One of the most common statements made by my pelvic floor patients is “I had no idea I had muscles down there!” Very often they say they had been told by a doctor or a nurse how to do “Kegels” to strengthen their pelvic floor, but that they did not continue to do the exercises because they had no idea if they were doing them right. Studies show that most women with pelvic floor muscle (PFM) dysfunction are not able to correctly contract their PFM with verbal instruction alone and a lot of those women cause more harm with incorrect technique due to Valsalva or so called ”bearing down”.
Many recent reviews have shown that all exercise interventions targeting pelvic floor muscles (PFM) may be effective in improving their function. However, exercise training that is supervised or includes some type of biofeedback device shows greater and faster improvements than unsupervised exercise training.
What is biofeedback for pelvic floor muscle retraining?
Biofeedback for pelvic floor muscle retraining is a treatment to help patients learn to strengthen or relax their pelvic floor muscles in order to improve bowel or bladder function and decrease some types of pelvic floor pain. Biofeedback allows you to see exactly what your muscles are doing giving immediate feedback (information) when you perform pelvic floor muscle exercises correctly or not. All this information or “feedback” is used to gain awareness, and with practice, control over pelvic floor muscle function. An important part of pelvic floor biofeedback therapy is consistent practice of the pelvic floor muscle exercises program at home. With biofeedback, you can learn to stop using the incorrect muscles and start using the correct ones.
Biofeedback can vary widely in pelvic floor physiotherapy. It can be as simple as teaching you to self monitor your PFM contraction using your finger tip, vaginal or anal probes, weighted vaginal cones (slippage of the weight provides immediate feedback), air pressure controlled devices or surface electromyography (sEMG).
My go-to tool in the clinic is RTUS (real time ultrasound). It allows to:
- teach my patients to connect to their pelvic floor
- view the movement of the pelvic floor,
- view the bladder neck, anorectal angle, pelvic organs support
- measure bladder volume
- keep my patients interested, engaged and motivated
The are two possible application depending on the goal of the assessment:
- trans-abdominal (when the probe is placed over your pubic bone to assess and teach pelvic floor muscle activity and measure bladder volume)
- trans-perineal (when the probe is placed against the skin between your back passage and your vagina to assess and teach pelvic floor activity, view pelvic organ support and more)
With ultrasound imaging our scope as physiotherapists is currently not
diagnostic. We are not looking to identify or rule out pathology in the uterus, ovaries etc. (for that you will need to see your doctor). We are simply extending our physiotherapy musculoskeletal assessment while also offering a biofeedback.
How to prepare for RTUS?
To get the best view, you need to have a full bladder. To make sure that you bladder is full when you arrive:
- Empty your bladder 1 hour prior to your appointment time.
- Immediately drink 500mls of water.
- Drink further 500mls of water within the next half hour.
If your bladder is particularly full when you arrive, let m know and we can start the assessment at the start of the treatment.
To book an appointment click in the link https://mnaphysiotherapy.wordpress.com/contact/
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