Pelvic Floor Muscle Strength Program

Innovative Physio physiotherapists are passionate about Women's Health.  Gill Smith and Lauren Hooper have post-graduate qualifications in Continence and Pelvic Floor Muscle Rehabilitation. It is very important if you have incontinence or prolapse issues that you are managed by a physiotherapist that has these post-graduate qualifications.

Conditions commonly treated by Pelvic Floor Physio

Conditions commonly treated by Pelvic Floor Physio

• stress urinary incontinence
• urge incontinence (overactive bladder)
• mixed urinary incontinence
• pelvic organ prolapse (POP)
• pelvic girdle pain (pelvic instability) ante-and postnatal
• low back pain with incontinence
Management strategies may include 

• teaching pelvic floor muscle contraction correctly via vaginal examination
• real-time ultrasound biofeedback to teach optimal motor control of the pelvic floor muscles
• individual targeted pelvic floor strength exercise program
• clinical pilates program to help bridge the gap between pelvic floor exercises in day to day pelvic floor function
• discussion of lifestyle change to help best manage the problem
• assessing how diet and fluid intake may influence their problem
• bladder training
• relaxation of the pelvic floor
• optimal defecation dynamics


Evidence supports Pelvic Floor Muscle Strength Training

The Good news is that in 2010 the Cochrane Collaboration (which puts all relevant studies together) published a review, Pelvic floor muscle training vs. no treatment, or inactive control treatments for Urinary Incontinence in women, which analysed the effectiveness of pelvic floor strengthening in stress, urge or mixed urinary incontinence. 
The conclusion of this analysis was the strongest level of evidence available, which is Level 1/Grade A evidence that pelvic floor strengthening should be offered as the first line of treatment for stress, urge or mixed urinary incontinence. 
 In Britain the National Institute of Health recommends that all women with Stress Urinary Incontinence (SUI) considering surgery should undertake pelvic floor strengthening education from a Pelvic Floor Post Graduate trained Physiotherapist.  Those clients who are unable to effectively strengthen their pelvic floor muscles to significantly reduce the symptoms of SUI are then considered for surgery.


Of interest


43% of subjects with incontinence and prolapse depressed their pelvic floor on ultrasound when instructed to lift (straining strategy)

Changes after Pelvic Floor Muscle strength training (RCT);

  • Correct motor control action of the pelvic floor muscles (PFM)
  • Increased muscle (PFM) thickness
  • Decreased vaginal opening
  • Shortened muscle (PFM) length
  • Elevated the position of the bladder and rectum
  • Increase maximal urethra closure (wee tube)
  • Reduced vaginal opening and muscle length at maximum Valsalva indicating increased pelvic floor muscle stiffness
  • Inhibition of detrusor (bladder) contraction (Obstetrics & Gynaecology(2010) Hoff Braekken)

 

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