Q. Do I need to purchase both Pelvic Floor Recovery and Pelvic Floor Essentials books?
A. Both books have the same content regarding pelvic floor information, good bladder and bowel habits and the defaecation position but the surgical book, ‘Pelvic Floor Recovery’ has lots of content about surgery (both gynaecological and colorectal surgery) whereas ‘Pelvic Floor Essentials’ has quite a few new chapters: The Early Years – bladder and bowel control for children, Pregnancy, Vaginal and Caesarean births and the Traumatic Vaginal Delivery. There is also information on Post-Partum Recovery for both caesarean and vaginal deliveries. If you are a health professional the different content will be relevant for different patients. If you are a non-health professional and just purchasing the books for yourself or your friends and relatives, you have to decide if the content of both books is relevant. They are always an excellent gift!
‘Pelvic Floor Recovery – Physiotherapy for Gynaecological and Colorectal Repair Surgery‘ was specifically written for women who are having or have previously had gynaecological or colorectal repair surgery or a simple hysterectomy. This new edition has lots of new information specifically looking at levator avulsion and the effect that this birth injury potentially has on the repair. There are lots of exercises in the book and evidence about lifting advice for the reader. This book is now available translated into the German language.
‘Pelvic Floor Essentials‘ is for anyone else! If you are nulliparous (never had children) or just had a vaginal delivery recently or well in the past, it is never too late to learn the preventative strategies for the bladder, bowel and pelvic floor. My goal is for all women to learn what is right and wrong to do in this vital area and therefore avoid problems in the future with preventative strategies. This edition of Pelvic Floor Essentials has new chapters on The Early Years– including toilet training hints, strategies for daytime and night-time wetting in children and paediatric bowel issues such as constipation and soiling. If you are a parent or grandparent this information will be helpful when bladder and bowel difficulties emerge. There are new chapters on Pregnancy, Vaginal Birth, Caesarean birth, the Traumatic Vaginal Delivery and the Post-partum period. This edition is packed full of information to help you with urinary incontinence, prolapse management, persistent pelvic pain management strategies plus lots more.
Q. How often should I do my pelvic floor exercises?
A. Firstly I should say that if you have any pelvic pain, or difficulty emptying your bladder or bowel, then it is important to have a consultation with a Pelvic Health Physiotherapist before you embark on an exercise programme. This is because you may have PF muscles which may be tight and doing lots of PF exercises may increase your pelvic pain or make emptying your bladder or bowel more difficult. With an assessment and treatment plan from your pelvic health physiotherapist, you will learn how to relax them effectively and your pelvic pain treated effectively. The value of this is that you will also ensure you are doing the correct action with your muscles.
We say to perform pelvic floor exercises around 30 times per day, with the main emphasis being on relaxed breathing while you do the exercises and working on the endurance of the muscles. After you have initially improved your awareness of the muscles and built up your strength, then contracting your PF and deep abdominal muscles in conjunction with other movements/exercises will further enhance your strength (added resistance) and teach you how to engage the muscles functionally. To learn further, read the extensive chapter in either of my books – ‘Pelvic Floor Recovery’ and Pelvic Floor Essentials’ where there is comprehensive information and tips on how to do the exercises, the ‘dos and don’ts’ of pelvic floor muscle training and of course the important info on the concept of the knack or bracing to counteract the downward forces of things like cough, sneeze or bending.
Q. Can conservative strategies cure prolapse?
A. There is good evidence that undertaking a course of treatment with a Pelvic Health Physiotherapist should be the first line of treatment for mild to moderate vaginal prolapse but also if someone has more significant prolapse and has to have repair surgery then learning these conservative strategies will help the woman understand what has to be done for the rest of her life in order to assist with a better outcome and longevity for her gynaecological or colorectal repair surgery. In the literature, up to 30% of gynae repair operations fail and if the woman has levator avulsion the risk of failure of the operation can rise to up to 80%. Doing pelvic floor muscle training and using the strategies from the book will help you to look after your operation. There is comprehensive information in both books on the management of prolapse including the use of pessaries to assist in the short-term, medium-term and longer-term. The concept of ‘watchful waiting’ is also explored.
Q. Can I do full sit-ups, full planks or double leg lifts at Pilates or Yoga after my repair surgery?
A. Edition 4 of the surgery book Pelvic Floor Recovery: Physiotherapy for Gynaecological and Colorectal Repair Surgery looks at the evidence about lifting and precautions for different exercises after repair surgery. It depends on the strength of your pelvic floor muscles and the extent of damage that may have occurred at childbirth, as to whether these types of exercises are to be avoided after you have had a hysterectomy or any repair surgery and even after a vaginal delivery if you have had significant muscle trauma such as a Levator Avulsion. There are many safe abdominal exercises in both my books for you to follow to avoid unnecessary downward pressure risking prolapse post-operatively or post-natally.
Q. Is it bad to lean back to pass a bowel motion?
A. Many women, particularly due to pelvic floor laxity and prolapse, have to do lots of different manoeuvres to achieve emptying of their bowels. Leaning back is just one of them. That is why I extensively cover the correct defaecation position in the chapter on bowels in both books – because bowels bring down prolapse and operations. The position for defaecation as described and illustrated in the books is very helpful in achieving more complete evacuation without the need to lean back or digitating to empty.
Q. What benefit will buying the books give me?
A. Well, what can I say but knowledge is empowering! If you understand about the anatomy; how to correctly contract the muscles to prevent incontinence and prolapse; how to prepare for surgery if you are needing it; how to empty your bladder and bowel easily and completely; and much more, then you feel more in control, have more confidence and feel less anxious. There is also information about managing chronic pelvic pain, sexual dysfunction, pelvic floor safe exercising and travel advice