Pelvic Floor Dysfunction

Lion Rocker Connect – February

Pelvic floor muscles are a group of muscles connecting from the pubic bone to our tailbone, supporting our bladder, bowel (colon) and uterus or womb (in women). It supports us in a hammock-like/ ‘sling’ type manner. There are a few main functions of pelvic floor muscles, such as,

• Helps support our pelvic organs
• Provide lower back and pelvis support
• Maintain our continence
• Sexual functions

In this newsletter, we are focusing on pelvic floor dysfunction in pre and or post-natal women population, and how physiotherapy management are able to benefit them!

Physiotherapy treatment and management
To tailor the most effective pelvic floor muscle exercises for each patient, our physiotherapists will conduct a thorough assessment together with real-time ultrasound technique in different positions to test the loading ability of the pelvic floor muscles.

Management

There are 3 ways of advice and management on pelvic floor dysfunction, including:

• Pelvic floor muscles strengthening + training
• Lifestyle modification
• Pessary management

Pelvic floor muscles exercise program

• Divide into: strength training, endurance training, co-ordination re-training, combination [Hay-Smith Cochrane Review 2011]
• Physiotherapist will determine the different types of pelvic floor muscle training, depending on the patients’ symptoms and conditions
• “The Knack” – very useful and common tool in physiotherapy management, to teach women the coordination of tightening their pelvic floor muscles, in preparing for a known leakage-provoking event

• This is a management strategy particularly for patient with higher grade of prolapse or very poor pelvic floor muscles activation

• It is a guided tool to actively assist better muscles contraction and managing any symptomatic prolapse features

• Research shown to be as effective as surgery outcomes at 1 year timeline

• Patient satisfaction of 70-92% Improvement in anatomical pelvic floor muscles change, sexual functions

• But, not tolerable for all women + possible risk of infection/ ulceration/ pain

Lifestyle modification

• Our physiotherapists are able to tailor an appropriate, pelvic floor safe exercise regime for our patients in returning to low/ high impact of sports. This is usually demonstrated through progressive clinical Pilates program/ other core activation training
• Physiotherapists are able to provide strategies and advices on optimal angle/ positions to minimize strains on toilet
• Limit strain on heavy weight lifting
• Manage chronic cough/ sneeze