What is PelvicPhysiotherapy.com?

The website is to teach you to recognise where tension in the pelvic floor muscles is getting in the way of your rehabilitation.  When you decide to strengthen your muscles – this is your one chance at making your pelvic floor exercises work. But what if it’s not working, we want to know why. Is it because you are not doing the exercises correctly?  Is it because the muscles are just not moving but you are doing the exercises correctly? If there is pain in the pelvic floor how do you recognise whether it is muscle tension that is causing it? Should you not be releasing the muscles then?

How can we help you ?

PelvicPhysiotherapy.com will work though steps with you to identify whether you have pelvic floor muscle tension.

If you have tension we will teach you to release it in order to have control over your pelvic floor.

If this is too difficult we have a section describing manual therapy where you may be able to access further help if there is a listed manual therapist near you and we have listed further resources and books that will be helpful.

We have a DVD Release to Balance that can be ordered that works though these steps with you in detail.

What if this is not for me ?

This is a conservative approach and basic muscle physiology – it is for everyone. It may not be the solution to all your problems but it is worth trying.

If this does not work for you – whether your problems are bladder or bowel related or whether they are pain related – the next step will mean more intervention.

More intervention means drug therapy, injections or surgery.

Even if additional intervention becomes necessary you will always do better if your pelvic floor is more balanced.

It is worth putting the effort in now.

Do I have to be lying down to do the exercises?

The exercises should initially be performed lying down but can be progressed to a sitting or standing position once mastered.

This progression to standing exercises is a good thing and fits more easily with the activities of daily living. Note you should only progress to standing when any bad habits are gone and you feel you have mastered the exercises.

Later, the more you practice in standing the better.

Can I do this standing or sitting in the car ?

If you find you are not getting to your exercises regularly then do them anywhere rather than not do them at all. It is preferable that you would stay lying on your back or side initially to eliminate the complication of gravity and posture until you can feel it. Once you can do them lying down, doing them in the car is a great idea !

Are there any other exercises I should be doing ?

The hardest thing you will do is Sniff Flop & Drop, once you have mastered this then you can progress as above, until you have mastered it you should stick to it. Walking is always a good idea as part of you daily plan.

Why do we concentrate on the muscle at the back so much?

Behind the rectum is where the bulk of pelvic floor muscle is, so we start here to make sure we are recruiting as much muscle as possible. When you feel the back coming in first you can then contract the muscles around the vagina.

Do I continue to do my other pelvic floor exercises ?

You should only do the exercises described and should not continue as you have been doing. The chances are that they were being performed incorrectly if you are still symptomatic.

Can I continue my Pilates ?

You can continue Pilates but you must be sure NOT to overdo the over-holding during exercise and when practicing outside classes as this can be counterproductive.

In classes make sure after you have done an exercise that you consciously fully release the pelvic floor before going on to the next exercise.

Pilates is a great way to progress your strength and co-ordination once you have mastered the basic techniques. There are some cases where we would advise to stop Pilates just for a short while and this would usually be where there is excessive tension that is not easily releasing.