Category: Pelvic floor problems

Experience of a modern approach to pelvic floor exercises

By Lottie Grey

My friend and I heard a talk by Maeve Whelan for the Pelvic Partnership when Maeve was addressing an AGM meeting a few years ago. We were interested in Maeve’s modern take on PGP and how often PGP symptoms were linked to a struggling pelvic floor (where muscles are often over-exercised and out of balance so they fail to function properly).

We both felt we would benefit from seeing Maeve but felt it was too far and too expensive to travel to her clinic in Dublin, so we looked at her website to see if we might be able to visit one of the other practitioners/ manual therapists she lists there who use manual therapy techniques to treat pelvic floor dysfunction.

My friend Ella and I had both experienced tearing during the delivery of our children and I knew that I had a slight prolapse where the vagina wall had been weakened as a result and was no longer as strong. As advised after the birth of my children, I did a pelvic floor course to regain strength and control again. This was held at a local gym near the maternity hospital where my children were born. I am reasonably fit and healthy and I still take regular Pilates classes, swim and run but I was still prone to urine leakage if I laughed, coughed or tried to exercise with a full bladder. My GP had referred me to see a physio at my local hospital. It was useful and I learnt that I was probably passing urine more frequently than I needed and that I tended to drink too much coffee and tea which were stressing my bladder. However, although I did the exercises I was taught and could feel that my muscles within my pelvic floor were stronger, I still leaked which was annoying and embarrassing so I didn’t think, overall, that I had made much progress.

Ella and I went to see Helen, a practitioner mentioned in Maeve’s list who lives quite close to our town. We chose her because she was an experienced physiotherapist, specialised in women’s health and had postgraduate qualifications. We both spoke independently to her on the phone to see if we could get consecutive appointments on the same day, enabling us to travel together. We also discussed our symptoms over the phone to make sure that she knew about our needs and what we wanted to get out of the session. In addition, both of us mentioned that we had experienced PGP symptoms and that both of us had overcome them with manual therapy during our pregnancies.

On the day, I went in to see Helen first and she was welcoming and very approachable although I thought she looked very young! She came across as very professional and in control of the interview. After covering my medical history at the start and going over my experience of PGP and incontinence, she moved on to examining me. She started with an examination to check how my pelvic joints were moving to see that I was fully recovered. She then moved on asking about my bladder incontinence and checked that I was happy to be examined internally.

I found that I felt at ease although I did feel odd having a normal conversation as she checked the strength of my pelvic floor! Helen was able to tell where muscles felt tight and where there were weaker areas of my pelvic floor. It was slightly uncomfortable as she worked on these areas but I did not find it painful. Helen also looked at the relationship between my abdominal muscles and my pelvic floor and we agreed that, although I was quite fit, I had some very tight muscles and some that weren’t functioning very well at all. She found various trigger points and worked to release tension and to bring my pelvic floor muscles into balance again. I agreed that I also had a tendency to tense up when exercising or relaxing, which we agreed was probably a legacy of trying to manage the pain I had experienced originally with PGP. I realised I hadn’t got out of this habit and we explored ways of relaxing my stomach and doing some exercises to keep my pelvic floor working efficiently. We also worked on my breathing and how to reduce the tension in my pelvic floor through specific exercises. I found my muscles tired quickly and so I had to stop for rests during the session but this gave me the chance to really concentrate on what Helen was explaining.

My friend Ella and I booked about four subsequent visits and we both made sure we practised what we had learnt during the sessions. A year down the line, I am much less likely to have episodes where I leak when I laugh or run for the bus. I know how to avoid over-stressing my pelvic floor and how to cope if I sneeze to avoid leakage. I can feel my pelvic floor is stronger. The sessions seem to have worked very well for me and I do feel that I have made significant progress since seeking help. Mind you, I am slightly jealous of Ella who seems to be able to go for hours and hours before needing the loo! She can also go running and have absolutely no accidents – even if she needs the loo towards the end of the run – whereas I still have to make sure I am completely empty before I start…

Thanks very much for sharing your experience of seeking help to improve your pelvic floor using the more modern approach.

Next steps with pelvic floor dysfunction

By Madeleine Speed

As mentioned in previous articles, there does seem to be a link between the symptoms of PGP and pelvic floor dysfunction. If any of these articles have raised issues that you recognise as being relevant to you, it is worth seeing a physiotherapist for treatment.

Have a look at the websites mentioned in our ‘The traditional and the modern approach to pelvic floor exercises‘ article. This will help you to understand some of the issues involved so you may feel more at ease about knowing what action you want to take.

If you go to see your GP as a first step, she or he can refer you to a physiotherapist on the NHS. This physio can discuss pelvic floor function with you and assess the strength of your pelvic floor. Some physios may encourage you to do exercises in line with the more traditional approach, although it is possible that you will be referred to someone who is aware of the newer techniques to bring the pelvic floor muscles into balance without overworking already stressed muscles. There are women who have success in improving their pelvic floor muscles with the more traditional exercises (as confirmed by the first article on this topic). If this approach doesn’t work for you and you can’t find the more modern approach through the NHS, you might consider finding a private physiotherapist who offers it (see a list of practitioners who have followed Maeve Whelan’s training offering the more modern approach to pelvic floor physiotherapy here).

Otherwise you may find specialist manual therapists (often women’s health physiotherapists for treatment of the pelvic floor) in your area and consider contacting some to discuss whether they are able to offer you the more modern techniques to resolve pelvic floor issues – do they use pelvic floor manipulation as part of their treatment?

Of course, you may already be seeing a physiotherapist, osteopath or chiropractor for manual therapy to treat your PGP symptoms. If this is the case – and you are happy with the progress they are helping you to make – you may want to ask if they offer help to overcome pelvic floor dysfunction or have a colleague that may be able to help. As mentioned above, PGP is often attended by a poorly functioning pelvic floor, so your manual therapist is likely to know of this link and may already be working with others to improve their pelvic floors.

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The Pelvic Partnership consists of volunteers who have had pelvic girdle pain (PGP) and wish to support other women. We aim to pass on information based on both research and the experience of other women with PGP. We are not medical professionals and cannot offer medical advice and the information we provide should not take the place of advice and guidance from your own health-care providers. Material on this site is provided for information and support purposes only.

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