3 Mistakes in Pelvic Floor Classes for People affected by Lymphoedema and Lipoedema

3 common mistakes that stop successful pelvic floor rehabilitation for those with lymphoedema or lipoedema and strategies that help you succeed

Following my posts "10 things you didn't know about the pelvic floor and lymphoedema" and "How I came to teach pelvic floor classes for lymphoedema" you might be wondering what you can do to maintain and regain a healthy pelvic floor if you have lymphoedema or lipoedema.

Maybe you have already tried some approaches. You might have taken a programme or class in the past which hasn’t worked for you. It may even have made things worse. So you might have given up and believe that there is nothing you can do to improve your pelvic floor. You might think that you have to live with it. In this blog I share 3 common mistakes that can stop successful pelvic floor rehabilitation for those with lymphoedema or lipoedema. I will also share strategies that help you succeed.

Mistake 1: thinking that lymphoedema or lipoedema does not affect the pelvic floor

Most pelvic floor programmes are designed for people of a certain shape. They do not usually take account of the fact that you may have one or two swollen legs or arms or maybe even swelling in the pelvis or back. So when you try and follow the exercises, restrictions in your body may mean that they either do not work at all or even make things worse.

Here is an example: Say your legs are very swollen and you therefore have to stand in a wide stance. Standing in a wide stance means that your pelvic floor is stretched wide and cannot work efficiently. Your pelvis will also be less likely to move freely which also impairs pelvic floor function.

This does not mean that you should never stand in that stance but if a programme doesn’t acknowledge your special need then in might not be particularly helpful for you. This also applies to those of you with upper body lymphoedema: if one of your arms is restricted due to swelling this may affect the movement of your pelvis. It might sound strange but it’s absolutely true: as we walk, our arms and legs usually work in opposition to each other. This supports our balance. So as the right leg steps forward the left arm usually swings to counterbalance that. If one of your arms is restricted the opposite hip tends to become more restricted too.

A pelvic floor programme suitable for you should acknowledge your particular restriction. Now, even a programme specifically designed for lymphoedema or lipoedema may not be able to fix everything. It should, however, be able to explain these mechanical details to you so that you can pick those exercises that work for you and leave out those that don’t. A one-size-fits-all approach will not work for you.

Mistake 2: focusing on the “what” rather than the “how” or “why”

Have you ever been to a class where you were desperately trying to follow the shapes a teacher was making at the front of the class? And your teacher was a size 10 ex-ballerina? Then you know how difficult that can be. To make things worse, our pelvic floor is a group of muscles and connective tissue that is hidden from view. So unless we have x-ray vision we couldn't follow what our teacher is showing us at the front even if we tried!

Just following the shape of an exercise is unlikely to have any benefit for our pelvic floor unless our pelvic floor is totally fit and healthy. If your pelvic floor isn’t working well, and especially if you have a restriction due to lymphoedema or lipoedema, this approach might have no benefit at all or, even worse, it might do more harm than good.

To regain a healthy pelvic floor you need to get precise instructions from your teacher. Just imagine if you had never seen a computer keyboard and someone told you to just press a button to turn it on…. You would ask which button, wouldn’t you? It’s the same with pelvic floor exercises. Pelvic floor exercises are most effective if you know exactly what you are aiming for, that includes instructions on how to do an exercise and ideally also what effect the exercise is meant to have. The latter is particularly important if you have lymphoedema or lipoedema as even with the best exercise programme you might still feel that a particular exercise is not working for you. Knowing what you are meant to be feeling means that you can adapt the exercise so that it will work for your pelvic floor.

Mistake 3: believing that one exercise will fix it all

Most women know about Kegel exercises (“pull up your pelvic floor as if you are stopping yourself from breaking wind or stopping a pee”). However, for many women Kegel exercises are actually not particularly useful - and for some they might even be the wrong exercise altogether!

Even if Kegels are a good exercise for your particular pelvic floor, they wouldn't be enough on their own. The pelvic floor needs to work dynamically and responsive, that is, it should respond to everything we do. It should have a natural rhythm of relaxing and contracting – and ideally at the right time. So if you suddenly heard a very funny joke and had to burst out laughing your pelvic floor should hopefully contract at the right time on its own accord - not because we do a pre-planned Kegel.

And there is more: pelvic floor health is much more complicated than just one muscle group. The pelvic floor is designed to support full body movement so a pelvic floor programme should involve the whole body; the feet, hips, pelvis, back, even the arms, shoulders, neck and jaw. It’s the same as driving a car: you can’t drive if all you have is an accelerator. You also need an engine, a gearstick, wheels, a steering wheel, etc. So a good pelvic floor programme always works the whole body. And actually that is perfect for anyone with lymphoedema or lipoedema – or actually anyone at all: A full body focus actually also means that a pelvic floor programme can support your general health. Win-win!

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Categories: : lymphatic health, womens intimate health