This patient information leaflet is for women and tells about
The pelvic floor
Discomfort from a weak pelvic floor
How you can train strenght and endurence.
The pelvic floor is the muscle group that closes your pelvis, forming the bottom of your body. It consists of layers of muscle and ligaments that stretch from the pubic bone at the front to the base of your spine at the back and from side to side (see diagram).
The pelvic floor lifts and supports your pelvic organs, so that they are held up in place. It is this muscle group which is used when controlling your bladder and bowel functions, to stop leakage of urine from the bladder and wind or faeces from the bowel.
The pelvic floor also has an important sexual function, helping to increase sexual awareness for both yourself and your partner during intercourse.
The Abdominal Cavity is the closed space formed by the diaphragm, the abdominal and pelvic floor muscles and the spine.
Increased pressure in the abdominal cavity increases the pressure on the pelvic floor.
At times of increased pressure in the abdominal cavity (for example by lifting, coughing and sneezing) it is important to contract your pelvic floor muscles to resist the pressure from above.
This will avoid long term weakening of your pelvic floor.
Remember always to contract the pelvic floor muscles when you
lift, push or pull
cough or sneeze
laugh
jump, run or dance
in the motion of standing up and sitting down
whenever you are using your strength.e.g. strength training.
after being at the toilet, to ”retract” the pelvic floor.
There are various reasons why women get a weak pelvic floor:
pregnancy and birth
overweight
constipation
lifting
coughing (smoking and lung disorders)
age (decreased muscle strength).
Be aware
A weak pelvic floor could eventually lead to:
fatigue and heaviness in your back and abdomen
incontinence, i.e. leakage of urine, wind or faeces
prolapsed uterus and/or bladder
unsatisfying sex life.
When you are contracting your pelvic floor muscles, your back passage closes
The pelvic floor is not a large and powerful group of muscles; therefore do not expect to see or feel a lot of movement when contracting your muscles.
It is almost like closing your mouth, but at the other end of your body.
You must feel that your back passage closes as this is where the majority of the movement takes place.
Training the pelvic floor muscles takes concentration.
Avoid unnecessary movements
When exercising, it is important that you get the feeling that only the pelvic floor is working. Be aware that you:
Do not tighten your buttocks
Do not contract the muscles on the inside of your thighs
Do not suck in your stomach or hold your breath
You can check if you are doing it right
You can with a couple of fingers on the perineum (area between the lower end of the vagina and back passage), feel the area become tight during a muscle contraction.
Or place the index finger and middle finger in the vagina, tighten the muscles and feel your vagina clamp around your fingers
You can also hold a mirror between your legs. Contract the muscles to see a movement around the urethra, vagina and back passage.
Adjust the severity of the exercises
In the beginning it is easiest to train lying down on your back, tummy or side.
Later on you must train sitting, then in standing position. And finally in motion (e.g. jump and run). This is to increase the difficulty of the exercises and thereby increase the strength of the pelvic floor muscles.
Exercises
When you feel sure that you are using the pelvic floor muscles correctly, you can train strength and endurance by the following program:
Before starting your pelvic floor exercises, it is a good idea to start with exercises to increase the blood circulation and to pump excess fluid from the abdomen and legs.
These exercises reduce the pressure in and around the pelvic floor area, making it easier to gain a strong contraction of the pelvic floor muscles.
Simultaneously the exercises will be beneficial if you feel heaviness in your abdomen from walking and standing during the day.
To do these exercises lie on your back with your legs bent:
Breath deeply 5-7 times.
Repeat following exercise 10-20 times:
Lift your pelvis up and down
Lift your right leg, grab your knee and bend and stretch your knee and ankle. Repeat with your left leg.
Lightly tighten the muscles around your back passage.
Slowly release. Repeat the exercise at least 10 times.
Tighten the muscles around your back passage, vagina and front passage and lift up inside. Hold the contraction for as long as you can (up to 8 sec.) and release slowly.
Take a break. The break shall be as long as the contraction.
Repeat the exercise at least 20-30 times (1-3 times a day).
Tighten the muscles around your back passage, vagina and front passage and lift up inside. Hold the contraction for as long as possible (up to 30 seconds).
Repeat the exercise 1-2 times.
More information
Afterwards continue to do your pelvic floor exercises to ensure that the problem does not come back.
Remember: you can exercise your pelvic floor muscles
wherever you are (when you are driving a car, cooking, watching television) - nobody will know what you are doing!
Your pelvic floor is strong:
When you without any difficulties in various positions can hold a powerful contraction for 6-8 seconds repeatedly 20-30 times in a row.
When you can hold a contraction for 30 seconds and repeat it a couple of times.
When you do not have any of the inconvenience that weak pelvic floor muscles can lead to.
It is important to follow up the training by good drinking habits. This means a regular intake of liquids (approximately 1½-2 liters) divided over the day.
If followed, you will need to use the toilet approximately every 3 hours. For some women, mostly elderly women, once or twice during the night. If you need to get out of bed several times every night to use the toilet, be aware of your intake of liquids after dinner.
It is of the most importance, that the bladder is emptied every time you urinate.
If you have any doubts whether you have emptied your bladder completely, then lean forward when sitting on the toilet seat.
You can find additional information and exercises at www.kvindekrop.dk. At this site there is also an app for your Smartphone. This enables you to always have your training programme with you.
Contact
Du kan kontakte vores afsnit, hvis du har spørgsmål til vores patientvejledning:
Fysio- og Ergoterapi Regionshospitalet Gødstrup Hospitalsparken 15, 7400 Herning.
Telefon 7843 4300 - mellem kl. 08.00-12.00.
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Direkte link til denne side: www.godstrup.dk/906749
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