HYSTERECTOMY: PELVIC FLOOR EXERCISES
The muscles around the pelvis are very important in supporting the bladder, urethra, vagina and rectum. Regular practice of pelvic muscle exercises can help to strengthen these muscles. The first step is to identify the correct muscles to exercise.
• To identify the muscles around the rectum, sit or stand comfortably and imagine you are trying to control diarrhoea by consciously tightening the ring of muscles around the anus (back passage). Hold this ‘squeeze’ for four seconds. Relax and repeat several times.
• Now go to the toilet and start passing urine. Try to stop the flow of urine in midstream. Once this is done recommence urinating until the bladder has emptied. The muscles used to stop or slow the flow of urine are the front pelvic muscles which help control the bladder.
• Some women find they can identify the correct pelvic muscles by inserting a finger into their vagina and then contracting the pelvic muscles to squeeze the finger. If there is no sensation of squeezing around the finger you may be exercising the wrong muscles. Note that you should not bear down as if trying to pass a bowel motion as this strengthens the wrong muscles. Do not despair if you do not seem to be making progress for several days; it may take a week or more to begin to identify the muscles that need to be exercised to strengthen and tone the pelvis.
The second step, having identified the target muscles, is to repeat the following series of exercises at least four times each day. Note that they should not be done while passing urine. With practice you will find that you can do them at any time — while waiting for a bus, watching television or setting the table.
1. While sitting or standing with thighs slightly apart, contract the muscles around the rectum followed by the front muscles around the vagina. Hold this contraction while counting to five slowly. Relax these muscles then repeat four more times. Try to be aware of the squeezing and lifting sensation in the pelvis that occurs when these exercises are done correctly.
2 While sitting or standing, tighten the muscles around the front and back passage together. Hold this contraction for just one second and relax. Repeat this exercise five times in quick succession. It is a good idea to return to the first step once every week or so, to check that you are using the correct muscles.
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