Definition & Overview
Abdominal and pelvic floor retraining is a treatment method that is designed to strengthen the muscles of the abdominal and pelvic floor, as well as its nearby muscles.
The muscles of the pelvic floor consist of a thin, stretched layer in between the tailbone (coccyx) and the pubic bone. These muscles are responsible for providing support to and allowing control of the bladder, bowel, and uterus (in women). When the pelvic floor muscles are contracted, the sphincters tighten the openings of the anus, urethra and vagina, thereby keeping them closed and controlled. When the pelvic floor muscles are relaxed, the passage of urine and faeces occur. Pelvic floor muscles are also vital in maintaining healthy sexual function in both men and women. These muscular structures also work with the abdominal and back muscles to stabilise and support the spinal column.
However, there are certain cases and causative factors that cause the abdominal and pelvic floor muscles to weaken. When this occurs, the internal organs are no longer supported and certain abnormalities in bowel, uterine, and urinary function may occur. Among causes of weakened pelvic floor include:
- Pregnancy and childbirth in women
- Gynaecological surgery in women
- Unnecessary straining during defecation (associated with constipation)
- Heavy lifting that creates undue pressure on the pelvic floor (may lead to prolapse)
- Chronic coughing
- High-impact exercises and sports
- Age (muscles tend to become weaker with age)
- Obesity (being overweight can place greater strain on pelvic floor muscles)
One of the few basic treatments for abdominal and pelvic floor muscle weakening is retraining exercises.
Who Should Undergo and Expected Results
Abdominal and pelvic floor retraining is suggested for those with abdominal and pelvic floor dysfunction. In general, pelvic floor disorders ultimately lead to hernias, wherein organs abnormally protrude due to the weakening of supporting muscles. Among common symptoms of pelvic floor disorder include:
- Urine leaks when coughing, laughing, running or sneezing
- Uncontrollable flatulence when bending over or lifting
- Heavy sensation in the genital area
- Distinct swelling at the vaginal opening (in women)
- Feeling of heaviness in the rectum or anus (in men)
- Failing to reach the toilet on time (incontinence)
Pelvic floor training exercises are also recommended for those with urinary stress linked to prostate surgery and patients with faecal incontinence.
Pelvic floor dysfunction is diagnosed through a pelvic examination using a speculum. During a check-up, the doctor may examine the internal structures, run tests to measure how much the bladder can hold, or may use a viewing scope to view the inside of the bladder. This can help determine the severity of the muscle weakening and determine whether surgical intervention is necessary. For milder cases, pelvic floor retraining or therapy can be considered sufficient treatment.
Pelvic floor retraining can help strengthen muscles under the bowel, bladder and uterus to ease the symptoms of pelvic floor weakening. In particular, the exercise can help:
- Improve bowel and bladder control
- Reduce the risk of prolapse of the bladder, uterus or bowel
- Improve recovery from prostate surgery (in men)
- Improve sexual function (in both men and women)
- Improve recovery from childbirth
- Increase social confidence
- Increase overall quality of life
How is the Procedure Performed?
Pelvic floor retraining is often performed with the guidance of a qualified therapist who instructs and monitors the progress of the retraining exercises. Therapists who specialise in this area, who are also known as continence professionals, can assess pelvic floor disorders and develop a customised and individualised training program that best suits patients’ needs.
In general, however, pelvic floor muscle training exercises is similar to pretending that one has to urinate, then holding it. Also known as Kegel exercises, the exercise can help strengthen the muscles to help them effectively support the bladder and the bowel. While doing pelvic floor exercise, it is important that the abdominal, buttock, and thigh muscles are relaxed. Certain devices may be suggested to further enhance the exercise.
Furthermore, biofeedback and electrical stimulation may be used to determine whether the correct muscle groups are being enhanced in the training exercise. In these methods, electrodes and sensors may be placed on target areas, while a monitor will determine which muscles are contracting.
Possible Risks and Complications
Abdominal and pelvic floor retraining exercises do not pose any considerable risk or complication. Their effectiveness, on the other hand, rests largely on whether the exercise is being done correctly. When done right and with the correct duration, pelvic floor muscle retraining is seen to be highly effective in improving urinary function and easing symptoms of pelvic floor dysfunction.
It is important to note however, that training exercises for pelvic muscle strengthening are only appropriate for mild cases of pelvic floor weakening. It is often not recommended as the sole treatment for severe cases of prolapse, with which surgical intervention may be necessary.
González Sánchez, B., Rodríguez-Mansilla, J., de Toro García, A.D., González López-Arza, M.V.Efficacy of training pelvic floor musculature in female urinary incontinence
Torkzadeh, A., Pormomeny, A., Zargham, M.The effect of two types of exercise therapy on improvement of stress urinary incontinence in women 2016 Journal of Isfahan Medical School