So what are you supposed to do and
how to do it? Your doctor may refer you
to see a physiotherapist for evaluation
and to design a program for you to
follow. This might include therapeutic
Pilates exercises, posture work and some
individual movements depending on
your needs or goals. Women can do this
before, during and after pregnancy as
well as later in life. Anyone and everyone
can use some work on the pelvic floor to
maintain its integrity.
The recommendation from most
physiotherapists is to learn how to
contract as well as relax the pelvic floor
muscles correctly. It might sound like
an easy task but it’s actually quite tricky
because these muscles are not usually
even thought about until a problem arises
(like the inability to control your bladder
or bowels). Coordinating the movement,
contraction and relaxation correctly
requires a fair amount of practice. Having
some guidance to do this is key.
Some of the tools used by
physiotherapists include; an ultrasound,
to see the underlying structures and
observe the muscle movement in real
time; internal exam, to diagnose the
extent of the muscle issues; and a
prescription for exercises, to specifically
target the problem areas for each
individual. For example, if you only
experience incontinence while doing a
specific move, like hitting a tennis ball
with your forehand or going from sitting
to standing in a hurry, a special set of
exercises can be designed to strengthen
your pelvic floor in those positions. At
each session, an evaluation is done to
see if progress has been made and to
tailor the present session to adjust to the
new condition.
Examples of beneficial exercises:
1.
2.
3.
4.
Alternate arm and leg lift (on all fours)
Leg lift sitting on an exercise ball
Bridge exercise with feet on ball
Pelvic tilts (similar to cat/cow poses)
while seated on an exercise ball
5. Standing balance work on Bosu ball
or balance disc
During these moves, see if you can
get your pelvic floor to relax on the
inhale. A secret to getting a good muscle
contraction is to achieve full relaxation
first because if the muscle is already tight,
there is no room for it to contract.
Think about connecting and
controlling your pelvic floor. Putting your
mind to it helps.
Considering these exercises, it’s
easy to see the pelvic floor is more of a
whole body issue than an isolated one.
With some effort, you can improve and
preserve your pelvic floor.
If you’re not successful with
physiotherapy, pilates or other exercises
to alleviate the problems you may be
experiencing, there are some alternatives
to consider but sometimes the next
option is surgery.
A word of caution about training your
pelvic floor, according to one physio with
a very informative website: Don’t pee and
blow your nose at the same time. We’ve
all done it! It saves time when you’re a
mum, right? Well, there’s a little problem
with that particular time-saving tidbit.
If you’re blowing your nose (an action
which naturally tightens the pelvic floor
and core muscles) while simultaneously
relaxing your pelvic floor to let out urine,
you’re actually retraining your pelvic floor
not to respond correctly. Not a good idea.
www.coreexercisesolutions.com/
why-multitasking-hurts-your-pelvic-
floor/
Answers from a physiotherapist
1
maternity
Alternate arm and leg lift
(on all fours)
Leg lift
sitting on
an exercise
ball
2
Bridge exercise with feet on ball
4
3
Pelvic tilts (similar
to cat/cow poses)
while seated on an
exercise ball
Playtimes asks Kate Smith, a woman's
health physiotherapist at Thrive Health
HK, a few questions about maintaining
the pelvic floor.
1. How common are pelvic floor
issues in your practice?
Very! All of my pre- and post-natal
clients experience a degree of pelvic
floor dysfunction at some stage. I also
see many women who aren't pre/
post-natal who experience stress or
urge incontinence, or have issues
with pelvic pain.
2. What type of symptoms do they
typically present with?
Incontinence, urinary urgency or
frequency, trouble holding in wind,
5
Standing
balance work
on Bosu ball
or balance
disc
Winter 2019
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