What is pelvic floor re-education?
Pelvic floor re-education aims to restore normal function, strength and tone to the pelvic floor muscles. Using physical therapy, the physicians at South Bay Urology can help women who experience urinary incontinence, overactive or painful bladder symptoms, pelvic floor myalgia (muscle pain) and pelvic organ prolapse (POP). During pregnancy, the pelvic floor muscles are weakened and undergo stretching and occasional trauma during delivery. Since the abdominal muscles and the pelvic floor muscles share the same connective tissue, you can experience pelvic floor issues even if you’ve had a C-section.
What is the pelvic floor?
What is pelvic organ prolapse?
Pelvic organ prolapse (POP) occurs when one of the pelvic organs prolapses (falls) from its normal position. It is caused by an injury to the tissues or muscles that support the pelvic organs. The main cause of this injury is pregnancy and childbirth.
The symptoms of POP include:
- A feeling of pressure, aching, discomfort or fullness in the pelvis
- Uncomfortable pressure during physical activity or sexual intercourse
- Feeling or seeing a bulge or something coming out of the vagina
- Problems inserting a tampon
- Urinary incontinence or problems having a bowel movement
Some women express that these symptoms are worse at certain times of the day, during physical activity or after standing for a long time.
What does pelvic floor re-education involve?
There are three main components to pelvic floor re-education:
- Biofeedback training
- Muscle training
- Neuromuscular re-education
Postural exercises, behavioral therapy, massage therapies, breathing exercises, relaxation techniques and myofascial release therapy may also be recommended by your healthcare provider.
Biofeedback training relies on electrical stimulation to increase control over your pelvic floor muscles. These muscles are trained to stimulate activity in order to effectively assess the strength of contraction.
Muscle training is commonly done with Kegel exercises. Kegel exercises are performed with three easy steps:
- Contract your pelvic floor muscles (around the urethra and vagina) – the feeling is similar to holding your stream of urine
- Lift your muscles (a feeling of sucking in your muscles) and keep your pelvic muscles contracted for 5-8 seconds
- Let go of your muscles and relax your pelvic floor
You will repeat this exercise 8-12 times a day, and it can be done from a sitting, standing, or lying down position. In order to improve your results, do not squeeze your buttocks, relax your thighs and maintain normal breathing while lifting and squeezing. Research data shows that, when executed properly, pelvic floor re-education/retraining results can be seen in as little as 2-8 weeks.
Neuromuscular re-education exercises encourages women to focus on joint positioning and movement. The key to these exercises is maintaining balance while performing specific movements. For example, pelvic tilt exercises help to properly position the pelvis. Unilateral balancing exercises help you to establish a proper pelvic tilt while balancing on one foot. A variety of bending and stretching techniques on an exercise ball also have neuromuscular benefits.