WHAT IS THERAPEUTIC EXERCISE?
Therapeutic exercises are specialized exercises to correct muscle imbalances due to compensatory patterns from pain and dysfunctions. It is important to understand that Pelvic Floor Dysfunction (PFD) is not treated the same as low back pain, hip pain, sacroiliac joint pain, or any other orthopedic condition. In the case of PFD resulting in pelvic pain, standard orthopedic exercises including strengthening and stabilizing core exercises are contraindicated and will typically exacerbate Pelvic Pain. The focus may be on gentle stretches and diaphragm breathing instead. Kegels are also contraindicated for those with pelvic pain.
When a pelvic prolapse or incontinence is present standard orthopedic exercises such as the clam, bridge, core exercises, and specialty exercises to strengthen the gluteals and external and internal rotators of the hip are indicated to increase pelvic support. In the case of pelvic prolapse and/or incontinence, Kegel exercises are typically recommended in conjunction with these exercises in the absence of pelvic pain. Remember it is important to isolate the pelvic floor as well as get a natural co-contraction of the pelvic floor muscles when performing orthopedic exercises.
It is important to see a pelvic floor physical therapist to know whether or not you are performing Kegels correctly as well as know if the pelvic floor muscles are naturally co-contracting when appropriate. If the pelvic floor muscles are not recruited correctly special retraining exercises and possible use of biofeedback and other modalities are required.