Pelvic Floor Maintenance for Seniors

Pelvic Floor Maintenance for Seniors by Kathryn Rogers, Pelvic Floor Physiotherapist at Alfred Health and Elizabeth Crowe, Nurse Continence Specialist at Alfred Health.

Incontinence and pelvic floor muscle weakness are very common in seniors but should not be accepted as “just old age.” The pelvic floor muscles play a key role in bladder and bowel control, so it is important to learn where they are and how to squeeze them correctly. And no, you don’t have to be able to get on the floor to exercise your pelvic floor muscles! They can be done anywhere, anytime and without any equipment, and you are never too old to try!

The pelvic floor muscles create a hammock of support for the pelvic organs in men and women (bladder, womb and bowel) and help with the
control of your bladder and bowel. You can think of them like the exit doors of your bladder and bowel, and you can learn to close and open them by contracting and relaxing these muscles. You can find these muscles by imagining you need to stop yourself passing wind or imagine stopping the
stream of urine. As a test to see if you have the right muscles, you could try to stop or slow the flow of urine on the toilet, but only do this as a one off. Do
not do this every time you go to the toilet to empty your bladder. Once you have found the muscles, then you should practice squeezing and holding them when you are away from the toilet.

It is important to do your pelvic floor muscle exercises every day to keep them strong. Pelvic floor muscles become weakened by lifting heavy objects, straining on the toilet to empty your bladder or bowels, pregnancy and giving birth, the aging process, hormonal changes, surgery and chronic coughing. Once you can contract your muscles correctly, you can tighten them when lifting objects, or while coughing or sneezing to prevent further weakening, and to prevent urinary or faecal leakage. If you are straining to open your bowels you may be using your muscles incorrectly, and this may also be weakening them. These muscles should be relaxed when you are sitting on the toilet to empty your bladder or bowel.

General physical fitness and maintaining muscle strength in your legs and pelvis, will also improve your pelvic health. Regular walking, tai chi, cycling, yoga or swimming at least three times a week are some good options. Being overweight often leads to pelvic floor muscle weakness and incontinence, so it is important to keep a healthy body weight.

Key Points

• Do your pelvic floor muscle exercises every day
• Tighten your pelvic floor muscles when coughing, sneezing and lifting objects
• Avoid lifting heavy objects, or share the load between two people 
• Do some general exercise at least three times a week
• Maintain a healthy weight
• Avoid straining to empty your bladder or bowel

See a Nurse Continence Specialist or physiotherapist for extra help and a pelvic floor muscle assessment.

For women, the effects of menopause on the vaginal tissues may contribute to bladder control problems, so keeping your pelvic floor muscles strong during and after menopause is vital. Some women experience pelvic organ prolapse as they age (where one of the pelvic organs drops down into the vagina), and pelvic floor muscle exercises may help to support these organs and stop the prolapse from getting worse.

A common problem for men, is “after dribble.” No matter how much you shake and dance, the last drop always goes in your pants! Doing two to three strong
pelvic floor muscle squeezes and releases, just after you have passed urine, may help these last drops to go into the toilet instead of in your jocks! Urine
leakage after prostate surgery may also be improved with regular pelvic floor muscle exercises. Erectile dysfunction is another area of male pelvic health that may be improved with pelvic floor exercises.

We know from research that one in every three women cannot squeeze their muscles correctly, and many men are unaware that they have pelvic floor muscles too! It is a rather tricky exercise to learn, because these muscles are inside your pelvis, and you cannot see them.

If you need help finding your pelvic floor muscles, or you have any of the problems described in this article, contact the National Continence Helpline on 1800 33 00 66. You may need to see a Nurse Continence Specialist or Pelvic Floor Physiotherapist for further assessment and advice, and the Continence Foundation of Australia can guide you to your nearest clinician.