Pelvic floor physiotherapy

Posted , 5 users are following.

Hello again ladies! I am 10 weeks post rectocele repair and started seeing a pelvic physiotherapist this week to strengthen my pelvic floor and hopefully prevent further prolapses in the future. We'll, she assessed my muscle tone and determined my muscles were tight and weak. I tried to perform a kegel and nothing moved!! I have been trying at home the last few days and still can't feel anything. I was never really informed about doing kegels before and havent done them my whole life (I am 37). Has anyone experienced this before? How can my muscles be tight (ie tensed up all the time) I was encourage to relax my pelvic floor but I am not sure I even know how.

0 likes, 11 replies

Report / Delete

11 Replies

  • Posted

    Hi Heather,

    I know exactly what you are talking about. Some days (especially after doing a shift or two at work) I find that my pelvic floor muscles are so tight I have problems relaxing fully and therefore can't do a full proper squeeze. It is very frustrating, but just have to keep trying and eventually after day or two my body must relax and I manage without any bother.

    After a shift at work my pelvic floor feels like it is lying low and very tight, think that is the muscles that I haven't used for last 3 months tightening up. Normally would have a wee glass of wine if not working next day which helps me too relax; but not been drinking alcohol much since before op, been drinking lots of water and cranberry to avoid any irritation in bladder from urine.

    Had a wedding aroubd 5 week post op and an afternoon tea 9/10 week post op for my sisters 70th birthday and When I did have wine (even if just one glass) , I feel it relaxed me too much and again can felt it next day as if the muscles on pelvic floor were too relaxed and were unable to support pelvic floor, so finding it difficult to get a happy medium.

    If you haven't done these exercises before it does take a little while to perfect them. I have too take really deep breathes and fully empty my lungs to relax pelvic floor properly.

    I hope that you eventually manage to master them. I'm sure there are helpful resources pinned on the homepage about kegals and who should or shouldn't do them and other exercises that can help; that reminds me that I am meant to be trying some of the others out myself.

    Good luck and do persevere you will eventually master it.

    Phyl x☺

    Report / Delete Reply
    • Posted

      Heather, I was exactly the same when I was learning how to do them first time. It does take time and practise to get it right. I found it really difficult to do them without tightening my buttocks and abs. Once you are doing them correctly you will definitely know as you can feel the muscles tightening up across the front of your lower pelvis.

      Phil x☺

      Report / Delete Reply
  • Posted

    Hi Heather,

    You might want to read the article in the moderator's sticky post about when kegels are bad for you.  It is written by a pelvic floor PT and is very relevant to your situation.

    From what I have read, and what I have experienced going to pelvic floor PT, if your pelvic floor muscles are too tight or in spasm you should NOT do kegels yet.  It makes it worse.  You have to learn to relax them first and get them out of spasm.  The "exercises" I was given to learn to relax my pelvic floor were breathing exercises.  I couldn't really feel what it was like to relax them until I got them out of spasm.  I would lay on my back with my knees bent (or elevated, that's ok too) and do deep diaphramatic breathing. Later I would also imagine my pelvic floor going down when I breathe in.  That would help me relax the muscles a bit.

    My pelvic floor physical therapist did a lot of internal and external massage.  It is possible to try some of the internal stuff but I was never asked to.  I did try to copy the trigger point massages on my abdomen.  The breathing and relaxing were the big things, though.  That and not doing kegels.

    I think it is normal for them to help you relax and then later add kegels if needed, but you have to get your pelvic floor out of spasm first.  Oh, if you want to google it the term I see used most of the time for your pelvic floor being tensed up all the time or in spasm is "pelvic floor dysfunction"

    good luck to you.

    Report / Delete Reply
    • Posted

      Thank you for sharing your experience. My physio had a similar approach for me. She told me she was "stretching me out" both internally and externally. I will try the deep breathing and see if it helps.
      Report / Delete Reply
  • Posted

    Hi Heather!

    Don't panic, you have had so many repose time that your PF is very weak now. I had anterior repair, and I also had my PF tight and weak at the same time.

    The treatment that my physio did was the following:

    - Internal and external massage once a week for 5 weeks. Not allowed to do kegel. Massage is very good to relax the muscle but also good to prevent adhesions and pain in intercourse.

    - When the PF was fine, then we began with kegel. I could squeeze the PF but in cases like yours they use electrotherapy: they put inside your vagina an electrode and using a device, the muscle is induced to squeeze.

    Btw how are you doing? I have a post repair scheduled for September... Have you noticed any difference?

    Hugs!!🌞

    Report / Delete Reply
    • Posted

      I was told I will have some biofeedback next week. She will insert something inside with sensors and it will show a graph on the computer to see if there is any muscle movement. I am very interested to see the results! I think I can feel my pelvic floor muscles but only right after I go pee am I able to contract them. No other time during the day. Weird.

      As far as the surgery, it was a big success for me. My main concerns prior to surgery were having difficulty with BMs. It never felt like I was completely empty. Also I am a runner, and I had to have a BM 3-5 minutes after I started running....Everytime! It was so annoying. I started my run on the treadmill, got off to go to the bathroom, then began my run outside. Less major concerns were feeling "open" down there ( so much that I often made noise when I walked!) and limited sensation during sex.

      The surgery has so far fixed all my concerns. I forgot so easy it was to go to the bathroom before the prolapse! Sex is much better. And I just started run/walking this week and no issues there. Definitely worth it!!

      Now I just need to strengthen up my pelvic floor so I don't have to worry about another prolapse again

      Report / Delete Reply
    • Posted

      I'm very happy for you Heather, it must have been very annoying! And happy to hear that the surgery solves the problems with BMs. Keep with physio, it's slow but you will notice improvement in the strength in some months. Hugs!
      Report / Delete Reply
  • Posted

    Hi Heather,

    Its great you have had an appointment with a Physio, as your treatment progresses you will be taught how to engage the muscles correctly, but also, and more importantly to see that the pelvic floor does not act in iscolation, it doesn't. Posture is a big deal here, walk tell, sit up straight, all of this helps the core to work with the pelvic floor to give you strength and control.

    Both you and Phyl mention a 'tight' pelvic floor, and yes, sometimes kegels are not suitable, and it is relaxation that is needed. This is trick in itself, to leaft to relax the muscles sometimes need professional help and you are in a great place for that. A tight pelvic floor is a dysfunctional as a weak on because it 'locks'. . The work you do now will really help you moving forward to prevent further surgery and make sure this repair last you a lifetime.You have a positive attitude and that is half the challenge! Good for you.

    Good luck. It would be helpful too if you could let us know how you get on with the Physio work, what happens - I know many women decline Physio appointments thinking that surgery is the last stage and they are 'fixed'. As many women will say, it is just the start of it and a Physio can help you tweak your lifestyle and any bad posture habits you may have to make you really strong.

    Good luck, keep strong

    S

    Report / Delete Reply
    • Posted

      Thanks Stephanie, I will let you know on my progress. I don't intend to stop physio until I see results. And now that I know about kegels, I will let my daughter know about them when she's older smile
      Report / Delete Reply
    • Posted

      Hi Heather, YES! you must tell your daughter - as there is a genetic link with pelvic floor problems. Chesk on your maternal side and you'll be amazed! It all fits into place the older and wiser we get and we must share it with the younger ones so they can avoid the challenges we have had if at all possible!

      Good luck S

      Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up