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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!

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Common symptoms:

  • Stress or urge urinary incontinence
  • Bladder or bowel leakage
  • Vaginal prolapse pelvic organ prolapse
  • Pelvic/ back pain

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

Pessary/ urethral support

 

[Int Urogynecol J. 2011 Jun; 22(6): 637–644.]

  • 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

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