Should pelvic floor rehabilitation end with pelvic floor exercises?
No, absolutely not!
We have to remember that each individual pelvic floor muscle is part of a whole. As with any other muscle in the body they can become weak, painful or overactive, with symptoms such as leakage, pelvic organ prolapse or pelvic pain. At this point local treatment or specific strengthening would be required. After this the muscles need to be re-educated and integrated back into working as part of the whole system. They need to know how to function when we when we move, be that getting out of bed or a chair, walking, running or lifting.
The advice ‘don’t lift’ or ‘don’t exercise’ is not helpful and does not allow a fully functioning individual to meet the requirements and demands of daily life.
You may see standard pelvic floor exercises promoted, and this is often a good starting point. However, if symptoms worsen or do not improve an assessment by a pelvic health physiotherapist should be sought.
Rehab should be specific to you
Rehabilitation should be specific to each individual’s lifestyle. What do YOU want to do? How do you want to move? Do you want to return to running, the gym, lifting weights, playing contact sports or just being able to walk and pick up your children? There is no ‘one size fits all’ and your rehab must to be tailored to you.
What about running?
Let us use running as an example. Running is a progression of walking with less time spent on each foot and a faster transition from one side to the other. Walking is a reciprocal motion; one leg is in-front of the other and either foot may be on or off the ground at any given moment. The pelvic floor muscle on each side will be working differently to the other side. The supporting limb needs to be stable from the pelvis, through the hip and knee and into the foot to be able to control, transfer weight and allow the other leg to swing by. This would indicate that we need adequate strength, balance and co-ordination. Your pelvic floor rehab should include training for this dynamic movement. If you are only re-educating your pelvic floor sitting or standing then how will it perform when you get back to doing what you want to do?
Below are a few video’s illustrating the progressive exercises that could be included in your pelvic rehabilitation to enhance your control and function if running was your goal. They are not exhaustive and would need to be adapted to meet your goals.
As always if you have any questions please get in touch.