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Had my first Perineal Physiotherapy session Had my first Perineal Physiotherapy session

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Unread 07-23-2003, 11:24 AM
Had my first Perineal Physiotherapy session

I know that some of your were interested in what would be the outcome of that therapy, so here's my experience with it.

First off, I couldn't believe it, but I found out some more things my doctor, who I know is a very, very good doctor (excellent has been used to describe him, by one of his colleague):

1) the therapist said that if I'd been sent for a consultation, right after the hyst and rectocele repair, the problems with incontinence could have been totally avoided!!!

2) at first, especially in cases like mine, where the perineal muscles are very, very weak, kegels should be done lying down. She equated doing kegels in a seated or a standing position when your muscles are too weak to having the efficacity of trying to lift 100 lbs weights when you can only lift 20 lbs: you won't be able to do it, you'll use the wrong methods and have the potential of hurting yourself.

Other tips I found out:

1) when having a bm, instead of sitting with legs spread, in the position of giving birth, we should sit with our thighs together: not only does this protect the perineum (sitting with thighs openned, opens up the perineal area, leaving it in a vulnerable position), it also favors evacuating towards the rectum, reducing the straining efforts. I tried it and found a difference immediately: much more effective!!!

2) when you have a huge urge and feel like you're not going to make it, stand against a wall, legs together but not crossed, and bring your pelvis in. Hold the position until you feel ready to go (ie, the bathroom is free again). This is the most effective position to help you keep it in.

Now, the way the therapy worked:

She uses a bell-shaped sounding device that is linked to a computer. You purchase the device, so it's yours to keep... and no risk of contamination

The device emits electric waves, they felt like tickles, and, at the same time, it forces your muscles to contract. As I got used to it, she had me contract the muscles along with the device. This lasted only 15 minutes, but, let me tell you, I was very exhausted at the end of the session!!!

When I left, she gave me some exercises to do: I have to 10 repititions of contracting the muscles, rest, then repeat for 3 times. The objective is to do 10 repititions, 10 times a day. The aim is to them right: lying down, ensuring that's it's the perineum muscles working, not the bum, not the tummy and not the thighs. As with most exercises, it's more important to do them right, than to do too many.

In my case, since pain is not an issue, I didn't feel any pain... just tired... and realized just how little I've been working those muscles.
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Unread 07-23-2003, 11:40 AM
Had my first Perineal Physiotherapy session

It certainly sounds like a great start! Good luck and do let us know how you're doing as the therapy progresses.
Unread 07-23-2003, 04:30 PM
Had my first Perineal Physiotherapy session

Please keep us posted on your progress. I am very interested in how you do with the therapy. I have heard it can work really well for the incontinence issues.

I have been going to a PT for my pelvic pain - I have no bladder leaking problems... I have lots of myofascial trigger points in my pelvic floor muscles and the muscles all around my pelvis etc. Anyway, it doesn't seem to be helping with the pain problem at all (I know this PT does alot of work with incontinence etc.). ANyway, I am not sure if I should continue or not since the few times she has done the internal massage on my pelvic floor muscles it has left me worse than before and I am worse now then when I started (which may just mean it is not having any affect since I have been getting worse since 2 months after my hyst anyway). I am going back to see the PCP... perhaps I just need a different PT who has more experience with pelvic pain. My Gyn thinks I still have endo so maybe it doesn't help at all for those types of problems.

Keep us posted. I am hoping to hear good reports. I imagine it will take a while since you have had the problem for a long time.

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Unread 07-23-2003, 05:48 PM
Had my first Perineal Physiotherapy session

Dany, that is all so interesting! You sound like you're really into it already and I think that's great! Keep up the good work, keep telling us about it and maybe I'll get enough incentive to do it myself.
Unread 07-24-2003, 10:41 AM
Had my first Perineal Physiotherapy session


Thanks for keeping us posted on this, I find it interesting that the exercises should be done lying down. I wonder how soon after surgery it is appropriate, I am curious in case I have to go back in for repairs in the future(sounds like a car doesn't )

((SBlumen))- I have had some success with Active Release Technique which was done by a chiro in my area. Here is the weblink, they have a provider search for certified chiros to see if there is one in your area if you are interested www.activerelease.com. I am not totally pain free but he was able to relieve some of the points of pain which were causing me lots of pain due to a vicious cycle of bad posture-ab protection totally messed up my back too which he worked on. Just an FYI, I know everyone is different.

Unread 07-24-2003, 10:01 PM
Had my first Perineal Physiotherapy session

(((Dany))) it sounds like you found a really good PT, who has plenty of helpful suggestions for you and even explains why they work. I hope this program will be the answer to your incontinence issues! Thanks for sharing this with us, hopefully more ladies will have access to programs like the one you've started.
Unread 07-25-2003, 06:34 AM

This is also known as biofeedback therapy... I had it done prior to my second baby to hold me off knowing I would eventually need a surgical bladder lift. And let me tell you it was GREAT. I used to call them my electronic kegels..... As for success, for me at that time, I regained 80% of my control. I was a new woman... I would highly recommend the treatments to anyone who needs to strengthen those muscles and need help. It is really easy. And now I even see that they have machines you can buy and use yourself at home....

I was lucky at the time, that my insurance covered it... I guess some dont... Which is a shame since it does have some benefit for alot of women.

Good luck to you, and I hope you get the success you seek!!!!
Unread 07-25-2003, 08:50 AM
Had my first Perineal Physiotherapy session

Thanks for the feedback, Suzie (sorry, no pun intended ) I'm encouraged that the therapy improved your muscle strength to 80%... If I can achieve that, I know that most of my problems will be solved.

The therapy is more expensive than I expected: the device, that I had to purchase, was $30.00 and the therapy sessions are $80.00. The cost is not covered by our Provincial Health Plans, however, my employers' group insurance does cover it, so I can expect to recover 80% of the costs.

I always think that it's such a shame that we sometimes have to forgo helpful, sometimes essential, medical services/therapies, due to financial concerns. In this day and age, services should be available to all

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