Pelvic floor rehabilitation: when is it indicated?

It treats and prevents, in a non-invasive way, often disabling dysfunctions

“We can imagine the pelvic floor as a rhombus that extends throughout its area in the area between the pubic symphysis and the coccyx and laterally up to the ischial tuberosities” explains the Doctor Chiara Barbieri, Midwife of the PacC. “The pelvic floor is made up of various muscular-connective structures which have the task of containing the viscera (the organs of the pelvic cavity), guaranteeing the correct functioning of the sphincters during evacuation and urination and allowing a satisfying sex life.

“We shouldn’t think of the pelvic floor as static, but rather as a hammock that adjusts to and accompanies the pressure changes in the abdominal cavity. We think during pregnancy about postural changes and the action of hormones in soaking tissues making them softer and more suitable for the birth of the newborn. During pregnancy, labor and childbirth the perineum plays a fundamental role and it is advisable to take care of it ”suggests the midwife of the Polyclinic City of Collecchio.

The pelvic floor muscles also require training. At best it is enough to perceive it, but for those who have never paused to listen to this area of ​​the body it can be difficult and a session with a pelvic floor rehabilitation specialist can make a difference.

“In case of more important issues, such as situations of hypotonus and hypertonus, several meetings are indicated with the midwife who, in agreement with the patient, decides the most suitable rehabilitation path. Hypotonus refers to a condition of laxity of the muscles that can cause incontinence of urine, stools and gas, prolapses, difficulty or inability to feel pleasure during intercourse. With hypertonicity, ie rigidity, there is difficulty in urination and evacuation, pain during intercourse, frequent cystitis and recurrent vaginal infections “.


Never underestimate the pain

“Il pain is never an aspect to be underestimated, it is a message from our body that something is not going and must always be listened to. This also applies to the dysmenorrhea, i.e. menstrual pains, which when they exceed a certain tolerability threshold should in no way be considered normality. This pain can often become disabling. The responsibility for this pain is to be found in several factors such as hormonal imbalancesincorrect diet, inadequate or excessive physical activity and also in a contractility of the pelvic floor. For this reason, in case of dysmenorrhea I also recommend an evaluation of the pelvic floor “suggests Dr. Barbieri.

Question from Mrs. Maria Elena from Parma

“At what age is a pelvic floor evaluation best suited?”

Answered by Doctor Chiara Barbieri, Midwife of the City of Collecchio Polyclinic

There is no age limit for pelvic floor assessment, from childbearing age to menopause and beyond. Even when there are no obvious problems, a consultation with the midwife can make a difference in acquiring friendly daily pelvic floor practices that can relate to posture such as nutrition.


What are the most effective rehabilitation techniques?

“Once the tone of the pelvic floor muscles and the problems reported by the patient have been assessed, a rehabilitation process can be started which, in addition to including anamnesis, lifestyle assessment, perception, relaxation and stretching, can be supported by different techniques “explains Doctor Barbieri.

“In particular, the following can be applied:

– manual techniques that is internal and external manipulations;

– electrostimulation is a completely painless passive stimulation of the pelvic floor muscles carried out through probes;

– electroporation which allows the absorption of creams / gels containing transdermal and transmucosal active ingredients;

– radiofrequency used for pain and other pelvic floor dysfunctions;

– oxygen therapy associated with hyaluronic acid to treat problems such as vaginal dryness, lichen, cystitis and vaginal infections “.

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