In the course of the clinic, patients are often advised to “pay attention to training the pelvic floor muscles in general”. However, due to the time constraint, it is always unclear and incomplete. Generally speaking, people have been neglecting this important training method, thinking that the only way to solve the problem is to rely on drugs and surgery. This is a big misconception. Compared to all the physical methods and conservative treatment means, pelvic floor muscle exercise is simple, cheap, cost-free, accurate, and can be trained anytime, anywhere, whether sitting, standing, lying. I. What is pelvic floor muscle training (PFMT)? Pelvic floor muscle training is the exercise of the muscles at the bottom of the pelvis, and one of the key links is to exercise the anal raphe. Anatomically, the anal raphe is made up of the triplet brothers, the puborectalis, pubococcygeus and iliococcygeus muscles. The PC muscle, which we often hear about online, is an abbreviation for pubococcygeus. Thus, the pelvic floor muscle group training is also known as being PC muscle training, anal training. Since the concept of training the pelvic floor muscle group was first systematically introduced by Dr. Arnold Kegel, it is also known as Kegel training. The pelvic floor muscles are the important muscles of the “lower body”, also known as the love machine. This type of training is very useful for the whole range of pelvic floor organ dysfunction related disorders: including urinary incontinence, urinary urgency, chronic pelvic pain syndrome, weak ejaculation, premature ejaculation, as well as erectile dysfunction and various kinds of dissatisfaction. Second, how to do pelvic floor muscle exercises? Remember the three steps: one seek, two shrink, three alternate. Tell us more about it. The first step, seek. The difficulty of pelvic floor muscle group training is to correctly find the anal levator muscle. The pelvic floor muscles, unlike other skeletal muscles, are not as mobile and are inherently limited in their movements, and it is difficult to feel them moving. In fact, the muscles around the eyes (the muscles used when closing the eyelids) are also very similar to the muscles of the pelvic floor. When trying to close the eyes completely, a pressure is felt on the eyeball, which is what is felt when the eyelid muscles contract. When performing pelvic floor muscle exercises, you can think of the same sensation and feel the contraction of the pelvic floor muscles. In summary, there are three main methods to find the anal raphe: 1. From the location, the anal raphe is located between the scrotum and anus, which is the middle of the perineum, and this area will be somewhat congested when erect, and you want to poop and can not find the toilet is also here to control; 2. Interrupt urination method: when urinating legs apart and shoulder width, and keep both legs still, concentrate on the intention to try to Contract the anus and the perineum to interrupt the flow of urine, the most tense muscle felt when the flow of urine is interrupted is the anal raphe; 3, erection control method: when the erection concentrates on the idea of contracting the perineum, feel the penis is more fully engorged with blood when the contraction is the anal raphe; 4, avoid contracting the muscles of the abdomen, buttocks or legs. Practice the process of touching the abdomen with your hands, if you feel tension in the abdominal muscles, then it is not the right way to move. If you find it difficult, can not find, there is a simpler way to confirm whether the contraction of the muscle is correct by anal finger examination, how to contract the pelvic floor muscle squeeze its fingers; women can show the finger and middle finger placed in the vagina, contracting the pelvic floor muscle group around the fingers feel pressure wrapped around, that is, the correct muscle group contraction. Step two, contraction. You have to contract the muscles correctly: remember that the correct direction of muscle movement should be upward and inward, not downward to hold your breath. In the early days of training, it is especially important to pay attention to the correct method of training. Remember, we are practicing “internal work”, so you can put your hands on your abdomen and hips to make sure that your stomach, thighs and hips remain stationary during the exercise. Ask the patient to take a supine bent knee position to mimic holding urine and contracting the corresponding muscles as much as possible, in this position the patient can easily feel the pelvic floor muscles. The first is the duration of each movement and the second is the number of times the movement is completed. Later, the patient can complete the above exercises in a sitting or standing position. Tell each patient how to contract the pelvic floor muscles and a few tips: 1. Empty your bladder before training, doing Kegel exercises when your bladder is full of urine will weaken your pelvic floor muscles and increase your risk of urinary tract infection. 2. 2. Don’t hold your breath, whistle normally. When training correctly, talking and chatting should be unaffected. But try to concentrate as much as possible, you can also try to count out loud. 3, don’t contract the muscles of the belly, thighs and buttocks 4, don’t pinch your legs The third step, alternatively. That means fast contraction and slow contraction, alternating. Slow contraction helps strengthen the pelvic floor muscles and can assist in urine control. The specific method is: 1, contract the pelvic floor muscles for a count of 3 seconds; 2, relax the muscles for a count of 3 seconds; 3, repeat this action 10 times. At the beginning, it may be good to hold on for up to 3 seconds, but don’t give up, keep insisting, and as the pelvic floor muscles strengthen, gradually increase the time of contraction to 10 seconds. Fast contractions help allow the pelvic floor muscles to resist sudden increases in abdominal pressure, like coughing, sneezing or laughing. The quick contraction comes into play when urination is suddenly interrupted. The specific method is: 1, rapid contraction for 1 second; 2, relax the muscle rest for 1 second; 3, repeat 10 times. Third, what frequency should be maintained for exercise? Anytime, anywhere, according to local conditions. 1.Do it anytime, anywhere: keep doing 3-6 sets of pelvic floor exercises every day as much as possible (1 complete set of pelvic floor exercises including a set of slow contractions and a set of fast contractions). 2, do it according to local conditions: use different postures (standing, sitting or lying) to practice, find the easiest posture to do, and continue to train. Fourth, how to know whether the exercise is effective? You can test it by using the “interrupt-start” urination test. When you urinate, first pass a portion of urine and then try to interrupt the urination movement. It’s possible that the brakes will be off when you first start training, but even if you can slow the flow of urine, it’s a good start. You can test it every two weeks, and if you can collect and release it freely, then congratulations, the results are showing! But please remember not to do this experiment frequently during urination, otherwise it will become a habit that will cause damage to the bladder’s forced urinary muscles. Finally, a few more words of advice: The key to pelvic floor muscle exercises is the correct approach and persistence. High patient compliance is important to ensure that treatment will go smoothly. One study reported that 45.4% of patients felt that the reason they did not adhere to treatment was because “the treatment was not as effective as they expected”. Therefore, reasonable expectations need to be established. The first 2 months may have little effect and you will not notice a change until 12-15 weeks later. If you have done all of the above, and after a few months you find that nothing is working, remember to see your doctor again for a definitive check-up to see if there are any other problems or to receive more aggressive treatment.