Pelvic Floor Physical Therapy

By: Steven Goldwasser

Pelvic Floor physical therapy is a structured program for reconditioning the pelvic floor muscles. Pelvic floor physical therapy can be used to treat pelvic pain, overactive bladder symptoms, urinary and fecal incontinence, and mild vaginal prolapse. The goal of treatment is to improve pelvic floor muscle strength, coordination and function. It may also be useful in helping to prevent these problems. All women are generally candidates for pelvic floor exercises.

The treatment can be done using manual manipulation, electrical stimulation and biofeedback. Pelvic floor physical therapy can be done under the direction of a health-care provider, or it can be self-directed. One of the biggest challenges of self-directed exercises is properly identifying the correct muscles while avoiding the use of accessory muscles.

Pelvic floor treatment is not painful. Typically patients will have four to six sessions of pelvic floor therapy, depending on the patient’s goals and success. Your initial visit will take one hour and follow-up sessions will take 30-45 minutes.

How do I do self-directed pelvic muscle exercises?

· Identify the correct muscle – To find the proper muscle, imagine having to pass gas while with a group of people. To avoid embarrassment, you squeeze the muscles around your rectum to hold the gas back. This is the muscle you want to exercise.

· Avoid common mistakes – Never use the muscles in your stomach, legs or buttocks, and don’t hold your breath. To be sure you are not using your abdominal muscles, place your hand on your abdomen while you squeeze the pelvic floor muscle. If you feel your abdomen move, then you are also using your stomach muscle.

· Exercise correctly – When exercising, it is important to squeeze and relax your muscles as prescribed*. One work/rest cycle is one exercise. If while you exercise, you no longer feel the contraction, the muscle is tired. Stop and rest for a few minutes and then go back to the exercises.

· Exercise anywhere – These exercises can be done anywhere at any time. If you are doing them properly, your legs, stomach, thighs and buttocks will not move, and no one will know you are doing your exercises. Do the exercise sitting or lying down when you first start the program. After eight weeks, you can do them standing, sitting or lying.

Can pelvis floor exercises harm me?

These exercises cannot harm you in any way. If you experience back or stomach discomfort after you exercise, then you are trying too hard and using extra muscles. Relax, and start over.

*Prescribed Exercise

· Contract the muscle for five seconds, then relax for 10 seconds (this is one exercise or cycle).

· Do five exercises in a row.

· Repeat this four times each day.

· Increase the contraction time by one second and one repetition every two weeks (always continue four times a day).

· Your goal is to contract for ten seconds, and then relax for ten seconds. Do ten exercises in a row, four times a day.

Try performing your pelvic floor exercises with an activity you do routinely every day, so you will be more likely to remember. Mealtimes, bedtime and driving in the car are very common. New mothers can perform them while bottle or breastfeeding.

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