Pelvic Floor Exercises Routine For After Hysterectomy – 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 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.
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