Q. How often should I do my pelvic floor exercises?
A. Firstly I should say that if you have any pelvic pain, or difficulty emptying your bladder or bowel, then it is important to have a consultation with a Continence and Women’s Health Physiotherapist before you embark on an exercise programme. This is because you may have PF muscles which are too tight and rather than doing lots of PF exercises, you may need to learn how to relax them effectively. The value of this is that you will also ensure you are doing the correct action with your muscles.

We say to perform pelvic floor exercises around 30 times per day, with the main emphasis being on relaxed breathing while you do the exercises and working on the endurance of the muscles. After you have initially improved your awareness of the muscles and built up your strength, then contracting your PF and deep abdominal muscles in conjunction with other movements/exercises will further enhance your strength (added resistance) and teach you how to engage the muscles functionally. To learn further, read the extensive chapter in either of my books in the ‘Pelvic Floor Recovery Series’ where there is comprehensive information and tips on how to do the exercises, the “dos and don’ts” of pelvic floor muscle training and of course the important info on the concept of the knack or bracing to counteract the downward forces of things like cough, sneeze or bending.



Q. Can conservative strategies cure prolapse?
A. There is Level 1 evidence (the best evidence there is) that undertaking a course of treatment with a Continence and Women’s Health Physiotherapist should be the first line of treatment with mild to moderate vaginal prolapse but also if someone has more significant prolapse and has to have repair surgery then learning these conservative strategies will help the woman understand what has to be done for the rest of her life in order to assist with a better outcome and longevity for her Gynae Repair surgery. Up to 30% of repair operations may have to be redone because they have failed.

Q. Can I do sit-ups, full planks or double leg lifts at Pilates or Yoga after my repair surgery?
A. These types of exercises are to be avoided after you have had either a hysterectomy or gynaecological repair surgery and even just after a vaginal delivery if you have had significant muscle trauma such as a Levator Avulsion. There are many safe abdominal exercises in both my books for you to follow to avoid unnecessary downward pressure post-operatively or post-natally.

Q. Do I need to purchase both books?
A. Only if you would like to buy one for yourself and one for your daughter, sister or friend! No but seriously the information is very similar in both books and you need either one or the other, unless you are a health professional or as I said you are going to give the best gift of your life to someone!

Book 1 – Pelvic Floor Recovery – Physiotherapy for Gynaecological Repair Surgery was specifically written for women who are having or have previously had gynaecological repair surgery or a simple hysterectomy.

Book 2 – Pelvic Floor Essentials is for anyone else! If you are nulliparous (never had children) or just had a vaginal delivery recently or well in the past, it is never too late to learn the preventative strategies for the bladder, bowel and pelvic floor. My goal is for all women to learn what is right and wrong to do in this vital area and therefore avoid problems in the future with preventative strategies.

Q. Is it bad to lean back to pass a bowel motion?
A. Many women, particularly due to pelvic floor laxity and prolapse, have to do lots of different manouvres to achieve emptying of their bowels. Leaning back is just one of them. That is why I extensively cover the correct defaecation position in the chapter on bowels in both books – because bowels bring down prolapse and operations. The position for defaecation as described and illustrated in the books is very helpful in achieving more complete evacuation without the need to lean back or digitating.

Q. What benefit will buying the books give me?
A. Well, what can I say but knowledge is empowering! If you understand about the anatomy; how to correctly contract the muscles to prevent incontinence and prolapse; how to prepare for surgery if you are needing it; how to empty your bladder and bowel easily and completely; and much more, then you feel more in control, have more confidence and feel less anxious. There is also information about managing chronic pelvic pain, sexual dysfunction, pelvic floor safe exercising and travel advice.