7.2: 7.2-Where Do We Begin? – Physiotherapy

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The first step in therapy is to have the sufferer visit a physiotherapist with a special interest in pelvic floor rehabilitation. The physio will assess the strength of the patient’s pelvic floor, and suggest exercise to enhance the muscle power of the Levator muscles. She will need to have a programme of daily exercises extending over a number of weeks.

Pelvic Muscle Exercises: Do 45 pelvic muscle exercises every day, 15 at a time, 3 times a day: 15 lying down in the morning 15 standing up in the afternoon 15 sitting down in the evening

For each exercise: Squeeze the pelvic muscles for 10 seconds (start at 1 second and build up) Relax for 10 seconds
Remember to relax at the muscles in your abdomen when you do these exercises, and continue to breathe normally.
Test the power and effectiveness of your exercises by placing 2 fingers in the vagina, and squeezing. The physio will assist in assessing pelvic muscle tone.

The physiotherapist may also choose to employ the following: Weighted vaginal cones, which are placed in the vagina while the patient actively squeezes the pelvic muscles to prevent the vaginal cones from falling out. The weights begin at 20g, and increase until the woman can manage to retain a cone of 100g, for 30min twice daily.
Faradism, where tiny electric impulses are sent through an electrode placed in the vagina. The current stimulates the correct muscles to contract, and so build Levator power.
Bio feedback, where the patient squeezes a balloon placed in the vagina, reflecting on an indicator the power of the pelvic muscle contractions.
If a woman persists in physiotherapy, there is no doubt that the technique will result in better muscle strength and control, with a corresponding improvement in bladder control.
Bear in mind that physiotherapy is without side effects, may be done at home, and empowers the sufferer to take charge of her recovery.
Physiotherapy is also useful in the management of the overactive bladder, when exercises are known as the “urge strategy”, and help in the management of urge incontinence.