PROGRESSIVE RESISTANCE EXERCISE IN THE FUNCTIONAL RESTORATION OF THE PERINEAL MUSCLES

Abstract The passage of the fetal head through the vagina during delivery is invariably attended by muscle injury. Excessive tension sever motor endplates attached to muscle cells from the terminal nerve filaments to which they are normally connected. This partial loss of innervation is in large measure responsible for the relaxation of perineal muscles so commonly observed after childbirth. Experience has shown that a demand for use is the most important factor in restoring the functional capacity of any skeletal muscle. Active exercise will aid in the reinnervation of injured muscle cells and will bring about a return of normal contractility. The shorter the time elapsing between muscle injury due to childbirth or a surgical procedure and the beginning of exercise, the less will be the amount of tissue atrophy and the shorter will be the time necessary to re-establish normal function. Exercise with the Perineometer is useful in restoring function and tone in the immediate postpartum period, improving early cystocele and rectocele during the childbearing years, improving the vaginal muscles so that a contraceptive diaphragm may be retained, and relieving urinary stress incontinence. Surgical procedures for the correction of vaginal, urethral, and rectal incompetence may be facilitated by preoperative and postoperative exercise which improves the texture, tone, and function of perineal muscles. The “Perineometer,” an instrument devised to register muscle contraction, is of great value as a visual aid in guiding the patient during the course of her exercises and in encouraging her to continue until the desired result is attained. The method of exercise described suggests a new approach to the studies of perineal physiology as related to physics.