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How long do I have to do these exercises? Once I notice a decrease in my symptoms, have I fixed the problem? If I had my baby 10 years ago, can I still rehab my pelvic floor or is it too late? I notice that I have increased symptoms when I carry around my 10-month-old. How do I help this? How long do I have to do these exercises?With any muscle group in your body, it typically takes from four to six weeks, consistently performing the exercises three times a week, to see the neuromuscular adaptations that are required for increased strength and endurance. That includes your pelvic floor muscles. You may notice a positive effect before that, but generally it will take four to six weeks of consistent exercise to see a significant change. Once I notice a decrease in my symptoms, have I fixed the problem?Unfortunately, no. Muscles get strong and stay strong only if we consistently exercise them. Our recommendation would be to continue a maintenance program once you have achieved your goal of a decrease or resolution of symptoms. A maintenance program would include performing 8-10 pelvic floor lifts and holds every day. Your goal should be to become independent with these exercises and that is why we demonstrate how to do them lying on your back, sitting and standing. Once you have mastered your pelvic floor contraction and elevation in all three of these positions, you should have no problem incorporating at least 8-10 contractions into your daily routine. This includes standing in the grocery line, sitting in your car or at work, and lying in bed, to give just a few examples. This should help maintain the increased pelvic floor strength you have achieved. Please note that continuing to work your entire abdominal basket would be ideal, targeting your low back, your glutes and your lower abdominal muscles. Whether you use your favorite exercises from our DVD or other exercises that target your abdominal basket, you must remember that these areas form a strong base for optimal posture and overall body health. These exercises remind me of low back exercises I learned last year. What is the difference between low back and pelvic floor rehabilitation exercises?As we stress in the DVD, both our pelvic floor and low back muscles work with our stomach and hip muscles to form our abdominal basket. You see the similarities because a healthy low back is dependent on a strong abdominal basket, requiring us to work our pelvic floor muscles, our stomach muscles and our hip muscles. Just the same, a healthy pelvic floor requires a strong abdominal basket, again, dependent on strengthening our low back muscles, our stomach muscles and our hip muscles. The differences in the two rehab regimens would be the emphasis on pelvic floor isolation exercises in a pelvic floor rehab program and the emphasis on isolating our low back extensors in a low back rehab program. What if I perform these exercises three times a week for six weeks and I experience no change in my symptoms?You should see a women’s health care specialist for a thorough evaluation. It’s possible you may not be contracting your pelvic floor effectively and may require additional intervention to get your pelvic floor muscles retrained to react appropriately again. This can be compared to a knee patient who is trying to fire the muscle in the front of her thigh so she can walk normally. Some patients are able to fire this muscle again shortly after surgery and some patients require electric stimulation to assist the muscle contraction until a normal firing pattern is achieved independently. If I had my baby 10 years ago, can I still rehab my pelvic floor or is it too late?You absolutely can still rehabilitate your pelvic floor. Focus on getting your pelvic floor to contract and elevate as described in the DVD and then work to strengthen your entire abdominal basket. You are four to six weeks from a healthier and stronger pelvic floor. I had surgery for a bladder sling and my symptoms stopped for a year then returned. Will the exercises help me?Yes. The surgery for a bladder sling will not inhibit the muscles of the pelvic floor. As long as you are able to achieve an effective pelvic floor contraction with elevation, the exercises will help control your symptoms. I notice that I have increased symptoms when I carry around my 10-month-old. How do I help this?You probably have increased symptoms for two reasons. First, you are carrying around an extra 20 pounds when you hold your little one and that extra weight puts more pressure on your already weak pelvic floor. Second, as moms, we tend to stand with our hips thrust forward, so our little ones can lean against our chest. This position rotates our pelvis, shifting our abdominal organs into a position that is much more susceptible to a prolapse. Wearing a front carrier or sling carrier can help decrease your tendency to stand in this “hips thrust forward” posture. |
resources
If you would like more guidance than our DVD can provide, we encourage you to consult with your women’s healthcare provider, who can refer you to a qualified physical therapist, OB/GYN, UroGYN or midwife. To find a physical therapist who specializes in Women’s Health in your area, please click on the link below. We encourage you to do your research before beginning a relationship with any healthcare provider.
Buy our Pelvic Floor DVD
Find a Physical Therapist
To find a physical therapist who specializes in Women's Health in your area, visit the APTA Women’s Health website. Women's Health Physical Therapists are specifically trained in working with women on pelvic floor conditions. If you need more personalized coaching or more individualized diagnosis and support than we can provide in our DVD, we encourage you to check out their site and to see if there is a specialist in your area. Do your research before beginning a relationship with any healthcare provider.
More Resources
Simon Foundation: A good resource for information on incontinence.
SUNA - Society of Urological Nurses and Associates In their for patient section, they provide a number of helpful fact sheets for more details on the medical side of incontinence.
NAFC - National Association for Continence Another good place to go for information on continence and pelvic floor problems.