Home Exercise Program: What Is It, and Why You Need It For Pelvic Floor PT
What Is a Home Exercise Program?
A Home Exercise Program, or HEP (pronounced "hep" or by saying the letters H, E, P), is a vital part of any type of physical therapy program. There is so much we accomplish during our weekly sessions with you, but the HEP is really where you get to establish long-lasting changes. Since we only spend about an hour a week together, much of your progress happens outside of our in-person sessions. Your HEP helps address the root causes of your issue and establishes good habits so you can get better—and stay better.
Home exercise programs can include a wide variety of options and will look different for each person. Most commonly, we'll focus on stretching and strengthening exercises to improve flexibility and strength. But HEPs go beyond that. We often incorporate habit and behavioral changes as part of your HEP because daily life—like bathroom habits, caring for kids, and work requirements—can contribute to pelvic floor issues. Some examples of habit changes include waiting a certain length of time before going to the bathroom, creating a bowel routine to help you go more regularly, or adjusting how you hold or feed your child. All of that is considered a home exercise program. Even setting a water consumption goal or practicing breathing techniques can be part of your HEP.
HEP for Pelvic Floor Physical Therapy
As we progress through treatment of your pelvic floor, more specifically for tight and painful pelvic floor muscles, we may ask you to work on keeping the pelvic floor muscles soft and flexible on your own. This would include at-home internal work as part of your HEP. Again, we only get to see you for an hour each week, so consistency is key to making long-lasting changes and supporting the progress we're making in our sessions.
Working your own pelvic muscle exercises at home can feel intimidating and uncomfortable at first, but we're here to help you feel confident about it. There are so many options of different pelvic floor tools that we may suggest to help you with internal pelvic floor muscle stretching. When we recommend a tool or device, we don't want you feeling confused about it or wondering how to use it. Our job is to make it make sense so you aren't left Googling for answers! We’ll show you in your session exactly how to use any necessary tools so you feel confident using them at home and don't create any additional problems. Just like we prescribe other exercises, we'll tell you how often to use a tool, for how long, and what you should expect to notice or feel with it. We'll also check in and modify how you're using the tool as your symptoms get better. This way, you're getting the most out of the tool, and it's actually beneficial.
Pelvic Floor Tools for Your HEP
Before you dive into researching pelvic floor tools, let's talk about which ones we commonly recommend to our clients for their HEPs. Most importantly, working with a pelvic floor therapist prior to purchasing one of these tools can help determine which treatment path is best for your unique pelvic floor!
Dilators
Pelvic floor dilators come in many shapes and sizes (and colors), which may be intimidating the first time you see them. Vaginal and rectal dilators are designed to stretch and create space in the pelvic floor, especially for people with significant pelvic pain or who have a difficult time relaxing the pelvic floor muscles. Dilators are designed to be used progressively; beginning with the smallest size possible and working up to the larger sizes. Most people find that doing deep breathing exercises while using the dilator makes the process more comfortable.
Dilators are also commonly used after internal pelvic radiation in certain cancer treatments to allow for proper tissue healing. In this case, your oncologist will likely provide you with a dilator and instructions on usage; please follow the instructions provided to avoid any complications. If you have further questions or are not offered this support, we encourage you to contact a trusted pelvic floor specialist for guidance.
2. Pelvic Wands
The pelvic floor muscles are like muscles in other parts of your body, like your quads, hamstrings, abs, or glutes. Just like we can get knots in those muscles, we can also get knots in the pelvic floor muscles. Pelvic wands are designed to reach the knots and trigger points in the pelvic floor muscles to relax. There are multiple pelvic wand brands, and each brand will have different shapes and features available so you can find the best fit for your symptoms.
3. Pelvic Floor Biofeedback Device
There are now apps that pair with sensors that are inserted into the pelvic floor to track how your pelvic floor contracts and relaxes. The apps can guide users through games to use contracting/relaxing the pelvic floor. While the games are fun, they might not be helpful for everyone. If your pelvic floor symptoms are the result of an overactive or tight pelvic floor, then repetitive contractions may worsen symptoms.
4. Kegel Weights
Pelvic floor weights look like small eggs and are inserted into the pelvic floor before practicing contractions. These little "dumbbells" for your pelvic floor can be helpful to add resistance to certain exercises. Research on using these weights is inconclusive and shows little evidence that they are more beneficial than standard kegels, but they may still offer benefits.
There’s a common misconception that pelvic floor therapy is all about kegels, but it’s so much more than that! Many people are surprised to learn that kegels aren’t always the right solution—sometimes, they can even make symptoms worse. If you're curious to learn more about why pelvic floor PT goes beyond Kegels, check out our blog, Is Pelvic Floor PT Just Kegels?
Next Steps
Please consult with your trusted pelvic floor physical therapist before purchasing and using any of the pelvic floor tools mentioned in this blog. It's important to work with a pelvic floor specialist who can recommend the correct tools to support your HEP and how to properly use them.
About Pelvic Health & Wellness
Pelvic Health & Wellness was built with you in mind. We practice whole-person, individualized pelvic floor physical therapy in a caring and safe environment. Our physical therapists specialize in treating pelvic health concerns such as pelvic floor dysfunction, bowl and gut health, pain, prolapse, constipation, incontinence, fertility, and various pregnancy and postpartum-related conditions.
We understand that being ready to talk about and address your pelvic floor wellness concerns comes from a place of strength. We are here to support and encourage you on your journey back to health so you can return to doing what you love! If you are ready to take the first step in reclaiming your pelvic health and wellness, don't hesitate to get in touch with us today.