We will initially go over a brief anatomy and physiology of the muscles that support the pelvic floor as well as the role the abdomen, diaphragm, and lungs play when strengthening these muscles. We will also spend some time talking about correct posture while sitting and standing and the importance of pelvic floor stability in overall pelvic health.
The assessment includes a vaginal exam where the clinician is able to palpate and evaluate the major muscles and ligaments that support the vagina/uterus, bladder, and bowel. You will be asked to try to “squeeze” or contract these muscles to determine if you are able to identify and engage them and whether the muscles have any strength. Often the first step in starting a program of pelvic floor muscle strengthening is learning to engage the correct muscles. We will also spend time reviewing breathing techniques that help relax the pelvic floor, a key factor in effective muscle contractions.
Once this assessment has been completed, small pre-gelled electrodes will be placed on the perianal region. The wires will then be attached to a special computer program that will allow us to evaluate the strength and endurance of your pelvic floor muscles. You will be able to view the graph that represents the electrical pathway of these muscles—this is the biofeedback portion of the exam.
By observing the screen, you will be able to control your muscle contraction and relaxation. From what we learn during this biofeedback session, you will be given a series of exercises to do at home. The success of your home exercise program is very dependent on performing these exercises every day.
Building pelvic floor muscle strength and endurance is like exercising any large muscle of the body. Because these muscles have not been used in a while, you will start the exercise program slowly and build as your muscles become stronger. It is very important not to over fatigue the muscles and to relax completely between contractions. The quality of the contraction is more important than the quantity.