5 - 2 litres of fluid per day.
• Don’t strain when using your bowels.
• Ask your doctor about hay fever, asthma and bronchitis to ease sneezing and coughing.
• Keep your weight within the right range for your height and age.

Loi duɛ̈ɛ̈ny kën bë ya kë duun ye looi abak

Na ca rut ku jön acuek aŋuum ŋic, ka path ba ya looi abak. Na ye looi abak ka path apɛy. Ye yï puöu tääu thïn tɛ̈ looi yïn yeen. Lɔc kaam bïn acuek aŋuum ya duääny. Tɛkdä ka lëu ba ya looi kuat tɛ̈ cïn la roor, tɛ dëk yïn, wälä tɛ̈ cïn yï kɔ̈u tääc agerem nhom.

Kä kɔ̈k lëu ba looi ba acuek aŋuum cɔl a ril:

• Ŋiëëjë – loi kalä, ye yï aŋuum dööt apath (ba acuek aŋuum rot ku jɔt keek) tɛ̈ ɣɔɔl yïn, tɛ̈ tïïm yïn wälä tɛ̈ jɔt yïn kë thiek.
• Ye rot cɔl a kony tɛ̈ jɔt yïn kë thiek.
• Ye cam mïth tiim ku yïth tiim ku ye lita tök ku abak agut litaa karou (dek 1.5 – 2 lita) pïu dek aköl tök.
• Duk ye cɔl apɛy tɛ̈ le yïn roor.
• Thiëc akïm tɛ̈ cï yïn thɛɛth, tɛ̈ leŋ yïn adhiama ku toŋgol rin kony tïïm ku ɣɔɔl.
• Duk rot cɔl aŋer piny riɛn cuai Ye cuai du cɔl a thööŋ rot.

Seek help

Qualified nurses are available if you call the National Continence Helpline on 1800 33 00 66* (Monday to Friday, between 8.00am to 8.00pm Australian Eastern Standard Time) for free:

• Information;
• Advice; and
• Leaflets.

If you have difficulty speaking or understanding English you can access the Helpline through the free Telephone Interpreter Service on 13 14 50. The phone will be answered in English, so please name the language you speak and wait on the phone. You will be connected to an interpreter who speaks your language. Tell the interpreter you wish to call the National Continence Helpline on 1800 33 00 66. Wait on the phone to be connected and the interpreter will assist you to speak with a continence nurse advisor. All calls are confidential.

* Calls from mobile telephones are charged at applicable rates.

Wïc kuɔɔny

Mathaat akïm cï piöc aabï tɔ̈ na yï ayup telepun Kuɔɔny Baai käk thiu thar ee nïmra kënëic tök, bɛ̈t, gueu, diäk, diäk, gueu, dhetem, dhetem*/ 1800 33 00 66* (aköl Tök agut aköl Dhiëc ee Läätic (Monday- Friday) kaam thaa bɛ̈t nhiäk-duur (8am) ku thaa bɛ̈t thëëi (8pm) ee thaa kɔc Australia ciëŋ Ciëën) aye gäm kɔc abɛc:

• Lëk/Wël;
• Wëët; ku
• Athör thiin ë lëk.

Na yïn acie ŋiëc jam thoŋ English apiɛth ka yïn alëu ba telpun luɔi ye kɔc Kuɔny wɛ̈r thokic yuɔ̈p. Cɔl nïmra kënë tök diäk, tök, ŋuan, dhiëc/13 14 50. Tueŋic, abï raan kɔŋ dhuk nhom ee thoŋ English, luel thoŋduɔ̈n ee yïn jam ku tiɛ̈ɛ̈t ee telepunic. Yïn abï tuɔ̈ɔ̈m thok kek raan kɔc waar thook/duwër jam thuɔŋdu, ku jal kek lɛ̈k wɛ̈tduɔ̈n wïc ee yïn kɔc Baai Kuɔɔny Käk thiu thar yuɔ̈p ee nïmra kënëic tök, bɛ̈t, gueu, diäk, diäk, gueu, dhetem, dhetem/ 1800 33 00 66. Tiɛ̈ɛ̈t ee telepunic ku bï yï gam ku duwër abï kony ba jam kek mathaat akïm kɔc lɛ̈k. Telepun duwër aye kɔc yup thïn abɛc/majan ee rin cïn en wëu ye wïc tënë yïn. Kek wël ëbɛ̈n aye thiaan yiic.

* Yup mobaalic ee wëu cam tëcït cɔ̈t baai ëtɛ̈n.