Common Mistakes Made by New Pelvic Health Physios - Part 1
Recently, while teaching a group of post-graduate students about advanced pelvic floor assessment and treatment, I was asked an interesting question: "What is the most common mistake new pelvic physios make?" At first, I found it challenging to pinpoint a single answer. But after reflecting on feedback and observations from the teaching sessions, one recurring theme stood out. So, let's dive into this common pitfall and explore how to avoid it.
Not Working Patients Hard Enough!
Remembering the Basics
One of the most frequent mistakes I see new pelvic health physiotherapists make is not pushing their patients hard enough during muscle assessments and training. Think back to your early education—remember the principle of progressive overload? This is crucial for improving muscle function. The pelvic floor muscles are no exception; they need to be challenged to their limits to grow stronger and improve in their function.
The Importance of Progressive Overload
To strengthen any muscle, including those of the pelvic floor, it must be worked to its limit. This means guiding patients to exert maximal effort during both assessments so we can design effective training programs and then to continue this optimal effort throughout home programs. Without reaching true muscle fatigue, the muscles won't adapt and grow stronger or improve their ability to perform the task you are training for.
Coaching and Encouragement
This is where your role as a coach comes in. Many patients might not fully understand how intense their effort needs to be for effective pelvic floor training. Often when you ask a patient to demonstrate the program they have been practicing - you will observe them perform a few pulses or sub-maximal holds. Lots of patients who say they have ‘tried pelvic floor exercises’ will demonstrate sub-optimal training programs based upon a leaflet or verbal advice. Our role in performing a muscle assessment and implementing a program is to coach our patients to maintain their effort and push through to genuine muscle fatigue.
Comprehensive Training Sessions
Another critical aspect is conducting full training sets during your sessions. This practice ensures that patients know exactly how hard to work and what true muscle fatigue feels like when they repeat their exercises at home. Just prescribing exercises without this hands-on, intensive guidance can leave patients under-trained and underwhelmed with their progress.
Tips for New Pelvic Health Physios
Here are a few practical tips to help you start or refine your practice in pelvic health physio:
Emphasize Effort: During assessments and training, consistently encourage patients to push to their limits. Monitor their effort closely and provide feedback.
Educate on Fatigue: Make sure patients understand what true muscle fatigue feels like and why it's necessary for improvement.
Demonstrate Full Sets: Always take patients through a full training set of any exercise you prescribe. This ensures they grasp the required intensity and duration.
Progressive Overload Principles: Keep revisiting the basics of progressive overload. Ensure your training programs are designed to gradually increase the challenge to the pelvic floor muscles.
Reflecting on these common mistakes and integrating these tips can significantly enhance your effectiveness as a pelvic health physiotherapist. It not only leads to better patient outcomes but also ensures that your patients are fully engaged and motivated in their treatment journey. Remember, the key is to push them just hard enough to make a real difference.