What is Pelvic Floor Physiotherapy?

This article will explore the Importance of Physiotherapy in pelvic floor dysfunction and its physiotherapy management. Let's start with the topic. Pelvic Floor Physiotherapy is a specialized form of physical therapy to address issues related to the pelvic floor muscles, ligaments, and surrounding structures. It focuses on diagnosing and treating conditions such as urinary incontinence, pelvic pain, and pelvic organ prolapse through targeted exercises, manual techniques, and education. This therapy helps improve pelvic floor muscle strength, flexibility, and coordination, promoting better bladder and bowel control, enhanced sexual function, and overall pelvic health. It is a non-invasive, evidence-based approach tailored to each individual's needs, fostering optimal well-being and quality of life.

Understanding Of Pelvic Floor Physiotherapy

If your pelvic floor muscles are weak, this can lead to symptoms such as urinary urgency and frequency, indigestion, etc. If the pelvis is weak, Kegels or pelvic floor strengthening exercises play an essential role in improving these symptoms. However, depending on your symptoms, Kegels are not always the best solution. Like all muscles, the pelvic floor muscles may be tight. In this case, you may experience pelvic pain, insufficient bladder or intestinal voiding, weak or erratic flow, and pain during or after sex. The key is to have a strong pelvic floor, not a narrow pelvic floor. In the case of the pelvis being too narrow, relaxation exercises and gentle stretching can help release the muscles of the pelvis, allowing you to improve your symptoms.

The core involves more than just our abdominal muscles. The core is an area that begins with the diaphragm and ends with the pelvis. Therefore, the core components include abdominal muscles, lower back muscles, pelvic muscles, and membranes. These muscles work together to support the contents of your abdomen. We want all parts of your core to work correctly. During Pelvic Floor Physiotherapy, we will assess all parts of the core and work on exercises to develop a good core function.

Female and Male Pelvic Floor Physiotherapy

Female Pelvic Floor Physiotherapy Exercises:

I. Kegel Exercises:

Kegel exercises are a beneficial form of pelvic floor exercises specifically for females. They target and strengthen the pelvic floor muscles, which play a crucial role in bladder and bowel control, as well as support for pelvic organs. Here's how to perform Kegel exercises:

1. Find the right muscles: Sit or lie down comfortably and try to identify the pelvic floor muscles. Imagine stopping the flow of urine or preventing gas from passing. The muscles that tighten in that action are the ones you want to focus on.

2. Proper technique: Once you've located the pelvic floor muscles, contract them by squeezing and lifting them upward. Be careful not to tighten the abdomen, buttocks, or thighs during the exercise.

3. Hold and release: Squeeze the muscles and hold the contraction for 3-5 seconds, or as long as you can comfortably manage. Then, release and relax the muscles for the same duration.

4. Repetitions and sets: Aim to do 10-15 repetitions in one set, multiple times throughout the day. Gradually increase the duration and number of sets as you build strength.

5. Breathing: Breathe freely and avoid holding your breath while doing Kegels.

Consistency is key with Kegel exercises. Regular practice can help improve pelvic floor strength, which may lead to better bladder control, reduced risk of urinary incontinence, and enhanced sexual satisfaction for females.

II. Bridge Pose:

Bridge Pose, also known as Setu Bandhasana in yoga, is a popular yoga pose that helps strengthen the muscles in the lower back, buttocks, and thighs, while also engaging and stretching the pelvic floor. Here's how to do it:

1. Start by lying flat on your back on a yoga mat or a comfortable surface. Bend your knees and place your feet flat on the floor, hip-width apart. Your feet should be close to your buttocks, and your arms should rest alongside your body, palms facing down.

2. Ensure your feet and knees are aligned with your hips and ankles.

3. Inhale deeply, and as you exhale, engage your core muscles and pelvic floor, and slowly lift your hips and buttocks off the floor. Keep pressing through your feet, and try to create a straight line from your shoulders to your knees.

4. Interlace your fingers beneath your body and press your arms down into the mat for support. Alternatively, you can keep your palms flat on the floor for stability.

5. Hold the pose for a few breaths, breathing deeply and evenly. Feel the engagement of your pelvic floor and the stretch in your chest and thighs.

6. To release the pose, gently unclasp your hands if they were interlaced, and exhale as you slowly lower your hips back down to the mat.

Bridge Pose is an excellent exercise for strengthening the pelvic floor and lower body muscles. It also helps improve spine flexibility and can be beneficial for relieving mild back pain. As with any yoga pose, listen to your body and avoid overstraining. If you have any pre-existing medical conditions or injuries, it's best to consult with a yoga instructor or healthcare professional before attempting the pose.

III. Squats:

Squats are a fundamental and effective lower body exercise that targets multiple muscle groups, including the quadriceps, hamstrings, glutes, and core. Performing squats correctly can also engage and strengthen the pelvic floor muscles. Here's how to do a basic bodyweight squat:

1. Stand with your feet shoulder-width apart, toes pointing slightly outward. Keep your spine neutral, shoulders relaxed, and arms at your sides.

2. Inhale deeply, and as you exhale, begin to bend your knees and hips simultaneously, as if sitting back into an imaginary chair. Keep your weight evenly distributed on your heels and the balls of your feet.

3. Lower your body until your thighs are parallel to the ground, or as close as you can comfortably manage. Your knees should track in line with your toes but not extend beyond them.

4. Engage your core muscles and pelvic floor as you hold the squat position for a moment.

5. Inhale again, and as you exhale, press through your heels to return to the starting position, standing upright.

6. Repeat the squat movement for the desired number of repetitions.

Tips:

Keep your back straight and chest lifted throughout the exercise.
Avoid rounding your back or letting your knees collapse inward.
Maintain control throughout the movement and avoid bouncing at the bottom of the squat.

Squats are versatile and can be adapted with added weights, such as dumbbells or a barbell, as you become more comfortable with the movement. They are beneficial for building lower body strength, improving mobility, and engaging the pelvic floor muscles as part of a well-rounded exercise routine.

IV. Pelvic Tilts:

Pelvic tilts are simple yet effective exercises that help engage and strengthen the muscles of the lower back, abdomen, and pelvic floor. They are often used in various fitness routines, rehabilitation programs, and during pregnancy to promote better pelvic stability and flexibility. Here's how to perform pelvic tilts:

1. Lie on your back on a comfortable surface, such as a yoga mat, with your knees bent and feet flat on the floor. Your arms should be resting alongside your body with palms facing down.

2. Take a deep breath in, and as you exhale, gently tilt your pelvis backward by pressing your lower back into the floor. Imagine tucking your tailbone between your legs.

3. Hold this posterior pelvic tilt for a few seconds, focusing on engaging your lower abdominal muscles and pelvic floor.

4. Inhale again, and as you exhale, return your pelvis to the neutral position.

5. Now, perform an anterior pelvic tilt by arching your lower back slightly off the floor. Stick your buttocks out and let your tailbone lift slightly.

6. Hold the anterior pelvic tilt for a few seconds, feeling the stretch in your lower back.

7. Inhale and return to the neutral position.

8. Repeat the sequence for the desired number of repetitions.

Tips:

Perform the movements slowly and mindfully, focusing on the engagement of the pelvic floor and abdominal muscles.
Keep your upper body relaxed throughout the exercise.

Pelvic tilts are excellent for promoting pelvic mobility, relieving lower back tension, and improving pelvic floor awareness. They can be done as standalone exercises or as part of a warm-up routine before other activities.

V. Pilates:

Pilates is a low-impact exercise method developed by Joseph Pilates in the early 20th century. It focuses on strengthening the core muscles, improving flexibility, and enhancing overall body awareness and control. Pilates exercises typically emphasize precise movements, proper alignment, and controlled breathing. Here are some key aspects of Pilates:

1. Core Strengthening: Pilates places significant emphasis on strengthening the deep abdominal muscles, pelvic floor, and back muscles, which collectively form the core. A strong core provides stability and support for the spine and enhances overall body strength.

2. Mind-Body Connection: Pilates encourages a mind-body connection, promoting mindfulness and concentration during exercises. Practitioners are encouraged to be aware of their body's movements and alignment throughout the exercises.

3. Controlled Breathing: Proper breathing is an essential component of Pilates. Breathing techniques help coordinate movement, enhance relaxation, and improve oxygen flow to muscles.

4. Flexibility and Range of Motion: Pilates exercises often involve gentle stretching, promoting flexibility and increased range of motion in the joints.

5. Equipment and Mat-based Exercises: Pilates can be practiced using specialized equipment, such as the Reformer or Cadillac, or through mat-based exercises that use body weight for resistance.

6. Adaptability: Pilates exercises can be modified to suit various fitness levels and accommodate individuals with injuries or specific health conditions.

Benefits of Pilates include improved posture, enhanced muscular strength and endurance, increased flexibility, reduced stress, and better body awareness. It is popular among people of all ages and fitness levels, from beginners to athletes and individuals seeking rehabilitation from injuries.

Male Pelvic Floor Physiotherapy Exercises:

I. Kegel Exercises: Similar to females, contract the pelvic floor muscles, hold and release. Repeat 10-15 times.

II. Squats: Perform squats (same as above) while consciously engaging the pelvic floor muscles. Repeat 10-15 times.

III. Lying Hip Adduction Exercise

The lying hip adduction exercise is a great way to specifically target and strengthen the hip adductor muscles in men. Here's how to perform it:

1. Lie on your back on a comfortable surface, such as a yoga mat, with your legs extended out straight.

2. Keep your arms relaxed at your sides, palms facing down.

3. Bend one knee and place the foot flat on the ground, keeping the other leg extended.

4. Engage your core muscles to stabilize your lower back and pelvis.

5. Slowly lift the extended leg off the ground, keeping it straight.

6. With control, bring the lifted leg across your midline towards the bent knee, as if trying to touch the knee with your toes.

7. Hold the position for a moment, feeling the engagement of the inner thigh muscles.

8. Lower the leg back to the starting position in a controlled manner.

9. Perform the desired number of repetitions on one leg before switching to the other side.

Tips:

Keep your movements slow and controlled throughout the exercise.
Focus on squeezing the inner thigh muscles as you lift the leg and bring it across your midline.

IV. Lunges:

Lunges are a fantastic lower body exercise that targets multiple muscle groups, including the quadriceps, hamstrings, glutes, and calves. They also engage the core for stability and balance. Lunges can be done with various modifications to suit different fitness levels and goals. Here's how to perform a basic forward lunge:

1. Stand with your feet hip-width apart, with your hands on your hips, or relax at your sides.

2. Take a step forward with one leg, ensuring a comfortable stride length. Both knees should be at a 90-degree angle when performing the lunge.

3. Lower your body by bending both knees, keeping your front knee directly above your ankle and not extending beyond your toes. Your back knee should be a few inches above the ground.

4. Keep your upper body straight, chest lifted, and shoulders relaxed throughout the movement.

5. Push through your front heel to return to the starting position.

6. Repeat the lunge on the other leg by stepping forward with the opposite foot.

Tips:

Ensure proper form by maintaining an upright posture and not leaning too far forward.
Engage your core muscles for stability during the lunge.
Perform the movement slowly and in control to prevent any imbalance or strain.

V. Dead Bug Exercise:

The Dead Bug exercise is a core strengthening exercise that targets the abdominal muscles, especially the deep stabilizing muscles. It also helps improve coordination and stability in the lower back and pelvic region. Here's how to perform the Dead Bug exercise:

1. Lie on your back on a yoga mat or a comfortable surface with your arms extended directly above your shoulders, pointing toward the ceiling.

2. Bend your knees and lift your legs off the ground, so your thighs are perpendicular to the floor, and your lower legs are parallel to the floor. Your knees should be at a 90-degree angle.

3. Engage your core muscles by drawing your belly button toward your spine, and pressing your lower back into the mat.

4. As you exhale, slowly lower your right arm and left leg toward the floor, maintaining a 90-degree angle in your knee and hip joints. Your arm should be next to your head, and your leg should hover a few inches above the ground.

5. Inhale and return to the starting position, bringing your right arm and left leg back up to the initial position.

6. Now, repeat the movement on the opposite side, lowering your left arm and right leg.

7. Continue alternating sides for the desired number of repetitions.

Tips:

Keep your lower back pressed firmly into the mat throughout the exercise to engage the core muscles effectively.
Maintain control and avoid arching your back or letting your lower back lift off the floor.
Breathe steadily and rhythmically throughout the exercise.

These exercises can help strengthen the pelvic floor muscles, promoting better bladder control, pelvic support, and overall pelvic health in both females and males.

Pelvic Floor Physiotherapy Techniques:

Pelvic Floor Physiotherapy employs various specialized techniques to assess and treat issues related to the pelvic floor. Here are some common physiotherapy techniques used in pelvic floor therapy:

1. Internal Manual Therapy: A physiotherapist may perform internal assessments and treatments by gently inserting a gloved finger into the vagina or rectum to feel the pelvic floor muscles' tension, strength, and coordination. This technique allows for precise evaluation and targeted therapy.

2. External Manual Therapy: External techniques involve applying gentle pressure or massage on the external muscles of the pelvic region to release tension and improve blood flow.

3. Biofeedback: This technique uses sensors or electronic devices to provide real-time feedback on pelvic floor muscle contractions. It helps patients become more aware of their pelvic floor muscles and learn to control and strengthen them effectively.

4. Pelvic Floor Muscle Training (PFMT): PFMT involves a series of exercises to improve the strength, endurance, and coordination of the pelvic floor muscles. The therapist will prescribe specific exercises based on the patient's needs and progress over time.

5. Relaxation Techniques: For patients with hypertonic or overly tight pelvic floor muscles, relaxation techniques are employed to help release tension and reduce pain.

6. Bladder and Bowel Retraining: The therapist may work with patients to establish healthy bladder and bowel habits, addressing issues such as incontinence and constipation.

7. Education and Lifestyle Modifications: Patients receive education about their pelvic floor anatomy and function, as well as lifestyle changes that may help improve pelvic health.

8. Electrical Stimulation: In some cases, electrical stimulation may be used to help activate or relax pelvic floor muscles and enhance muscle function.

9. Therapeutic Exercises: Apart from pelvic floor-specific exercises (mentioned above already), the therapist may prescribe complementary exercises to improve overall core strength and stability.

10. Postural and Body Mechanics Training: Addressing posture and body mechanics can be crucial in managing pelvic floor dysfunction and preventing future issues.

Pelvic Floor Physiotherapy is tailored to each individual's unique needs, and the treatment plan is based on a comprehensive assessment by a qualified pelvic floor physiotherapist. The goal is to address pelvic floor issues and promote optimal pelvic health and overall well-being.

The Buddha Said!

What is Pelvic Floor Physiotherapy?

What is Pelvic Floor Physiotherapy?

Understanding Of Pelvic Floor Physiotherapy

Female and Male Pelvic Floor Physiotherapy