Pelvic floor muscle training (PFMT), also known as Kaigl training method, was originally invented to teach expectant mothers or lying-in women to train during the perinatal period, so as to facilitate the smooth delivery and postpartum rehabilitation. Later, the application scope was greatly expanded, and it was found that this training method was very useful for diseases related to pelvic floor organ dysfunction, including urinary incontinence, defecation dysfunction, and various dysfunction and dissatisfaction related to female pelvic organs ... you know.
Pelvic floor muscles are a group of muscles at the bottom of the pelvic floor, which support many organs, such as women's uterus, bladder, small intestine and rectum. The contraction of pelvic floor muscles also maintains the normal functions of these organs. Although the task of this group of muscles is arduous, it is very fragile. Obesity, pregnancy, childbirth, surgery, cough, aging ... are all killers of pelvic floor muscles. But we can gradually restore and strengthen the pelvic floor muscles through training to resist the increase of abdominal pressure.
Whether it is a natural delivery or a caesarean section, women need to do pelvic floor rehabilitation after delivery. In the process of pregnancy in October, under the action of progesterone, the pelvic floor will become relaxed; As the fetus grows up slowly and the fetal position moves down, the compression on the pelvic floor will be bigger and bigger, which will damage the pelvic floor muscles to varying degrees. However, after delivery, with the delivery of the fetus, some ligaments relax and the elasticity of the "spring bed" becomes worse, which makes the organs unable to be fixed in the normal position and leads to dysfunction. Therefore, women who deliver caesarean section naturally need to do pelvic floor function evaluation and pelvic floor function rehabilitation after delivery.
Initial performance:
Vaginal relaxation
Unsatisfied sex life
Abdominal distension
pyuria
constipation
Medium performance:
Urinary incontinence: You will leak urine when coughing, sneezing, laughing or lifting heavy objects.
Pelvic organ prolapse (uterus, bladder, rectum, etc. ); There is a feeling of falling in the vagina, vaginal swelling and discomfort, accompanied by abdominal distension and pain, backache and backache;
Serious performance:
Urinary incontinence: urinary incontinence occurs when standing.
Pelvic organs are separated from the vaginal opening and often rub when walking, causing ulcers, suppurations or uterine hypertrophy.
Chronic pelvic pain, sexual dysfunction and other diseases
Rehabilitation training of pelvic floor muscles
When a woman gives birth, the pelvic floor muscles will be seriously damaged, so almost all women need to do pelvic floor muscle rehabilitation training after delivery. So how to carry out the rehabilitation training of pelvic floor muscles? Today, I will introduce you to the rehabilitation training method of pelvic floor muscles.
Pregnant women and lying-in women can practice some targeted actions under the guidance of doctors or professional therapists, which can open the pelvis and facilitate the smooth delivery; Enhance muscle tension and body balance, improve the elasticity and flexibility of the whole muscle tissue; At the same time, it stimulates glands that control hormone secretion, increases blood circulation and eliminates physical discomfort. It is also a very good rehabilitation training for pelvic floor muscles.
However, pregnant women should pay attention to bending over, holding their breath and pressing their abdomen when exercising, otherwise it will easily hurt the fetus.
Sitting posture, knees bent open, hands holding toes. Stretch the spine, keep the soles of your feet close to each other, help your heels close to your body with your hands, and press your knees down close to the ground. Pay attention to your chest and shoulders when you move. Keep breathing naturally for 3-5 times while doing it. This posture can increase the blood circulation of the lower back, abdomen and pelvis, and practice every day will reduce the pain during childbirth.
Chair-style: Knees and feet are tight (or naturally separated), and you are half squatting, just like sitting in a chair. Raise your arms above your head, palms facing each other. Hold this position and take three deep breaths. This posture can strengthen the body function, open the pelvis, and help to give birth smoothly.
Cat stretching: stretching like a kitten, lying on the ground, stretching the spine while breathing. Hands and knees touch the ground at four o'clock, thighs and arms are perpendicular to the ground; Inhale, sink your back, lift your chin, and lift your hips; Exhale, arch your back and bring your chin and chest together. It can improve the blood flow of the spine and spinal nerves, and also relieve constipation that many pregnant women are prone to.
Leg lift: Lie on your back, slowly lift your legs together to make 30 degrees with the ground, stay for a while and then raise them to make 60 degrees with the ground, and then stay for a while and raise them to make 90 degrees with the ground. Do 2-4 groups at a time, the slower the speed, the better the effect. This action can exercise the lower abdominal muscles.
Baby supine: inhale, bend your legs, put your head in your hands, exhale, and press your legs to your chest. Inhale first, then exhale, and look up to your knees at the same time. So repeatedly, * * * do it three times. It can stretch and strengthen the neck muscles, nourish and strengthen the abdomen, eliminate the dirty qi in the abdomen, and slow down constipation symptoms.
Basic principles of postpartum pelvic floor muscle rehabilitation
The main goal and basic principle of postpartum pelvic floor muscle rehabilitation is to improve the contractility of pelvic floor muscle, prevent PFD and improve the quality of sexual life. In 1940, Dr. Arnold Kegal proposed Kegal training method to strengthen the strength of pelvic floor muscles and reduce the occurrence of urinary incontinence. On this basis, supplemented by biofeedback technology and electrical stimulation technology, the therapeutic effect of pelvic floor rehabilitation treatment has been greatly improved.
Pelvic floor muscle exercise (PFME), also known as Kaigl exercise.
The method is: tighten the anus for at least 3 seconds at a time, and then relax. Continue to do 15 ~ 30 min, 2 ~ 3 times a day; Or PFME 150 ~ 200 times a day, and 6 ~ 8 weeks is 1 course of treatment.
Pelvic floor muscle training needs to consider five aspects:
(1) strength, muscle contraction can produce the maximum tension;
② The ratio of speed, maximum tension and time required to reach the maximum tension;
③ Duration, the length of time that muscle contraction can last or repeat;
(4) Repeatability, that is, the number of times that a certain tension can be repeatedly contracted;
⑤ Fatigue refers to fatigue caused by maintaining muscle contraction to meet the required or expected tension.
Class I fiber training mainly focuses on strength, duration and repeatability;
Type II fiber training mainly focuses on strength, speed and fatigue.
Key points of rehabilitation
1, women with good uterus recovery and no infection more than 42 days after delivery can detect pelvic floor muscles in time to determine the degree of injury.
2, feel and learn to contract-relax the pelvic floor muscles, learn to identify and consciously control the pelvic floor muscles, master the correct pelvic floor muscle contraction method (avoid abdominal muscle contraction).
3. Under the guidance of doctors, according to individual symptoms and pelvic floor muscle injury (degree and type of muscle fiber injury), comprehensive techniques are used for targeted training.
4. 10- 15 After pelvic floor exercise, you can do self-exercise.
5, step by step, timely and moderate, perseverance.
If you are not familiar with Kegel exercise, you can download the mobile phone software G Motion to exercise pelvic floor muscles. G Motion has specially designed a series of Kegel exercise training programs for different groups of people. From white to advanced, the training difficulty will be adjusted according to your pelvic floor muscle strength, and the level of the program will be upgraded according to your exercise duration and feedback to achieve gradual and scientific exercise.
Indications and contraindications of postpartum pelvic floor muscle training
Strictly speaking, all postpartum women in the middle and late pregnancy are suitable for pelvic floor muscle rehabilitation training.
For those who have the following conditions, pelvic floor muscle rehabilitation should be carried out as soon as possible:
① The pelvic floor muscle strength is weakened. If you can't resist, the duration of uterine contraction is less than 3s (pelvic floor muscle strength grade is less than grade 3) or the vaginal systolic pressure is less than or equal to ≤30cmH2O.
② Postpartum urinary incontinence occurs or persists after delivery.
③ Pelvic organ prolapse occurs after delivery, such as POP-Q system score 1 or above, especially accompanied by anterior and posterior vaginal wall bulging.
④ Perineal wound scar pain.
⑤ The quality of postpartum sexual life decreased.
⑥ Abnormal postpartum defecation.
⑦ Postpartum urinary retention.
Do not choose pelvic floor training for the time being if the following conditions exist, which is a contraindication:
① Vaginal bleeding (such as late postpartum hemorrhage and menstrual period). ).
② Acute urogenital inflammation.
③ Those who need to implant pacemakers.
④ Patients with pelvic organ malignant tumor.
⑤ Dementia, or unstable attack.