Pelvic Floor Exercises PDF

Pelvic floor The network of muscles, ligaments, and other connective tissues in the lower abdominal area that provide support to the uterus, bladder, vagina, and rectum. Pelvic floor exercises Exercises can be done from any comfortable position for the mother Po...

Pelvic floor The network of muscles, ligaments, and other connective tissues in the lower abdominal area that provide support to the uterus, bladder, vagina, and rectum. Pelvic floor exercises Exercises can be done from any comfortable position for the mother Position of the therapist: stands beside the mother at the level of her pelvis  Command: try to contract as if you control urethral sphincter, or bowel action and draw the vagina up, hold for five seconds then relax for five seconds. Any contraction of the glutei must be avoided. Uses: Antenatal: to improve pelvic floor strength and elasticity. In post natal period: to strengthen pelvic floor muscle to avoid stress incontinence or genital prolapse. Pre and post vaginal operations. Pelvic Rocking (tilting) Exercises They include muscles of the anterior abdominal wall and muscles of the posterior abdominal wall. Muscles of the anterior abdominal wall: External oblique muscle Internal oblique muscle Transversus abdominis muscle Rectus abdominis muscle Muscles of the posterior abdominal wall Psoas major muscle Iliacus Quadratus lumborum Pelvic rocking exercises Upward backward “posterior pelvic tilting”: the acting muscles are the abdominal and hip extensors muscles. Downward forward “anterior pelvic tilting”: the acting muscles are the back extensors and hip flexors muscles. Pelvic rocking exercises can be performed from the following position: crock, creeping, sitting, and standing against the wall. I. Upward backward pelvic rocking exercise 1. From crock lying: Position of the therapist: standing at the level of woman’s pelvis Grasp: thumb on the ASIS and fingers fanning laterally around the pelvis. Command: contract glutei, abdominal muscles and press lumbar region down, hold then relax. 2. From creeping position: We must take care that: Back parallel to the ceiling 90 degrees between arms & trunk; trunk & thighs; thighs & legs and legs & ankles. Then ask the woman to contract glutei, abdominal muscles and try to make her back as a hump, hold then relax. 3. From standing against wall: There must be a foot distance between the feet of the woman and supports the back against the wall. The woman contracts glutei, abdominals muscles and press lumbar region against the wall, hold then relax.  II. Downward forward pelvic rocking exercises: 1. Crock lying position: try to make a tunnel between lumbar region and floor through contracting back extensors and hip flexors, hold then relax. 2. From creeping position: ask the woman to increase the lumbar curvature. 3. From standing against wall: ask her to try to make a tunnel between lumbar region and the wall. Abdominal Exercises Functions of the abdominal muscles Help in respiration and defecation Protect the abdominal viscera and keep them in their position Cause forward flexion of the trunk  Play an important role in labor. Assist in maintaining erect posture Stabilize the pelvis (especially rectus abdominis) during straight leg raising Types of abdominal exercises: Static abdominal exercises, Dynamic abdominal exercises. 1) Dynamic abdominal exercises 1) Lateral flexion of the pelvis (hip shrugging): it is helpful to strengthen the quadratus lumborum.. Position: half crock lying Position of therapist: standing with the outer hand holding the straight leg just above the ankle joint, while the other hand supporting the poster lateral aspect of the knee and the thumb just above knee joint to prevent its flexion. Command: contract abdominal muscles, draw the straight leg up towards the ribs to seem shorter then push down to seem longer, relax and return to starting position. 2) Lateral flexion of the trunk: It strengthen the internal oblique muscle. Position: crock, supine, sitting or standing Command: from crock or supine, contract abdominal muscles, try to touch with the tips of the fingers the farthest point on your leg, with the head following the movement and eyes looking behind the shoulders, hold and relax. 3) abdominal muscles as pelvic rotators To strengthen the external oblique muscles Position of the patient: crock lying position Command: contract abdominal ,muscles, try to touch plinth with flexed knees, hold and relax 4) Abdominal muscles as trunk rotators: Position: sitting on stool or standing Command: with maintaining the pelvis fixed, contract the abdominal muscles, turn upper trunk to the right as far as you can, and let your head and eyes follow the movement, hold and relax. 5) Abdominal muscles as antero-posterior flexors of the trunk Position: crock, or supine lying. Command: contract abdominals, raise the head, shoulders and upper trunk and look to the feet, hold and relax. Come to the sitting position with stretched arms in front