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3 Therapeutic Exercise > Pelvic Health > Flashcards

Pelvic Health Flashcards

1
Q

Functions of Pelvic Floor

A

Sphincteric
Support
Stability
Sexual
Sump pump

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2
Q

Sphincteric

A

prevents leakage

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3
Q

Support

A

support for pelvic organs, bladder, urethra, uterus, rectum

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4
Q

Stability

A

the floor of the core
attachments to pelvis and hip

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5
Q

Sump pump

A

lymphatic pump of the pelvis

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6
Q

Layers of Pelvic Floor

A

Layer 1: sphincteric and sexual function
Layer 2: compresses and supports
Layer 3: Levator ani, supports, lifts, aids in pressure

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7
Q

Perineum

A

inferior portion of the pelvic outlet
diamond shaped that connects coccyx, pubic bone, ischial tuberosities

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8
Q

Puborectalis

A

Pubic bone and rectum
slings around the rectum, relaxes for defacation

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9
Q

Chronic constipation…

A

tightness of puborectalis

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10
Q

Fecal incontinence…

A

weakness of puborectalis

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11
Q

Coccygeus

A

connects ischial spine to coccyx/sacrum
pulls coccyx anterior after defacation
responsible for tailbone pain

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12
Q

Urinary Stress Incontinence

A

Involuntary loss of urine with physical exertion or effort, pelvic floor muscles aren’t strong enough to keep bladder closed

coughing, sneezing, laughing, exercise
common in pregnancy/postpartum, crossfitters, prostatectomy

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13
Q

Urge Incontinence

A

contracting when not full
involuntary loss of urine with strong urge
associated with overactive bladder, urinary frequency, BPH in men

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14
Q

Mixed Incontinence

A

Combo of stress and urge

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15
Q

Bladder Norms

A

voiding every 2-5 hours
5-8 voids/day
0-1 voids a night
capacity is about 400-600 ml

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16
Q

Dysfunctional Voiding/Bad Habits

A

Going just in case
hovering/semi-squatting
straining
kegels mid stream
reducing fluid intake to reduce frequency

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17
Q

Stress Incontinence Treatment

A

pelvic floor strengthening
pelvic floor coordination retraining and diaphragmatic breathing, pressure management

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18
Q

Urge Incontinence Treatment

A

voiding behavior education
SCRUB technique

19
Q

Behavioral Interventions

A

Avoid bad habits
limit bladder irritants
voiding schedule

20
Q

SCRUB

A

helps to control urinary urgency

STOP
CONTRACT
RELAX and breathe
URGE assessment
BATHROOM

21
Q

Age related bladder changes

A

Bladder capacity decreases
decreased bladder contractility
impaired emptying
increased residual volume
night urine production increases
pelvic organ prolapse

22
Q

Pregnancy issues

A

pelvic girdle pain
LBP
round ligament pain
pubic symphysis dysfunction
diastasis rectus abdominus

23
Q

Treatment for Pregnancy issues

A

contract vs relax of pelvic floor muscles
lumbopelvic stabilization
activity modification
belly support, KT tape

24
Q

Treatment considerations for pregnancy

A

avoid supine after 20 weeks
ligamentous laxity
edema
postural and COG changes

25
Q

Exercise guidelines for Pregnancy

A

150 mins/week mod intensity
minimum 3 days a week
do not exercise to point of breathlessness or exhaustion
avoid exercises that could contribute to falling, diastasis recti, pelvic obliquity

26
Q

Postpartum

A

just because its COMMON doesn’t mean its NORMAL
pelvic girdle pain is the leading cause of disability postpartum

27
Q

Postpartum return to running

A

screen for stress incontinence and pelvic organ prolapse

check for leaking, sensation for bulging, pain w/bathroom or period, can you walk 30 mins w/out pain

28
Q

Constipation

A

most common GI complaint, has to be at least 3 times a week
screen in chronic low back pain
Commonly caused by lack of fiber, lack of PA, recent surgery, chronically ignoring urge to go

29
Q

Treatment for Constipation

A

establish bowel routine
defection mechanics–>positional, relaxation of pelvic floor, breathing
abdominal wall massage
diet

30
Q

Prolapse

A

descent of one or more of the pelvic organs

associated with connective tissue laxity, loss of nerve, muscle, ligament or fascial integrity

31
Q

RF for prolapse

A

childbirth
surgery
chronic constipation or straining
chronic cough

32
Q

S/S of prolapse

A

vaginal bulging
pelvic pressure
pelvic heaviness
LBP
constipation
urinary incontinence

33
Q

Treatment for prolapse

A

activity modifications
IAP management
constipation management
pelvic floor and abdominal strengthening

34
Q

Indications for internal exam

A

incontinence
voiding dysfunction
pelvic pain
prolapse
sexual dysfunction

35
Q

Contraindications to internal exam

A

lack of consent
<6 weeks postpartum
<6 weeks postoperative
current infection
sexual abuse hx
pregnancy
pediatric client

36
Q

What occurs during inhale?

A

diaphragm descends
abdominals relax/expand
pelvic floor lengthens/relaxes

37
Q

What occurs during exhale?

A

diaphragm rises
abdominals contract/draw in
pelvic floor contracts/lifts

38
Q

Cues for females for pelvic floor

A

Stop the flow of urine
squeeze a marble vaginally
pull pubic bone and tailbone together and in

39
Q

Cues for males for pelvic floor

A

stop the flow of urine
lift the scrotum and retract the penis
“nuts to guts”

40
Q

Tips for pelvic floor activation

A

ensure gluteals, abdominals, adductors are not gripping
no breath holding
relax AND contract are important

41
Q

Indications for pelvic floor strengthening

A

PFM weakness
stress incontinence
pelvic organ prolapse
fecal incontinence

PFM overactivity
urge incontinence

incoordination

42
Q

Contraindications for pelvic floor strengthening

A

overactive pelvic floor
pelvic pain

43
Q

Dosage for pelvic floor strengthening

A

30-80 reps a day
submax contraction, 10 second hold, 8 week training

quick flicks and elevators
coordination training, fast twitch

Lifelong maintenance

3 Therapeutic Exercise (12 decks)

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