If you have a pelvic health condition, have had a baby, are postnatal or are going through the peri/post menopause, you may already be undergoing treatment with a Women’s Health Physiotherapist and it’s quite possible that you have been instructed to regularly exercise your pelvic floor as part of this.
But many women find it difficult to keep up with regular pelvic floor exercises over time and with the drastic change in many of our routines through COVID19 [resulting in home-schooling and working from home for example], this may have become even more challenging.
To be frank, pelvic floor exercises are not the most exciting, many women find them boring, they forget to do them and with the lack of regular clinician follow up and contact, how do you know if you’re even progressing with them?
We know from research that ‘supervised’ pelvic floor exercise [with regular guidance from a clinician], is more effective than unsupervised exercise and this lack of contact can contribute to a drop in adherence to pelvic floor exercise programs.
So how can you keep motivated to continue with your pelvic floor exercises during the ‘lock-down’ period?
Here are our top tips;
- If you don’t believe they will work, they probably won’t
Understanding what you are exercising and why is an essential part of the rehabilitation process. Normally your Women’s Health Physiotherapist will have explained your condition to you thoroughly, taught you how to correctly activate your muscles with an internal examination and explained why you need to do what you need to do. They will also provide you with an individualised pelvic floor exercise program that is specific to you and your needs.
However, if you are still unsure about how and why you need to exercise these important muscles, this will surely affect your motivation to do them and belief that they will work. Our previous blog posts ‘What is the pelvic floor, where is it and why is it important?” https://www.enlivenhealth.co.uk/the-pelvic-floor-where-is-it-what-does-it-do-and-why-is-it-important/ and “The Pelvic Floor: How to exercise it to achieve optimal function” https://www.enlivenhealth.co.uk/the-pelvic-floor-muscles-how-should-you-be-exercising-them-to-achieve-optimal-function/ will provide you with more detail regarding this, so check the links here if you need to.
We know that for many women, particularly those with incontinence or pelvic organ prolapse, pelvic floor exercises do work. This is why they are prescribed as the first line of treatment for these conditions, as recommended by the National Institute of Health and Care Excellence [NICE].
But it is also important to remember that in order for these exercises to work they need to be done, they need to be done regularly each day, they must be performed over a period of 3-6 months and in a way that will provide appropriate changes to the muscle which is relevant to your ability and needs. Just doing them ‘here and there’ will not provide these all-important muscular changes and this if often why women give up with their exercises when they do need see improvements quickly.
- Try to establish a routine
Easier said than done of course, but particularly with things the way they are with ‘lock-down’, routine is so important for getting these exercises completed during the day and so finding one that works for you is essential.
I normally recommend to ladies to try to complete their exercises by lunchtime. This means there is no need to worry about them for the rest of the day, or indeed having to do them towards the end of the day when the muscles are more tired, or when symptoms are often worse. I recommend doing a set of exercises first thing in the morning, mid-morning then just after lunch, and remember it takes no more than 10 minutes to get each set done!
You could also try linking your exercise times with daily activities eg when sitting down feeding your baby or when you are cleaning your teeth. I would advise against doing them when you are driving as it tends to distract you away from the road [not to mention the fact that we aren’t supposed to be driving anywhere at the moment anyway].
- Use Pelvic Floor Exercise Apps
Research has suggested that using Pelvic floor exercise apps may help with adherence and compliance with pelvic floor exercise programs. They can also be useful as you can set a [subtle] reminder to do your exercises throughout the day, and you can input your program into the app so that you can follow it clearly from the screen which can make exercising more interesting. These apps are mostly paid apps and there are many to choose from, however there is an NHS app called ‘Squeezy’ which comes highly recommended and its use is frequently suggested by Women’s Health Physiotherapists, to support treatment regimes.
- Chart your progress
Sometimes women give up with their pelvic floor exercises as they just can’t see any improvement. It is important to remember that it can take up to 6 months for symptoms to improve with regular pelvic floor training and so keeping on with them for this time frame is vital.
Documenting your exercise can help to keep you on track, however it can also help you to realise your progression. If you note how long you can hold each contraction for and how many repetitions you can do each week this can help you stay motivated if you see that you are steadily able to more.
Keeping a diary of leaking episodes can also be useful as these should also reduce with ongoing regular exercises.
- Do a class
There are currently many options available of low-impact and pelvic floor-friendly online exercise classes as the current COVID19 situation has forced many therapists and practitioners to take their services online. These provide options whereby you can mix up your exercise and try something new or varied to make your routine more enjoyable.
If you are experiencing symptoms of Pelvic organ prolapse, incontinence or diastasis, you may need to be careful about what types of exercise you choose to do online. However, if you choose a practitioner or instructor who is appropriately trained in pelvic health conditions, or a Women’s Health Physiotherapist, they should be able to instruct you appropriately. It is important to note that if your symptoms worsen or develop during or after a class you stop straight away and contact your therapist. Different forms of exercise can be greatly beneficial and can help with motivation and compliance as well as keeping you generally more strong and active.
- Bring Pelvic Floor exercise into function
We know from research that the best way of improving pelvic floor function is through specific pelvic floor muscle training, and this has been shown to provide the best improvements in pelvic health symptoms. However, the pelvic floor must also be trained to be able to activate during everyday function. Practising your pelvic floor exercises each time you get up from sitting, whenever you squat, bend or pick something up can assist with this, as well as mixing up your general training program.
- Contact your Women’s Health Physiotherapist
Obviously, services are currently much more limited and regular supervision and guidance from your clinician is likely to be reduced. However, we are still here and have not forgotten you. Many of us are still contactable by email or are offering free telephone consultations.
If you are struggling with your exercises, are lacking in motivation or are finding that your symptoms have worsened, make contact with your therapist and try to organise a time to discuss your issues with them. Remember they are here to help and are supportive and want you to get better too! Supervised pelvic floor training is more effective than unsupervised training and so do make sure that you contact your Physio for support if you are finding it hard to keep the exercise going.
If you need help with your Pelvic Floor exercise program feel free to get in touch for a free telephone consultation. We are here to help!
