Exercises for prolapse of internal organs in women. Therapeutic exercise for prolapse of internal genital organs

Pelvic floor incompetence vaginal prolapse, internal genital organs and functional urinary incontinence in women are pathological processes that are closely interrelated in etiology and treatment methods.

The main etiological factor in the occurrence of these processes is the combination of birth injuries with the previously existing insufficient physical development of the patient. Much less often, prolapse of the internal genital organs occurs as a result of exposure to only one of these factors. Observations show that female athletes, as a rule, do not have pronounced degrees of prolapse of the genital organs, not only at an older age, but also during a violation of the integrity of the pelvic floor due to birth injuries. In the literature, even in casuistry, there is no mention of uterine prolapse in female athletes. Clinical and radiological studies have shown the importance of well-developed intrapelvic muscles (obturator, piriformis) in maintaining the uterus in the correct position even with a significant increase in intra-abdominal pressure.

There are 5 degrees of omission:

I - gaping of the genital slit, with straining there is a slight prolapse of the vaginal walls;
II - significant prolapse of the vaginal walls, with straining some prolapse of the uterus;
III - prolapse of the uterus until the cervix touches the pelvic floor;
IV - incomplete uterine prolapse;
V - complete prolapse of the uterus.

With I and II degrees of prolapse therapeutic physical culture is exclusively effective method treatment that completely eliminates functional disorders, and with systematically continued exercise, anatomical and morphological changes.

At III degree prolapse, therapeutic physical culture contributes to a significant reduction in functional disorders, trophic changes, restoration of tissue turgor, development of the corresponding muscle groups and normalization of conditioned reflex connections. The prolapse, however, persists, and functional improvement is noted only during the period of systematic exercise. Therefore, therapeutic physical culture should be regarded as a means of preparation for surgical intervention.

With IV and V degrees of prolapse, the effect of therapeutic physical training is negligible. Surgical treatment Necessarily. Physical exercise should be regarded as a means of preoperative preparation.

At the core therapeutic effect Exercise therapy for urinary incontinence has a general strengthening effect on the body as a whole, increasing the tone of all muscle groups, in particular the sphincter of the bladder; reduction of trophic disorders due to improved blood and lymph circulation in the pelvic organs; restoration of impaired conditioned reflex connections and cortical regulation of functional disorders. The positive effect is achieved by the fact that hip abduction and abduction exercises are performed in a supine position with a raised pelvis; standing exercises - with tightly closed hips with tension in the adductor muscles; walking - with short or cross steps or with a medicine ball squeezed between the legs. Resistance exercises for the lower extremities are very useful when lying down. Signs of improvement appear after 5-6 sessions. At the same time, the patients’ mood becomes elevated, interest in activities and a favorable emotional mood appear, which, in turn, helps to increase the effectiveness of treatment. After 1-1.5 months, patients note a significant improvement in urinary incontinence, nagging pain disappears. By the end of the 3-4th month of training, most patients stop urinary incontinence; some do not suffer from this even during physical work.

Treatment course physical culture in a medical institution for patients suffering from prolapse of the internal genital organs and urinary incontinence is 4-6 months. Classes are held every other day, the duration of each of them is 45-50 m. After completing the course of classes, you must complete special exercises Houses.

Exercises for prolapse of internal genital organs and urinary incontinence

I. p. - standing, hands on the belt: hands back in the “lock”, slowly raise them above the head with palms outward, at the same time tilting the head and torso back, retracting anus- inhale, and... p. - exhale. Alternately moving the arms to the side while simultaneously turning the body as much as possible - inhale, and. p. - exhale. Walking 1.5-2 min. holding a medicine ball or exercise stick between the knees.

I. p. - lying on your back against the gymnastic wall, feet resting on the bar as high as possible: spreading and bringing the legs together (6-8 times), rotational movements in hip joints(8-10 times), lifting the pelvis with support on the feet and shoulder blades (3-4 times).

I. p. - lying on your back, legs apart: alternately raising your legs to a right angle, circular movements in the hip joint (up to 1 min.); “bicycle” 1 - 1.5 min.; “scissors” (legs apart - legs crossed).

I. p: - lying on your stomach: crawling on your belly - 1-2 minutes.

I. p. - lying on your back in pairs, with your legs facing each other: the legs of one patient are on the legs of the other, the second is trying to raise her legs, overcoming the resistance of the legs of the first. Then the roles change; The legs of one patient are between the legs of the other, the first tries to spread her legs, overcoming the resistance of the second. Then the roles change.

I. p. - standing, arms to the sides: turn to the right, reach with your right hand with your left hand; turn left, reach with your left hand with your right hand.

A definite problem of modern obstetrics has been the steady increase in the number of births complicated by damage to the perineum. The number of patients suffering from the consequences of birth injuries, pelvic organ prolapse, urinary incontinence, etc. is not taken into account even in most countries of the world. Now there are several hundred types of operations aimed at surgical treatment postpartum complications related to the problems mentioned above. But, unfortunately, neither patients nor doctors are satisfied with the results of treatment. Moreover, no delivery system has led to a real reduction in perineal injuries.
I think that prolapses, or omissions internal organs pelvic floor should be considered as a pelvic hernia, and the main factor in the development of the disease is the weakness of the muscular layer of the pelvic floor and the ligamentous apparatus of the uterus. At the Center for Security and Correction women's health"were able to summarize the experience of world and domestic medicine and create an adequate treatment and preventive program for women of all ages with the aim of correcting and restoring the functional usefulness of the perineum, pelvic floor, vagina, bladder and rectum. Implementation of this program based on the restoration and strengthening of the muscle layer pelvic floor and perineum, helps improve the gynecological and somatic health of women, improving their quality of life.
I have been working with the muscular-ligamentous structures of the human body for a long time. The problem of non-surgical treatment of spinal hernias, which once seemed unrealistic, is now recognized and successfully applied. So, in the matter of returning women's health, we managed to create the only treatment and preventive program for today to restore the failure of the musculofascial plate of the pelvic floor.
It was necessary to create a system of anti-gravity simulators capable of influencing the muscular-ligamentous areas of the perineum, thereby helping to restore blood flow and nutrition to the pelvic organs. Controlled diaphragmatic breathing, used when performing special (female) exercises on these simulators, eliminates the negative effects of intra-abdominal pressure and helps restore the perineum and elasticity of the pelvic floor. This applies to age characteristics women and after menopause.
We at the Kinesitherapy Center tried to take a broader look at the problems of pelvic pain and included in the rehabilitation program not only our own muscles of the perineum and pelvic floor, but also muscle groups lumbar region spine, adductor and abductor muscles of the thigh, diaphragmatic breathing, which reduces intra-abdominal pressure. The abdominal muscles are not activated. The exercises I recommend can be successfully performed at home.
1. “Iron” (walking on the buttocks).

I.P.: Sitting on the floor, back straight, arms bent at the elbows, legs straight or slightly bent at the knees. Moving around the room, corridor. Start from 1 minute and up to 5-10 minutes.

I.P.: Lying on your back near a couch, sofa, bed. The legs are bent at the knees, the shins are lying on the couch, the buttocks are pressed tightly against the couch. Raise the pelvis (as if we were doing a bridge), exhaling and squeezing the buttocks (20 to 50 times).
3. "Invisible jumps."
Sitting on a chair or stool with a wooden surface, preferably a hard one, squeeze your buttocks so that your body rises sharply (as if jumping). If performed more correctly, you can feel two liftings of the body, which occur due to the contraction of first the external sphincter (compressor) of the anus, then the internal one, located 8 cm above. This exercise can be done at the workplace during the working day several times a day, 20-30 times, or 1-1.5 minutes. At the top point, when contracting the gluteal muscles, linger for 2-3 seconds.
All exercises are performed until a burning sensation is felt in the working muscles (more is possible, but preferably no less).

Prolapse and loss of internal genital organs is a violation of the position of the uterus or vaginal walls, which is manifested by displacement of the genital organs to the vaginal opening or their prolapse beyond its limits. Prolapse of the female genital organs occurs due to the weakness of their ligamentous apparatus, as well as due to weakness of the pelvic floor.
IN a set of exercises for prolapse of the female genital organs includes general strengthening gymnastic, breathing and special exercises.
It should be noted that good effect therapeutic exercises with prolapse of the internal genital organs gives only in the initial stages of prolapse of the genital organs. When they fall out, it is already necessary surgery. But even in this case, physical therapy is indicated in the pre- and postoperative periods. However, in the acute period inflammatory diseases internal genital organs, therapeutic exercises are contraindicated.

Special exercises for prolapse of the internal genital organs:
1) I.P. - standing. Walking in place, breathing evenly - 1.5 minutes.
2) I.P. - standing, arms to the sides. Make a right turn and reach for your right hand with your left hand. Then turn left, reach your left hand with your right hand. Perform 6-8 times.
3) I.P. - standing, hands on the belt. Then clasp your hands in a “lock”, slowly raise them above your head with your palms facing outwards, while simultaneously tilting your head and torso back and retracting the anus - inhale, return to the starting position - exhale. Repeat 6-8 times.
4) I.P. - the same. Perform alternate abduction of the arms to the side while simultaneously rotating the body as much as possible - inhale, return to the starting position - exhale.
5) Walk for 1.5-2 minutes while holding a medicine ball or gymnastic stick between the knees.
6) I.P. - standing, legs together. Perform abduction of the arm and rotation of the torso, while squeezing the hips and buttocks - inhale, then return to the starting position - exhale. Repeat 4-6 times to the right and left.
7) I.P. - the same. Stretch your arms forward - inhale, then squat, squeezing your thighs - exhale. Next - stand up and spread your arms to the sides - inhale, return to the starting position - exhale. Repeat 6-8 times.
8) I.P. - lying on your back. Perform alternate lifting of the legs - inhale, then return to the starting position - exhale. Repeat 6-8 times.
9) I.P. - lying on your back. Raise your arms and pull in the anus - inhale, return to the starting position - exhale. Repeat 6-8 times.
10) I.P. - the same. Perform gradual abduction of the legs in a semicircular movement in the air - inhale, return to the starting position - exhale. Repeat 6-8 times.
11) I.P. - the same. Perform leg bending - inhale, then lift the pelvis and retract the anus - exhale. Next - lowering the pelvis and relaxing the pelvic floor muscles - inhale, straighten the legs - exhale. Perform 6-8 times.
12) I.P. - the same. Perform circular movements with raised straight arms, breathing evenly - 1 minute.
13) I.P. - the same. Perform movements with elevated legs that imitate riding a bicycle. Breathing is uniform - 1 minute.
14) I.P. - the same. Perform circular movements with both straight legs raised, breathing evenly - 1 minute.
15) I.P. - lying on your back against the gymnastics wall, feet resting on the rail as high as possible. Fulfill:
a) spreading and closing the legs - 6-8 times
b) rotational movements in the hip joints - 8-10 times
c) lifting the pelvis with support on the feet and shoulder blades - 3-4 times.
16) I.P. - lying on his stomach. Crawl on your bellies for 1-2 minutes.
17) I.P. - standing on all fours. Push out the anterior abdominal wall - inhale, then draw it in - exhale. Repeat 6-8 times.
18) I.P. - the same. Perform alternate straightening and lifting of the legs - inhale, then return to the starting position - exhale. Perform 4-6 times with each leg.

Women suffering from incontinence should know that the reason is often.

Pelvic organ prolapse and, as a result, incontinence occurs due to weakening of the ligaments that hold the uterus. Due to difficult childbirth or injuries, the ligaments lose their strength properties and, pulling the bladder and rectum with them. Causes may also include large and poorly healed tears, the use of obstetric forceps, age, heavy lifting, frequent intense coughing, obesity, heredity, and a sedentary lifestyle.

Check yourself.

If you have too frequent urination, the bladder does not completely empty, pain during intercourse, and discomfort in the perineal area while walking, constipation, a feeling of the presence of a foreign body in the lower abdomen, then, most likely, the pelvic organs have dropped.

If this early stage illness, then you can correct the situation with the help of physical exercises, if the disease, of course, is not advanced. At a later stage, exercise alone may not help and surgery will be required.

Modern medicine can correct the pelvic floor without making incisions on the body, and is held there using a mesh. The next day you are healthy, just avoid heavy lifting and cross-armed midwives.

However, you should not bring the matter to a late stage and surgery. How can you regain lost strength in much-needed muscles while avoiding surgery? Of course, like the rest of our body, they can be strengthened through training.

Special physical exercise , including from the region traditional medicine, will help strengthen the pelvic ligaments and eliminate all the inconveniences associated with prolapse of the pelvic organs.

Lying on your back with your knees bent and your arms under your head, lift your torso up and lower it down.

Walk around the room in small steps, holding the ball between your legs, closer to your perineum.

Try to train your muscles while urinating, then delaying this process, then continuing it. This will have a beneficial effect on the pelvic floor muscles.

Regular exercise leads to good results, but there is one subtlety. Women, after childbirth, often lose control over the muscles of the perineum and forget how to properly tense the necessary muscles. Sometimes it seems to them that they are doing everything right, but it turns out that nothing is happening, or the wrong muscles are tense: for example, the gluteal muscles, the muscles of the thighs and abdominals, the diaphragm. Contracting the wrong muscles can make the problem worse by increasing the stress on the pelvic floor. To avoid these false sensations, there is imbuilding, a system of exercises with simulators. It includes special complexes for restoring the pelvic floor muscles, based on the principle of biofeedback.

In addition to Imbuilding, there is also a training program with PelvicToner, doing Dr. Kegel exercises.

Sometimes the following gymnastics are enough to treat uterine prolapse:

Lying on the floor, place a roll made from a mat under your buttocks. Your back should be on the floor. Raise your left leg without bending your knee at a right angle, then lower it. Repeat the same with right foot. Cycle - seven times. Then lift both legs in the same way, also seven times.

Scissor the air from your legs for forty-five seconds, then perform the bicycle exercise for the same amount of time.

Lift your straight legs up and straighten. Take your left and then your right leg to the side and rotate clockwise for half a minute.

With your legs raised, without bending your knees, try to reach your fingers lying behind your head. Repeat seven times.

Bend your knees, press them to your stomach. Tilt your bent legs to the left, then to the right. Don't lift your back off the floor. Seven times in each direction.

Roll over onto your stomach, placing a cushion under it. Try to raise your arms and legs as high as possible above the floor. Don't bend your knees. Freeze for half a minute.

Arch your back up and down seven times while standing on all fours.

Without changing your posture, alternately lift your right and left leg as high as possible without bending the knee. Also seven times.

Exercise while standing. Swing your left and then your right leg seven times.

While standing, rotate your straight leg to the side for half a minute. Seven times with each leg.

For forty-five seconds, do a “swallow” on each leg.

Exercises are done in the morning on an empty stomach.

Many people praise this product. Place a half-liter jar on the floor. Lie down on it so that the navel is in the center of the neck, and wait about five minutes. Do the same with the right and left sides. At the end of the exercise, lie on your back, tie your stomach with a scarf or elastic bandage. Get to your feet. This entire complex should not last less than twenty minutes. Do this every day. If it stops giving you pain, it means that the uterus has returned to its place.

Therapeutic exercise and massage for prolapse of internal organs

Splanchnoptosis (prolapse of internal organs) is a fairly common disease. Women get sick more often. The disease is characterized by a lower location (compared to the norm) of one or more internal organs. The reasons for such changes may be rapid and significant loss of body weight, polyhydramnios or multiple pregnancies, weak physical development, in which inadequate physical activity, and others.

Prolapse of the stomach, kidneys, transverse colon, and pelvic organs is most often observed. Depending on which organ is omitted, certain features are revealed clinical picture diseases. But any form of splanchnoptosis is characterized by complaints of constipation, decreased appetite, decreased performance, and sleep disturbances. The pain appears over time, gradually and intensifies towards the end of the working day, at the same time in a horizontal position it decreases.

With any form of splanchnoptosis, weakness of the skeletal muscles is observed. As muscle strength decreases, the ligamentous apparatus weakens, the balance created by the pressure of the internal organs on each other is disturbed, bottom part the abdomen protrudes. Plays a certain role in maintaining the normal position of organs adipose tissue abdominal cavity. With moderate amounts, her organs have good passive support. With significant weight loss, the layer of adipose tissue decreases, and the entire burden of the internal organs falls on the muscles.

The purpose of exercise therapy: against the background of general strengthening of the body and its psycho-emotional state, increase the tone of the muscles of the pelvic floor, abdominal wall, lumbar region and diaphragm, improve functional state digestive organs.

Basic principles of compiling sets of physical exercises for visceroptosis

1. The exercises should be simple; when performed, the abdominal organs move towards the diaphragm, i.e. movements are recommended lower limbs and the body with lifting its lower end, but movements with the transition from a supine position to a sitting position and straining are prohibited (see table).

2. Physical exercises must be performed on an inclined plane with the leg end raised by 10–12 cm, unless there are contraindications.

3. I.p. in the first 6–8 weeks - lying on your back, on your side, on your stomach, standing on all fours.

4. Starting from the 6th–8th week after achieving stable positive result(improvement of the subjective state, normalization of stool, improvement of appetite, sleep, performance) the complex includes exercises for training posture in IP. standing (no forward bending of the torso).

5. During the course of treatment, it is advisable to use no more than 3 individualized sets of exercises, changing them no earlier than after 1–2 months of training.

6. Duration of classes during the 1st week: 15–20 minutes. 1 time per day; 2–3 weeks – 20–30 min. 2 times a day; during the 4th, 6th, 8th week and further – 30–40 minutes. 2 times a day. When the position of the lowered organ approaches the normal position, classes are held once a day.

9. To activate motor function gastrointestinal tract Massage of the lumbosacral region, colon massage, and self-massage of the abdomen are recommended.

An approximate set of exercises for splanchnoptosis (first 3–4 months)

1. I.p. lying on your back, legs bent at the knees and hip joints, feet shoulder-width apart, one hand on the chest, the other on the stomach. Abdominal breathing. Perform 6–8 times.

2. I.p. Same. Hands along the body. Tighten your buttocks, thighs, retract your anus - inhale, hold in the current position for 5-8 seconds. Exhaling, relax. Perform 8–10 times.

3. I.p. Same. Leaning on your heels, the back of your head, your arms, raise your torso - inhale (“half-bridge”). Return to i.p. - exhale. Perform 8–10 times.

4. I.p. lying on your back, arms along your body, legs straight. Inhaling, spread your arms to the sides. Exhaling, pull one knee toward your stomach with your hands (do not raise your head!). Perform 5-8 times with each leg (complication – pull both legs to the stomach).

5. I.p. Same. Sliding your heel along the inner surface of the other leg, bend and move your leg to the side. Perform 8–10 times with each leg.

6. Lying on your back, legs bent, feet supported. Without lifting your feet from the support, place your bent legs to one side, then to the other. Perform 6–10 times. After 6–10 days of training, keep your bent legs suspended.

7. Lying on your right side. The right hand is under the head, the left hand is pointing in front of you. Abdominal breathing. Perform 5–8 times.

8. Lying on your right side. Left hand raised up, left leg laid back. Change the position of the limbs with a swinging movement. Perform 8–10 times.

9. Lying on your right side. The right hand is under the head, the left hand is pointing in front of you. Abdominal breathing. Perform 5–8 times.

10. I.p. Same. Take your leg back, raise your hand up - inhale, pull your knee to your stomach with your hand - exhale. Perform 8–10 times.

11. I.p. - Same. Inhale – move your arm and leg to the side – inhale. Return to i.p. - exhale. Perform 8–10 times.

12. Lying on your left side, perform exercises 7, 8, 9, 10, 11 (after 3–4 days of training).

13. I.p. knee-elbow, arms and legs shoulder-width apart. At the same time lift up right hand and take your left leg back – inhale. Return to i.p. - exhale. Perform 6–8 times.

14. I.p. knee-carpal. Without moving your arms and legs, moving forward, sit on your heels and lower your chest. Return to i.p. Breathing is voluntary. Perform 6–8 times.

15. I.p. lying on your stomach, arms under your head, legs straight. Alternate extension of straight legs at the hip joints. 6–10 times with each leg (complication: a) extension of both legs; b) the movement is performed from the position. - legs suspended).

16. I.p. lying on your back, arms and legs straight. Alternately bending straight legs at the hip joints. 6–10 times [complication: a) both legs are bent simultaneously (the lower back is pressed) and b) the position is held for 3–8 seconds].

17. Lying on your back, arms along your body. Raise both straight legs and place them to one side, then to the other. The exercise is performed after introducing exercise 16 b into the complex.

18. I.p. lying on your back on the floor, perpendicular to the wall. Stepping your feet along the wall (gymnastic wall), lift your torso into a stand on your shoulder blades. The torso is supported from below by the arms. The exercise should begin on the 6th–10th day of classes. Repeated 3–6 times. After training, the stand is performed without support from the wall.

19. I.p. shoulder blade stand. Imitation of the movements of a cyclist, “scissors”.

20. I.p. lying on your back, legs bent at the knees and hip joints, feet shoulder-width apart, one hand on the chest, the other on the stomach. Abdominal breathing. Repeat 6–8 times.