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Re-education and training of the pelvic floor
What is the pelvic floor?
The pelvic floor is the set of muscles, ligaments and fascial tissue that closes the pelvis in its lower part. It guarantees support for the viscera, contributes to urinary and faecal continence and guarantees good sexual activity. Furthermore, its state of health and its correct activation are essential in breathing and during physical activity.
How to keep the pelvic floor healthy?
First of all, maintaining correct daily habits such as drinking a lot of water, going to empty the bladder only when you feel the urge, thus avoiding the “safety pee” when the bladder is not yet completely full but at the same time do not wait too long in addition to the sensation of stimulus.
Avoid peeing suspended from the toilet since the pelvic muscles would not be in the posture suitable for complete relaxation during urination; it is good to have a toilet cover when using a public toilet or prefer the squat toilet.
For the perineum, the posture assumed in the faecal evacuation is also very important, to avoid having to push too much; the ideal position would be the crouched one, as acquired by the use of the squat toilet, but since we have got toilet bowls at home, it is advisable to put a wedge under the feet to close the angle between the torso and the thigh.
Many people believe that prolapses or incontinence are completely normal with advancing age, but most of these situations could be avoided thanks to good prevention.
How to re-educate the pelvic floor in Post Pregnancy, especially in case of incontinence?
Most women after pregnancy are very keen on returning to physical fitness, but most of the time the focus is mainly on abdominal work, without re-educating the pelvic floor first. This can be harmful, because the increase in intra-abdominal pressure, without having worked on the perineum first, can lead to some of its dysfunctions and over time also to the onset of the aforementioned pathologies.
The pelvic floor during pregnancy is severely tested due to the weight gain it has to support; re-education is absolutely necessary if any lacerations or episiotomies are added during childbirth.
Scars lead to thickening and a loss of elasticity of the tissue; it will be the physician’s responsibility to evaluate the most suitable path for the patient. In some cases, it is good to contact the functional rehabilitation department of your hospital or a trusted midwife for internal rehabilitation; in other cases, it is sufficient to follow courses in small groups aimed at pelvic floor gymnastics, in which some exercises are taught which must then be continued at home.
The same care and attention must also be paid to operations relating to the abdomen and hips. The pelvic floor is formed, in addition to the muscles, by a large amount of fascial tissue which, among its functions, connects and transmits forces to other adjacent structures. Therefore, it is important to consider not only the muscular part that affects the orifices, but our attention to movement must be more global, attentive to the connections that the pelvic floor has with hips, abdomen, and lumbar area.
In conclusion, it is good to train the pelvic floor as we would train any other part of the body, increasing the proprioception of an often-forgotten area, performing voluntary contraction exercises but also relaxation and trying to connect its activity with the other parts of the body during the physical exercise.