Pelvic Floor Exercises Routine For After Hysterectomy

Hi, I’m Michelle. Today I’m going to be helping
you with starting your pelvic floor exercises after hysterectomy. So this is a real beginner’s
lesson. So, what we’re going to be doing, is doing some exercises on the ground and
then you can progress those exercises to sitting up. And these are exercises that you start
to strengthen your pelvic floor muscles when you have approval to start your exercises
from your doctor or from your surgeon. So if you think about where the pelvic floor
muscles are�if you think of the pelvis, and that’s the front of the pelvis and underneath
is a space (underneath here) you’ve got your two sit bones and you’ve got the tailbone.
So the pelvic floor muscles run underneath this area of your pelvis, in and around where
you sit. From the pubic bone to the tailbone so from front to back and also too from side
to side. So you can see that they fill up that area there, and that’s what’s holding
everything up. So after your hysterectomy surgery it’s really important that you have
those muscles strong and supportive to support your surgery and the stitches that have been
put in and the repair long-term. So, let’s get started lying down. Just before
we do start, make sure that these exercises feel really comfortable, so, we’re really
focusing at strengthening gradually and just doing what you can do little bit by little
bit. Let’s start down on the ground now. So you’ve got somewhere at home or if you’re
watching this video if you can lie yourself down with a comfortable cushion and a mat
or a towel on the ground. Let’s get going. Okay, so we’re in our lying down position,
and the idea with lying down for your exercises is that your pelvis is like this, so really
your muscles aren’t under the load of gravity and body-weight, so your insides aren’t pushing
down. So in that lying down position, it can make the muscles a little bit easier to activate
and it can just decrease the load on your pelvic floor a little bit more. And you {2:01
wern/would/worried?} if you’re doing these exercises lying down. So, I’ve got two pillows here. I’ve got one
for underneath my head and I’ve got one to support my legs. Now a lovely position to
lie in after your surgery is on your back with a pillow underneath your knees particularly
if you have a tummy; you’ll find that’s much more comfortable. So you can be positioning
yourself lying down, in this position just coming down gently, lying on your back with
your legs on the pillow like that. Or, alternatively you could lie on your side (and I’ll face
you this way) with a pillow between your legs like that, so that you’re nice and comfortable.
And now we’re going to just start with a couple of repetitions of these exercises. So, before
we start, let’s visualize the area that we’re working. We’re visualizing the muscles in
and around the back passage around the anus in and around the vagina and in and around the
urethra (or the urine tube.) Those muscles are going to be just gently lifting and squeezing
inside, and then releasing down and relaxing. And to start with, we’re only just going to
start with a couple of repetitions being mindful that this is really gentle to start with.
You shouldn’t be feeling any discomfort at all with this exercise. And just do what you
can do. So let’s start. So I’m imagining my drawing
up action is this way. So I’m going to start and I want you to start at home by just drawing
in and around gently, in and around the back passage, the vagina and the urethra, lifting
up and squeezing inside. Lifting and squeezing, lifting and squeezing and relax, and let
go completely. And take a deep breath in and out. So I’m not squeezing my bottom muscles,
and I’m not pulling my tummy in. Those areas are staying relaxed. I’m drawing up in and
around the area where I sit in and around those pelvic openings. Let’s try again. Here
we go: Just gently, lift and squeeze, and lift and squeeze, and then completely relax
and let the muscles go. And have a deep breath in and out. Let’s try one more time at home. So just once
more, just to see how we’re going. Here we go. Back, middle and front, lift inside drawing
up and in lift and squeeze, keep lifting, keep breathing relax the muscles right
back down to resting. Big breath in into your belly. Let the muscles relax breathing
out and rest. So that’s how you’d start, with just those few repetitions, and that
might be just enough to do today. See how you feel, and if you feel okay then you might
repeat that same little routine tomorrow. I also want to show you how to do some seated
exercises. So we’re going to move on now to some upright seating exercises that you can
progress to at home. Okay, so we’ve moved now into sitting; I’m just sitting on a low
stool, you can be sitting on a chair or a fit-ball if you choose to at home. And remembering
that now we’re doing the pelvic floor muscles and lifting them against gravity. So ideally
we all want our pelvic floor muscles to work upright (against gravity) so that we can exercise
them sitting, upright or standing upright, so that they’ll work in those positions. If
we do all our exercises lying down where those muscles don’t have to work against gravity they’re
not going to strengthen nearly as effectively. So let’s get started with our seated exercises
for after your hysterectomy surgery. I’ll just put my pelvis down over here. So,
I’ll sit side-on to you, or just sit on an angle so that you can see my positioning.
So, what I want you to do at home, is with your feet flat, a small inward curve in the
lower back, lengthen your spine so lift up your spine roll your shoulders back and
down always feels good to do that anyway. So that’s your posture to start your pelvic
floor exercises. And, I hope that you can feel between your sit-bones and your pubic
bone, you can feel that diamond area that triangular area in there and imagining back
towards the tailbone. That’s the area we’re lifting in and lowering down. So again really
gently at home, I’d like you to draw in and lift up around your three pelvic openings,
so lift up inside and keep breathing. Lift and squeeze, and keep breathing, lift and
squeeze, and lower down slowly, slowly slowly. And have a big breath in and let it go. So if your muscles are weak, you might only
feel a little bit of a flicker; you might not actually feel the pelvic floor muscles
lowering down. Just do what you can do and work with it gradually over time. It will
take time to re-strengthen. Just give it the time and persevere with your exercises. Let’s
go again. So, at home, lifting up inside, just gently lift and squeeze, lift and squeeze
inside keep lifting pelvic floor muscles inside and relax down slowly. Take a deep
breath in, into your belly, let your pelvic floor right down, back to relaxation position.
And let’s go one more time, lifting up just gently, lifting and squeezing, squeeze and
lift inside, squeeze and lift and lowering back down, right back down to rest. Deep breath
in and out, and let your pelvic floor completely relax. And again, that might be the little routine
that you do just for the first week, just doing a couple of lifts and lowers. As you as
your recovery takes place you can start to do more repetitions in a row, but you won’t
start to increase the strength of the holds until you can get up to a good ten repetitions
in a row. That’s when you start to be doing stronger holds. Initially you’re starting
to increase the duration or the length of your holds. So let’s review what we’ve just done. We’ve
talked about our exercises lying on the ground so our pelvic floor exercises lying down you
could do those on your bed, for when your pelvic floor muscles are weak and when you’re
just starting back into your exercises. And then we’ve talked about progressing your exercises
into sitting, so that you get a little bit more strength and a little bit more functional
strengthening real world strengthening to get your muscles strong for every day, walking
around and moving and doing the things you need to do. We’ve really emphasized starting
off gradually the exercises being pain-free, starting off with a gentle contraction and
relaxation really being very important. Gradually increasing how long you’re doing your holds
for, and then finally increasing the strength of your holds. So, I really hope those exercises help you
with your hysterectomy recovery, and taking the time to really develop strong pelvic floor
muscles to support long-term after your surgery. Well, that’s all for me today. For more information
on your pelvic floor exercises, visit me at I’ll look forward to
exercising with you again soon. Bye for now.

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