Sheila -- Any insight on pelvic floor muscle recovery??...

LovingLife

LovingLife

Cathlete
Hi Sheila -- I just had my 6th baby in November and learned at my 6 week visit that I had cystocele (bladder prolapse). My OB mentioned prolapse after my 4th and 5th, but I wasn't bothered much by it (well, actually, I do remember some problems that first year after my 4th which sound more like a problem with rectocele, but it cleared up on its own).

My OBGYN recommends pelvic floor repair surgery along with a hysterectomy. While I don't want to have any more children, I also don't want a hysterectomy -- nor do I see how to "fit in" surgery and all that entails in recovery with my family. I've read up on this quite a bit in the past few months and recently went to be fitted for a pessary just to alleviate the pressure I sometimes feel from the prolapse. I'm really happy with it and my hope is that this added support to the pelvic floor muscles will help it be in a better position to heal.

Also, I do Kegels and even ordered a Kegelmaster to give resistance with the Kegels, which seems to be helping too.

I've read that reduced estrogen levels contribute to weaker PFMs and that while breastfeeding, the estrogen levels are lower. So I'm also hoping that once I stop breastfeeding, my PFMs will become somewhat stronger too. (And I wonder if that helped with the problems I was having after my 4th baby).

I was just wondering if you had any insight on certain exercises that help to strengthen or mend this area or if you've had any experience with clients with prolapse. -- Renee
 
RE: Sheila -- Any insight on pelvic floor muscle recove...

Hi Renee,

Wow, yes I do have some insight on pelvic floor recovery, both on the personal and professional level. You see, I had a bladder prolapse with my first child born in 1996. My doc told me that there was nothing that he could do but "fix it," and only after I was "done having babies." Luckily, I was "in the business" and knew where to look otherwise for help with the problem before I resorted to the surgery. My advice to you is to find a physical therapist that deals in OB related problems. There is a woman's health section of the American Physical Therapy Association. I would contact the APTA if you can't find a PT in your area that deals specifically with your problem. They could probably direct you to someone. That is exactly what I did and have never regretted it. Not only did I correct the problem, but when I delivered my son 27 months later, I did not incur another prolapse. I am pessary free I might add.

In the meantime...... Take all of the impact out of your cardio. This is imperative as it will just add more stress to an already traumatized pelvic floor.

Keep us posted. I've definitely been there and can totally relate.

Sheila

Sheila S. Watkins, MLSci.
Founder and National Program Director
Healthy Moms(R) Fitness
www.healthymomsfitness.com
 
RE: Sheila -- Any insight on pelvic floor muscle recove...

Thanks so much Sheila! You don't know how much this means to me to learn this (well, maybe you do because you've been in my spot :)). I hadn't thought of physical therapists having a specialty in this area, but it makes sense. I live in a rural area, but there are a few reputable PT groups that say they deal with this (just did a quick yellow page ad search) and I'm going to call and find out more. I also went to the APTA website and searched for specialists and found some farther away from here, but if need be, I'll look into that.

Did the therapy mostly deal with kegel exercises or were there other exercises too?

Also, thanks for the info on the high impact. Do you think I could do kickboxing without the impact or step work without the jumps and hops? I'd to give up Cathe's cardio, but if need be, I will. Also, how long do you think it would be before I could resume to high impact cardio if and once the PF muscles heal properly?
 
RE: Sheila -- Any insight on pelvic floor muscle recove...

Could you describe what this feels like? I suspect I have something wrong but I don't know what it is. What are the symptoms?
KathrynH
 
RE: Sheila -- Any insight on pelvic floor muscle recove...

Kathryn -- From what I understand, there are 3 kinds of prolapse -- bladder, rectal, and uterine. Symptoms can include incontinence, problems with bowel functions, and pressure or pain from the weight of any of these prolapsed organs (are they organs?). Some compare it to the feeling of when a tampon isn't inserted correctly, but for me, the pressure was more like an uncomfortability really late in pregnancy. In severe cases, you can actually see or feel the organs protruding from your pelvic opening.

I've read a few books on this and have searched the internet for information too. The best book I found so far is called "The Incontinence Solution -- Answers for Women of All Ages" == It covers all kinds of prolapse and incontinence and offers information on surgical and non-surgical ods for repair or healing.

Shiela -- Did your Physical Therapy include bio-feedback? I saw that listed in the PT ad and remember reading about it in my book. Also, I called the PT group and they do have a specialist in PV repair, so I'm going to see if my doctor will give me a referral when I go in next week, so my insurance will cover it and I'll go see what they can do.
 
RE: Sheila -- Any insight on pelvic floor muscle recove...

Renee - I've just very recently noticed that feeling of pressure on my behind area. I've had a problem with leaking during high impact workouts since my daughter was born in '98, and it's never gone away, but just recently, I've noticed slight pressure....I guess I better go see a doctor. Thank you for the reply!
KathrynH
 
RE: Sheila -- Any insight on pelvic floor muscle recove...

Hi Sheila -- Just wanted to update you on my PT progress (small as it may be :)). I went to my OB today and told him that I have a friend who had success with her prolapse with PT and he kind of chuckled and said that he didn't think it would help in my case much. He said it was like throwing a match to help a bonfire :). But I stayed strong and told him that I'd like to explore every possible avenue before considering surgery (which he tried to encourage me once again to get -- telling me that I would have no problem with it, etc.). He's a wonderful doctor and I respect him in many ways, but he's so pro-hysterectomy that I have to remember when I'm in his office what my desires and goals are. Bottom line is that I got the referral and am going to call the PT office in the morning to see when I can get an appt. I'll keep you posted.
 
RE: Sheila -- Any insight on pelvic floor muscle recove...

Good luck! Sorry I did not answer the question regarding biofeedback. Although my treatment did not include the use of biofeedback, I am aware of other women who did utilize this in their rehab.

Thanks for keeping us posted.

Sheila

Sheila S. Watkins, MLSci.
Founder and National Program Director
Healthy Moms(R) Fitness
www.healthymomsfitness.com
 
Some more info on pelvic floor rehab and Kegels

I have found a great article, "The Bastardization of Dr. Kegel's Exercise," at www. incontinet.com/articles/art_urin/bastard.htm

It is not an article for the casual Kegler, but for those wanting to know more about Dr. Kegel and his methods for offering an alternative for surgery for those with urinary incontinence, his area of research.

I, as a fitness instructor, have always seemed to avoid the term Kegel and have used "pelvic floor exercises" instead - and this article seems to support my suspicion, that what many people seem to refer to as Kegels, or Kegel exercises, are just part of Dr. Kegel's method. Biofeedback was an very important part of his method and most people who believe that they are "doing Kegels" are probably not even doing it right (ie. squeezing glutes, adductors and abs and not really even knowing where their pelvic floor muscles are or how to engage them) - why biofeedback was so important to his method.

Now as a part of the emphasis on core stability, the term "Kegel" is being thrown around in fitness studios all the time - often by those who have know real idea what a Kegel and who simply offer that old "squeeze to stop the flow of urine" tip - but as is pointed out in the article, if someone is incontinent and has weak pelvic floor muscles, they can't stop the flow nor really feel the muscles that are supposed to do it. And besides, what about all of the other layers of the pelvic floor muscles, not just the sphincter around the urethra? Those are the ones that really help your core stability.

I am also a prenatal fitness instructor and Kegels were just a small part of my prenatal certification. However, I have completed a 3 day pelvic floor muscle training instructor certification (just when you thought you had heard of all the wild and wonderful certifications out there) and it really was just the tip of the iceberg - I am finding more information all of the time (and realized that in Julie Tupler's book, Maternal Fitness, she only mentions the outermost layer of muscles). I did the certification here in Germany and don't really know of anything comparable in North America (other than some workshops of Elizabeth Noble). So if you have any interesting links or other resources, let me know! :)
 
RE: Some more info on pelvic floor rehab and Kegels

Thanks for sharing all that information! Can you tell me what website that article was on? I tried the link and it said it couldn't be found.

One more piece of information that I learned from the Physical Therapist. She said that stopping the stream is not recommended as part of pelvic floor testing, except for maybe once a month because it will interfere with the messages that go from the bladder to the brain and can lead to bladder control problems. She said that once you relax those muscles for ion, you should keep them relaxed until you are finished (without getting too terribly descriptive here :)). YOu may already know that from your training, but I thought that was interesting.

My physical therapy has been interrupted due to insurance authorization delays (they approved me being treated for 3 months, but only for one visit -- errr!!!}( -- but that is all cleared up now and I go back again next week.
 
RE: Some more info on pelvic floor rehab and Kegels

Oops - forgot an "n" in the Website address. It should read:
www. incontinent.com/articles/art_urin/bastard.htm

It always bothers me when people or articles suggest stopping the flow of urine in order to learn how to do a Kegel exercise - I learnt, that an additional danger of doing that is the risk of bacteria entering (or re-entering) the urethra and possibly contributing to an urinary tract infection.

Happy Kegeling!
 
RE: Some more info on pelvic floor rehab and Kegels

Thanks -- I found the article. I really liked seeing that women have dealt with avoiding surgery in the past, but it makes me sad that we still have to today. It amazes me every time I go see my OB how he sees his option as "a piece of cake" with no side effects on my part. He just can't be that sure and it bothers me that he wouldn't have to deal with any of them -- and I would.

I go see my Physical Therapist again tomorrow. Got delayed a bit because of Insurance authorization hold-ups, but it looks like I'm clear for 3 more visits anyway.

Can you tell me more about the class you took for your certification? From whom or where do you get this kind of an education?
 
RE: Some more info on pelvic floor rehab and Kegels

Hi - sorry it has taken me so long to respond - I have been so busy with work and my family, that I rarely have a chance to go online - but yesterday was my last day at work (yeahhhh!).

I took a 3 day certification course in Pelvic Floor Muscle Training through the DTB (Deutscher Turner Bund = German Gymnastics Federation) in Frankfurt, Germany. It was led by a physiotherapist who, after years of clinical practice, established her own fitness studio. In Germany, pelvic floor muscle training courses are offered as classes through community centers, recreation centers and women's centers - much like how step classes are offered in North America. The attendees are of all ages (not just new mothers) and some classes cater particularly to men (ie. after prostate surgery). I learned alot through the certification course, and although I am not presently leading a class for pelvic floor muscle training, I do incorporate what I learned into my other classes (and not just my pre and postnatal classes!) I have amassed quite a library of books on pelvic floor muscle training - however, the books are all in German. I also belong to the Postnatal Exercise Instructors Guild in the UK and hope to attend their workshop in October in London on the latest research in pelvic floor muscle training - including more information on the use of biofeedback.

However, in North America (I am originally from Canada), there doesn't seem to be much going on in this area - unfortunately. As I mentioned before, Elizabeth Noble offers courses but I haven't heard of anybody else. But can you imagine pelvic floor muscle training becoming commercialized like other fitness trends? "Reebok - The Kegel", "Nike PFMT - Just Do It" ... but it probably won't happen.;)
 
RE: Some more info on pelvic floor rehab and Kegels

Thanks for your response. Don't worry about how long it takes you to write back -- it's just good to hear from you.

That's wonderful that the training is so thorough in Europe. Some things take longer in our western world. But maybe we'll catch up someday.

I just went to my PT today and she is SO impressed with my progress. It's hard for me to tell how things are progressing -- I see some outward signs, but she told me today that I've come farther in a shorter amount of time than any patient she's ever had. And she also said that my progress is making her have some confidence in the Kegelmaster's abilities. I'm going back in another month and hope to continue to improve, then to go another month before my annual check-up with my OBGYN and hopefully really have a difference for him to see so he can have some faith in the Physical Therapy approach and recommend it to other patients. (And, maybe he'll stop pushing the }( Hysterectomy }( to me :) . -- Renee
 
You must log in or register to reply here.

Our Newsletter

Get awesome content delivered straight to your inbox.

Top