LECTURE 4: PELVIC FLOOR Flashcards
pudendal nerve innervates external genitalia. What nerve roots?
S2-4
dermatomes: S2-5
anal wink: S4-5
sympathetic does___
parasympathetic controls____
SNS: storage (pelvic floor contract)
PNS: peeing (PF, relax)
5 pelvic floor functions
- sphincteric (continence)
- sexual
- stability
- sump pump (veins, lymphs)
- support
abdominal cavity changes ____, thoracic cavity changes____ in breathing
abdominal: shape (water balloon)
thoracic: volume (accordion)
What is form closure?
ligaments, joints
What is force closure
muscular support
healthy amount to pee per day
4-7 times a day
every 2-5 hours
0-1x/night
What is normal bowel movement frequency?
3x/day
3x/week
what bladder irritants should you avoid?
carbonation
caffeine
alcohol
sugar!
Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
stress incontinence (PRESSURE)
sudden, intense urge to urinate followed by an involuntary loss of urine.
You may need to urinate often, including throughout the night.
Urge incontinence may be caused by a minor condition, such as infection, or a more severe condition such as neurologic disorder or diabetes.
You experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.
Overflow incontinence
A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
functional incontinence
Experiencing more than one type of urinary incontinence.
mixed incontinence
Feces or gas leaks unexpectedly from rectum.
fecal/anal incontinence
If pelvic floor mm are really weak, what position can you start in?
gravity reduced!
supine
prone
quadriped
recommended weight gain in pregnancy
15-35 lbs, 11-20 if obese
exercise precautions for pregnancy
- avoid heat
- prologned supine (less than 5 min)
- contact sports, scuba diving, risk for falling
*consider pelvic floor stretching in 3rd trimester
*maintaining PLOF/intensity is good!
When should you stop exercise in pregnancy?
- vaginal bleeding
- dizzy
- SOB
- chest pain
- headache
- mm gets weak, calf pain/swelling
- contractons of uterus!
- fluid from vagina
relative contras for pregnancy exercise
Severe anemia
▪ Unevaluated maternal cardiac arrhythmia
▪ Chronic bronchitis
▪ Poorly controlled hypertension, pre-eclampsia, seizure, DM1, thyroid disease ▪ Extreme morbid obesity or BMI less than 12
▪ Current IUGR (intrauterine growth restriction)
▪ Heavy smoker
▪ History of extreme sedentary lifestyle
▪ Hemodynamically significant heart disease
▪ Restrictive lung disease
▪ Incompetent cervix/cerclage
▪ Multiple gestation at risk for premature labor
▪ Persistent 2nd or 3rd trimester bleeding
▪ Placenta previa after 26w
▪ Premature labor during current pregnancy
▪ Rupture of membranes
▪ Pregnancy induced hypertension
absolute contras for pregnancy exercise
If someone has persistent back pain post partum, not getting better… what could it be?
pelvic floor! prolapse
considerations before progressing exercise in pregnancy
*Should not have coning/doming
*Should not have heaviness in pelvis or vagina
* Should not have leaking
PF strength requirements to run post natal
▪ 10x fast reps
▪ 8-12 reps of 6-8 s max voluntary contraction ▪ 60s submaximal 30-50% contraction
